March 2016

 “Top down, bottom up” approach agreed to develop Integrated Pharmacist Services in the Community

In early March 44 delegates gathered in Wellington to plan out the way forward for pharmacist services in the community.  Attendees included consumers, pharmacists, primary and secondary care specialists, and representatives from District Health Boards, Ministry of Health and the Accident Compensation Corporation. 

The group was tasked with taking all the ideas and dialogue from the National Stakeholder Forum in November 2015, and the more recent regional discussions and melding this into an agreed direction. 

Over two days (afternoon of 3 March and all day 4 March) intense discussions and workshops were held that also considered the Pharmacy Action Plan and the lessons learnt from the evaluation of the CPSA 2012.

A highlight of the Forum was the address  by the Minister of Health, Dr Jonathan Coleman, who said the sector must continue to work together.  “It’s an exciting time as we look to better integrate pharmacy services with other health professionals in multi-disciplinary teams.”   Watch his full presentation.

Delegates want a “one team” approach to developing the next pharmacy contract, with a “top down, bottom up” approach to designing the services.  One strand of work will focus on developing a national framework for pharmacy services (top down), and the other strand (bottom up) will focus on developing local design groups, led locally by DHBs.  The meeting agreed that there were three key service areas to focus on locally; services for vulnerable children (working with other agencies), the frail elderly, and mental health consumers.

Consumer representatives were very much engaged in the new focus and have asked to play an ongoing role in the development of the new service model.

What happens next

DHBs have been briefed on the forum, and the pharmacy programme team are planning out what needs to happen to deliver on the outcomes the Forum asked for. 

We wanted to give you an idea of the type of innovative thinking that came out  - here’s an example of the ideas when we asked the delegates to visualise pharmacist services in 2026.

At another workshop session, we asked the group to define success. Here’s three things they came up with:

  1. Consumers and prescribers understand what pharmacists can do for them
  2. Pharmacists in the community are recognised as a professional member of the primary care team
  3. Consumers can be confident they are getting the right medicine that is safe for them.

Check out the agenda for the day and the list of delegates and the individual presentations from the two days. 

We will post further news on this website as soon as the next steps are confirmed by DHBs and the sector representatives. 

Presentation Library - Videos and presentation slides

Hon. Dr Jonathan Coleman - Minister of Health
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Introduced by Professor  Ian Town
Speech notes

Cathy O'Malley - Director Service Commissioning, Ministry of Health    
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Presentation slides  

Carolyn  Gullery - General Manager Planning & Funding-Canterbury DHB 
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Presentation slides

Dr Kevin Snee - Chief Executive - Hawkes Bay DHB
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Presentation slides

Rachel Mackay - Programme Director - Pharmacist Services in the Community
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Presentation slides

Presentation slides from Day Two of the Forum.

What people said

Forum attendees were tasked with a homework activity during the two day meeting. They were to base their responses to two questions on six key themes.

Below are the questions, the themes and snap shot of what attendees said.

Six key themes

Homework themes image 090316

 Question 1. What will pharmacist services in the community look like in 2026?

What people said about...

Access to pharmacist services

Safe supply of medicines

Consumer empowerment through information

Integration of social support and care provision

Improved support for high needs Service Users

Utilisation of pharmacist as a first point of contact within primary care

 What people said about access to pharmacist services 

  • Accessible to the community they service and their needs e.g outpost clinics, mobile services, maraes
  • Professional services independent of the retail arm of the pharmacy.
  • Virtual pharmacist services
    • Mechanics for video conferencing with GPs
    • Longer hours and 24/7 access to pharmacist services online for simple queries
    • Online purchasing and home delivery
    • Video consults for remote populations
  • Affordable with more funding tiers
  • Larger pharmacies with bigger teams to provide clinical services to more consumers.
  • Good design that enables easy access especially for those with disabilities and provides confidential consultation environments 
  • Linked/proximal /co-located to General Practice hubs.
  • Improved access to clinical services
  • Pharmacists working in all practices as integral member of team
  • Pharmacies and pharmacist services set out to provide physical access and space with appropriate privacy while allowing for workflows that facilities service delivery.

 What people said about consumer empowerment through information

Service users will:

  • Know that pharmacists will have time to spend with them as part of funded services that are of a consistent high quality throughout NZ
  • Be spoken to directly by their pharmacist - in the appropriate language with advice provided at the right level.
  • Understand pharmacy role and increased capability within the public/ health system
  • Tailored information will available online so that consumers can access pharmacist services and information 24/7.
  • Pharmacist will work as an advocate for the consumer.
  • Pharmacists outside the pharmacy will be common place e.g. in GP clinics.  

 What people said about the safe supply of medicines

  • More options when it comes to collecting medicines – e.g. pick up, delivery to the Service User, delivered to the pharmacist who then has an interaction with the patient.
  • Stop gap between consumers and prescribers – errors and omissions
  • Medicines Therapy Assessments (MTAs) will be routinely delivered.
  • GPs will be referring consumers directly to the pharmacist.
  • Changes made to concept of 3 monthly prescriptions for long term medicines.
  • Continued free pharmacist services
  • Staffing of pharmacies is sufficient with appropriate education and training so that support to have an active front line role delivering professional services.
  • Pharmacist advice, assessment and management of appropriate conditions is acknowledged, shared and remunerated. 

