From uncertainty to success

government. And at the very same time, the signing of the very first strategic agreement on professional pharmacist agreement between PSA and the Commonwealth government, essentially sharing a commitment where we would lift the bar and ensure there's professionalism, consistency, and a willingness continue to expand the scope and the role of pharmacists across all areas of practice, including in primary care. So I think that definitely there are a number of successes that we need to

celebrate. If you think about it, in the first half of this year, so the first half of 2024,

our profession was still faced with uncertainty. There was still many pharmacists were still quite anxious because that was when we saw the second tranche of a 60 day dispensing and without an agreement being signed, there was still a lot of questions and nervousness in the first half of 2024, but I would say in the second half of 2024, since the signing of these major agreements, there have been some significant improvement in terms of the confidence of amongst members of the profession.

And I would say the positivity, there's obviously also a number of other things that we should be celebrating that I would consider as successes in 2024, we have continued to see the continued expansion of scope of practice of pharmacist, whether it's in immunization or in the prescribing and the management of a range of common conditions, whether it's acute or long-term conditions, whether it's pilot or otherwise permanent across the jurisdictions,

including in Queensland. Then we saw further movements in New South Wales, in South Australia, in Australia and also in Northern Territory. So these are all absolutely brilliant news in terms of once again cementing pharmacist core role in quality use of medicines and medicine safety and how pharmacists can continue to improve patient access to care and Carlene.

What I would also class as a success in 2024 is the release of what we've all been anticipating for a good 12 months already, which is the scope of practice review, also known as the unleashing the full potential of our health workforce review. Your listeners would know that the scope of practice review commenced around about 12 months ago and it was a piece of work that the PSA has fully invested into.

It is a review that is commissioned by the federal government and being chaired independently and led independently by Professor Mark Cormack. And it is, as I mentioned at the very start, if you rewind 12 months back this time last year, in fact when we were chatting, I mentioned about the importance and the significance of scope of practice

review and what I anticipate this would bring. And if we rewind 12 months back, we really invested into this journey because this is probably a once in a 50 year journey where we are really seeing an appetite for change in health system administration and an appetite to, I would say remove any impediments that limits or impedes all health professionals including pharmacists from practising to a full and top of scope. So the scope of practice review was released only just a couple of weeks ago

and it is a journey. As I mentioned, PSA has participated through a multifaceted approach. So I serve on the scope of practice review expert advisory committee and we had regular meetings with Professor Mark Cormack and his team as well as of course on top of that there is the regular written submission and consultation of the members around

what we would like to see in the scope of practice review. And your listeners would also be able to anticipate that this had been a journey that was quite polarizing because every discipline would want different things and would want the best for their discipline.

But PSA has very much come forward with the lens around this is all about patient, this is about how can we as a nation improve patients access the care in an equitable, timely and affordable manner and leveraging the accessibility and the expertise of pharmacist to be able to do that. So the report is out there and your listeners are very welcome to go and have a look, but there are multiple areas where the role of have been emphasized.

In particular, it came out with 18 recommendations to the government around how we can fully unleash the potential of our health workforce, including pharmacist. Whether that's in either of those three categories, for example, how can we remove regulatory and legislative barriers, how can we ensure that there's consistent funding and funding policy so that health disciplines are adequately supported and remunerated to do the role that they're meant to do.

And there is also the ongoing, all of the recommendations that relates to calling on the government to invest into health workforce design and development. There are again, a number of I can keep going on, but there are just ongoing. It's just literally absolutely a big year as well.

Another area that your listeners may also be aware of is on the 1st of July this year we had the launch of the aged care onsite pharmacist program, which was a program that was, I would say committed around about two years ago in response to the Royal Commission into age care around how medicine safety and governance of medicines can be improved within residential age care facility by integrating and having a pharmacist onsite to be able to help improve

QUM. And that started on the 1st of July this year. And obviously it's ongoing and of course the ongoing multiple innovative projects as well that has been going on around the country.

So of course there was pharmacists are now able to provide vaccination under the National Immunization Program, vaccination in pharmacy program or the NIPVIP and we are continuing to see the prescribing scope continue to be expended. Started from pharmacists prescribing and management of uncomplicated urinary tract infections in women to then the resupply of or cord deception across jurisdictions to then now management of skin infections, for example in New South Wales and Victoria.

And also seeing other states and territory governments subsequently making commitments around full scope of practice, whether it's in Western Australia, in New South Wales, in South Australia and otherwise. So I think those are all the changes that have continued to occur throughout 2024 but will continue to occur into 2025. And in terms of other changes, we are also seeing increasing amount of innovative projects

that are happening across the country. About three weeks ago, the PSA released an inaugural report called the PSA impact report. And the reason for launching this report is to showcase the importance of pharmacist role in qualities of medicines, but through PSA support of a number of these important QUM

projects. Now these are obviously all projects and pilots, but projects and pilots, pilots are so important because they actually provide the evidence that is required before any white scale implementation of any work can occur. But it also allow local innovative ideas to be trialed, validated and tested and to be used as evidence as we continue to advocate for wider implementation.

So over the financial year 24, over a 12 month period, PSA participated and supported over 40 QUM projects across the country and we continued to work collaboratively with stakeholders, whether it's government, the department, the PHNs or universities and other stakeholders to be able to undertake this work and including other stakeholders such as when it comes to transitions of care, palliative care and of life management and the lease goes

on. So all of these things are continued changes, but I would say that they are actually good changes that are ongoing.

I would say it really had been quite diverse. And as you would know, PSA, we represent all pharmacists, all of the 39,000 registered pharmacists in Australia across all areas of practice. And it is something that we are in a unique position where we are hearing the diverse views from pharmacists. So on any single policy topic we always get divers very, very diverse views across the whole spectrum,

all the way from fully supportive to being in full disagreement. But as always, PSA has always taken an approach where we felt strongly that regardless of policy changes, because we can't always control policy changes and doesn't matter what policy positions there may be, we've always taken the approach in terms of being fully supportive of

pharmacists on the ground. So all policy would have its pros and cons, but PSA's view is that we would continue to be on the ground and support pharmacists so that for those who wish to participate in any policy or any programs, they can feel fully supported to undertake those basically to practice.

pharmacist practice. However, members of the profession would know that there are a number of programs that will no longer be governed within a community pharmacy agreement. That being a whole range of workforce incentive programs, some of those programs like the N-I-P-V-I-P, O-D-T, some of the other programs that our credential pharmacists undertake, like HMRs, RMMR, ACOP and other emerging areas of practice, all of these would require ongoing work.

And we're currently right now as we speak in the process of that, and of course with anything there is in the presence of an NDA I can't really speak too much to it, but I would say that those are work that is ongoing that will continue, that will still continue. We have to continue to do and PSA being the lead in this process, we're absolutely not slowing down in this regard.

Other challenges, all of the other programs that I've spoken about, there are ongoing challenges with those programs as well. I've spoken about in the implementation and the commencement of the aged care onsite or ACOP program. Whilst the ACOP program commenced on the 1st of July, we are seeing as we anticipated a slow uptake of the program across the country. And that is largely to do with the

program rules and the implementation. For example, how are we going to ensure that there is the workforce and implementation success in rural and remote areas where the needs of residential aged care homes are quite different and workforce distribution is quite different as well. There've been also ongoing uncertainty around what about other emerging areas of practice? And of course there is the never ending medicine shortages issue that we face in a country and something

that affects pharmacists the most. I reflected this time last year, we already had issues with medicine shortages including ozempic and believe it or not, 12 months. Fast forward 12 months later, we are still facing that issue. So ozempic is still scarce, but I'm just using that as one of the many examples of commonly used medicines that are in scarcity.

And I would say that pharmacists, because we are frontline and we are the first port of call when people come forward to us when they need medicines, I never want to underestimate the amount of pressure and dilemma that pharmacists would face on the ground when you have a real patient in front of you needing a medicine, but the medicine is in short supply. So I think that that absolutely is an ongoing challenge.

And there are also ongoing issues around whether it's the need whilst we spoke about continued expansion of scope being an excellent and in a much needed way forward, not just for our profession but also for people who live in Australia and for our health system. Of course there are ongoing challenges that pharmacists would face. Pharmacists want to know that there is enough and adequate and appropriate remuneration for the work that they do.