 What people said integration social support and care provision

  • Pharmacists as part of an integrated team
  • A national integrated shared care electronic record/ IT platform
  • Consumers will have a team who can contact each other directly and make appointments for the pharmacist to see the consumer if face to face contact is required.
  • Collaboration and integration between pharmacist services and existing social agencies
  • GP's advising consumers about the benefits of using the same pharmacy and some practices will be aligned to specific pharmacies.
  • Increased trust from other health professionals and consumers in pharmacist knowledge and expertise
  • Pharmacist qualifications easily recognised
  • Practice coordinators coordinating pharmacist appointments
  • Pharmacists supporting other health providers e.g Mental health support workers, whanau-ora navigators, community nurses.
  • Skype meetings held daily between primary care teams including pharmacists.
  • Pharmacists working in conjunction with other pharmacists

 What people said about improved support for high needs Service Users

  • Identified at risk Service users receiving enhanced attention and services
  • Increased ‘consults’ and ‘sit down discussions’ with consumers arranged
  • A greater amount of consumer friendly information available, some of which is free for certain high risk consumer groups.
  • Medication reviews for consumers at vulnerable transitions points e.g. discharge and admission.
  • High needs service users have a care plan available to all in the “MDT team”.
  • The support available to high need service users has been made highly visible.

What people said about the utilisation of pharmacists as a first point of contact within primary care

  • Pharmacist services in the community viewed as an accessible information center.
  • Pharmacists will exercise a first care role with  service users consulting them as the entry point into care, either managing conditions with therapies they are able to provide or via referral to other MDT members using electronic health records and other communication tools. 

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Question 2.  How will the Service User experience these services in 2026?

What people said about.....

Access to pharmacist services

Consumer empowerment through information

Safe supply of medicines

Integration of social support and care provision

Improved support for high needs Service Users

Utilisation of pharmacist as a first point of contact within primary care

What people said about access to pharmacist services

  • Services are wrapped around Service User’s needs. 
  • This includes provision of services in the Service User’s own environment where necessary eg. at home, work, at school, in residential care, on the marae or to prevent or follow up a hospital admission.
  • Services are easily accessible and highly responsive
  • The ability to experience flexible pharmacist services via a variety of other modes of interaction and technology:
    • mobile health buses (integrated MDT)
    • information portals, Hubs (one stop shops), Telehealth and service navigators
    • Portable records – encrypted on phones/IT devices
  • Equal access to services for those in rural and deprived communities
  • Services will be cost effective with financial barriers removed
  • Services will be an integrated ‘one stop shop’ 
  • Longer hours and 24/7 access to pharmacist services online for simple queries
  • Online purchasing and home delivery
  • Services are available in residential care with support for a GP
  • The pharmacist is identifiable within the pharmacy

 What people said about consumer empowerment through information

  • Enhanced health literacy will form a central part of the services provided by community pharmacists to consumers
  • A focus on interactive health learning and communicating with Service Users with an increased cultural awareness
  • Information about each Service User’s medicines/health will be available to both them and the members of their MDT via interactive patient information portals, phone/tablet apps.
  • Information about what pharmacist services are available at their local pharmacy and within their region or town will be online
  • Information will be tailored in a way that suits their needs and situation e.g. via email, online or face to face
  • Services available to consumers are promoted and tagged onto community activities and health events

 What people said about  the safe supply of medicines

  • Service Users can expect medicines to be supplied in formats that support adherence and recognized their individual needs. 
  • Medicines will be provided proactively to people with long term conditions and this will managed as a principle pharmacist service to ensure continuity of care.
  • Service users could pay one fee which covers any testing, expert advice, medicines and information consults they require.

 What people said about integration of social support and care provision

  • Information moves efficiently from pharmacy to all members of the health care/MDT eg. GPs team
  • Pharmacists in the community can access primary and secondary health system info about each Service User
  • Service Users are confident that they are receiving a high quality, trustworthy service from their pharmacist
  • Pharmacists are at the front of their pharmacies
  • There is a focus on care not supply
  • Social services receive referrals to help ‘ in need’ Service Users manage the cost of prescriptions.
  • Seamless between all providers and the system takes responsibility so that it isn’t all up to consumers to navigate.

 What people said about improved support for high needs Service Users

  • Support will be provided for for high needs Service Users to ensure continuity of care
  • Safer medication delivery through shared care records
  • Funded consultations so that Service User medicines management and health needs are discussed and tailored appropriately.

 What people said about utilisation of pharmacist as first point of contact within primary care

  • By accessing pharmacist services in the community as their first and regular point of entry into primary care. 
  • Pharmacists will be funded to provide early intervention, triaging services to determine the Service Users care need and have ability to refer them to another he#Whatpeoplesaid">Back to top