Pharmacists also want to know that there is certainty and stability in the work in their career, but also importantly, we must also never underestimate the amount of effort that pharmacists would have to put in to be able to do these expanded scope. We are calling for pharmacists of course, as we continue to expand the scope, there are upskilling that is required by our profession. So as a pharmacist, as a practising pharmacist myself, I never want to underestimate

the amount of work and effort. Imagine you're doing a full-time role, you're helping your community, you're practising, and then when you get home in your own time, you're going to have to undertake further studies and upskilling. I mean I understand pharmacists as well. I think I do as one of the members of the profession. Pharmacists are pretty resilient when it comes to things like that. We just continuously step up and do and do, do more. If it's in a rules that we must do this,

we would absolutely go forward and do it. But it does come, it's costing us time, money, effort, time away from family and this sort of stuff. But I have absolute full, I would say trust and belief and confidence in our profession. Whilst I have that, as I said, I never want to underestimate the amount of pressure that our profession continues to face.

And that has also been successfully achieved through the strategic agreement which PSA signed on behalf of the profession for the very first time with the Commonwealth government. We also, in light of all of these changes, we felt that our profession absolutely needed a very clear roadmap in terms of what our practice would look like into the next six years into

2030. And this year, PSA has also launched our pharmacist in 2030, which is a visionary roadmap to our practice in the next six years in terms of how pharmacist skills and experience can be fully utilized to improve qualities of medicines, medicine, stewardship, medicine safety, improving patient's access to care, improving equity access to care. And all of these things are, I think things that we anticipated to deliver 12 months ago and that we had

seen successfully delivered. The other thing also is that this year, PSA has also launched our PSA foundation, which is obviously an initiative of the PSA. And it was launched this year to coincide with World Pharmacy Day, but it is really a project that had been in progress for the last 18 months and it is a foundation that has received a charitable status. We are A-C-N-C-D-G-R registered, we have a very robust

independent board. And the foundation serves to, obviously the vision and the mission of the foundation aligns with the overarching PSA's vision and mission in terms of how pharmacists can improve quality healthcare for Australians. But it also is an entity that allows us to do a lot of charitable work and to continue to support pharmacists and our workforce in terms of how

we can continue to do better. So for example, the first project of the foundation was to support pharmacists to be able to undertake mental health as a training so that we can actually not just look after ourselves, look after the people around us, but also continue to provide quality and I would say appropriate support to people that we care for in terms of mental health.

And also it was only just last week that it was announced that the government, so our health minister, the Honorable Mark Butler, announced at the Pharmacy Guilds parliamentary dinner of the new Doctor of pharmacy title for an A QF level nine extended master's degree, which is a new degree that will be able to allow obviously lifting the bar for all of our prospective students and new graduates, but also how this will allow reciprocity and alignment with international

practices and bring us in line with international standards. So I mean all of those things I would say the Doctor of Pharmacy was something that was actually in the seventh Community Pharmacy agreement and again in the eighth community pharmacy agreement and now obviously the formalization of this. So I think all in all, there are all of these big pieces of work that we anticipated to see in 2024 that we are seeing whether it's an

outcome or significant progress. But again, as I always say, it's not the end. It is something that will require ongoing work and the work is not done yet.

But what PSA will absolutely not slow down and will even double our efforts here is in 2025 is to actually very, very strongly call on the government to implement as soon as possible all of the 18 recommendations from the scope of practice review, there is obviously ongoing primary care, tenure action plan. We will need to continue to, that will continue to affect our practice that we will need to continue on. Now also in 2025,

we are going to anticipate a federal election. Yes, the dates are not confirmed yet, but it is the understanding of everybody at the moment that it would occur around midyear sort of may in the first half of the year. So we will obviously be

eagerly anticipating what that would look like. Now, going back to one of my earlier point, really, PSA has always taken the approach whereby it, regardless of who is in government and regardless of what the policy changes might be, PSA will and will continue to always be there for pharmacists to support pharmacist practice. Because regardless of whether one supports any policy or health policy decisions, there will still be ongoing need to support pharmacists on the ground.

And of course in 2025, we should be anticipating an outcome from the other agreement that we are currently working on provide again, which will address, I would say, which will address all the other programs that will no longer be governed within a community pharmacy agreement. And that includes all the other emerging areas of practice. So in 2025, we are definitely anticipating that to continue.

I would say though that 2025 is not going to be a very different year to 2024, but I would say that 2025 will continue to bring more certainty and an upward trajectory to our profession. And I'm very confident to say that would be the case.

And I would just say that 2025 another year of change, but we should all be embracing changes and leveraging the opportunities that are in front of us, not underestimating the challenges, but again, that's where we really need to continue to support each other.

And from the pig body's perspective, we will continue to advocate for pharmacists wherever medicines are used, and for pharmacists to be adequately supported to improve access to care by people who live in Australia, and also improving qualities of medicines and medicine safety.

It is an ongoing journey where pharmacists can slow down and we need to continue to embrace the change and whether it's upskilling and keep on our toes around policy changes. But all in all, we need to look after ourselves. I think as pharmacists, we don't talk about ourselves enough in terms of how we can look after our own physical health, mental health, and emotional health.

I think it is really a year, if you think about it, we have had five years of Covid and an ongoing other health changes around us and whether it's RSV or otherwise, and pharmacists have never, I say slowed down, pharmacists have never slowed down, but we are all humans. And really speaking from my heart, I want to use this opportunity to call out to all pharmacists to look after our own physical and mental health.

And if we can't look after ourselves and if our cup is not full, we can't continue to look after other people and we can't look after other people in a sustainable manner. So I think we need to look after ourselves and whenever we have the capacity, because we all have our ups and downs and when we are on the down, look after ourselves, but also be open and willing to receive support from the people around us.

And when we're feeling on the up, it is absolutely incumbent on us to support the people around us. So continue to look after each other as well, everyone within our profession and your loved ones around you. And speaking of looking after everyone amongst ourselves within our profession, I would say that we are a very small but mighty profession. And I've said this 12 months ago, and I think that has not changed. We are a small but a mighty profession.

There are 39,000 of us registered in Australia, just for comparison. There are over 340,000 nurses, let alone the other workforce like the allied health and the medical profession.

So we are relatively small in numbers, but if you think about the amount of weight that we lift in our health system in terms of helping people to ensure that Australians can continue to have timely and affordable access to essential medicines to healthcare, and now improving patient's access to primary care, all of these things I think are, and not forgetting our hospital pharmacist, colleagues and pharmacists in other clinical settings where they're actively

improving qualities of medicines and medicines governance. We are as a profession, very mighty when it comes to the amount of weight that we lift from our health system, but also because we are such a small profession from a numbers perspective, it is more paramount that we remain united. I can't stress enough of these. I remember when I first started in this journey two and a half years ago as the president, I felt strongly already at that time, and that sentiment really has not changed.

Now you fast forward two and a half years later, I really feel that we need more unity within our profession because we're such a small profession. Scalability is not always on our side. And if we continue to have more division amongst ourselves, that really does not come back to serve our profession well. We should be working towards more unity, more consolidation, and in that way we can better support our profession as a whole moving forward. Because unity is our string.

We cannot afford any forms of division or duplication. So I think that's something that we will continue to strive moving forward into 2025, it is, I would say, a very, very unique time when we are seeing significant appetite for change in our health system.

I know I have not seen pharmacies evolved in 50 years, but I have been advised by many of my very wise mentors who have been in the system for 50 years even they agreed that right now they have never ever seen such significant appetite for change, nothing like what we're seeing right now. We are seeing primary 10 year action plan. We are seeing strengthening Medicare efforts, we're seeing national health reform agenda, scope of practice review.

We are seeing such significant change and significant appetite for change because we do know that as a country with aging population and increased medicine use, our health system is not sustainable. Our people are not getting healthcare as quickly as their condition needs them to be. And absolutely it is time where there is a lot of appetite for change, but appetite for change is good.

It's good for our profession and it's good for our profession to support members of Australia. But we also must make sure that as a profession we are adequately and strongly represented and that we have strong unity within our profession. And PSA, I'm really saying this as a member of the profession, PSA is the only government recognized peak body that represents pharmacists across all areas of practice.

And PSA has always helped the belief that the more united we are as a profession, the stronger we are, and therefore the more benefits we can bring back to our profession as a whole. We should absolutely be doing everything that we can to reduce any tension within ourselves, but also we must leverage any opportunity to collaborate with other profession as well. Because a multidisciplinary team approach to patient care is the only way forward.

And that's something that PSA would absolutely continue to strive. And I really, as I always say, if someone is a member of the profession, they need to be a member of the PSA as the body that represents all of the pharmacists, because that's the only way we can achieve true strong representation patient to leverage and capitalize on the current appetite for change to

advance and bring our profession forward. Whether it's removing legislative barriers, whether it's workforce investment, and whether it is fighting for better remuneration for pharmacists to be able to do the role that we do in a sustainable way moving forward, and to continue to advocate for pharmacies wherever medicines are used. So 2025, I think in summary, another year of change, another year of opportunity, but also not to underestimate the challenges.

And I very much look forward to a positive 2025 with everyone.