Could the pharmacist in general practice model expand?

‘Very collaborative and collegiate.’
 
That is the verdict from Associate Professor Rashmi Sharma, Chair of the RACGP Expert Committee – Funding and Health System Reform, following the inaugural General Practice-Pharmacists Symposium, which discussed the role of pharmacists in general practice.
 
Professor Mark Morgan, Chair of RACGP Expert Committee – Quality Care, also attended the event and spoke as part of a panel discussion.
 
Hosted by the Pharmaceutical Society of Australia (PSA), the Melbourne event brought together pharmacists and GPs to consider a much-discussed role which still faces many challenges to work at scale.
 
Associate Professor Sharma, who presented on ‘barriers and enablers’, is a big believer in the type of multidisciplinary care that embedding a general practice pharmacist embodies.
 
‘Pharmacists and GPs genuinely enjoy working together, and we recognise and respect one another’s skill set,’ she told newsGP.
 
‘Fundamentally, that goodwill is there on the ground and we know the difference that we can make to our communities.’
 
As a participant in previous pilot schemes, Associate Professor Sharma has had three general practice pharmacists working in her own practice and understands the value first-hand.
 
‘There is definitely a benefit for general practice from a quality use of medicines point of view, building up that multidisciplinary team, and also from an educational standpoint – helping with medical, nursing and pharmacy students,’ she said.
 
‘Pharmacists are crucial members of that multidisciplinary team.’
 
However, she is also a realist and points to the balancing act facing many clinics, even taking into account the Workplace Incentive Program (WIP). It is a situation she believes relies too heavily either on unsustained, short-term funding or the goodwill of individual practice owners.
 
‘The issue is, there’s also an opportunity cost,’ Associate Professor Sharma said.  
 
‘As a practice, you’ve got to say, “okay, if I devote my room to a pharmacist, if I had a GP in there, I could probably be generating more income for the practice”.
 
‘It’s difficult to implement this model unless you happen to be part of a pilot or a research project, so that’s really what we need to try and move forward from.’
 
In her presentation, Associate Professor Sharma said GPs identified space and funding as the two largest barriers to integrating a new team member into their practice.
 
Alternatively, when asked about the enablers to integration of multidisciplinary members in a general practice team, GPs top answers were funding and the benefit to patients.

Professor Mark Morgan speaking as part of the Symposium’s panel discussion. (Image:PSA)

Both the RACGP and the PSA have called for increases in the WIP, with the PSA advocating for it to double in its election advocacy.
 
At the time of the conference, PSA President Associate Professor Fei Sim noted pharmacists’ ‘invaluable’ contribution to general practice teams, as well as her organisation’s advocacy for general practice pharmacists for more than 13 years.
 
She emphasised the need for long-term, sustainable funding through the WIP ‘to encourage general practices to embed pharmacists into their teams’, and pointed to the likely benefits for medicine safety and patient care.
 
‘We know that each year 250,000 Australians are admitted to hospitals due to medication-related problems, which is only set to rise with the growing prevalence of chronic health conditions,’ Associate Professor Sim said.
 
‘We must support our healthcare system to meet this demand by investing in multidisciplinary care now, supporting general practitioners to grow their teams and foster greater pharmacist-GP collaboration to achieve true patient-centred care.’
 
The RACGP’s 2025 Federal Election Platform also cites a lack of funding preventing many clinics from employing more pharmacists.
 
The 19-point plan makes a similar call to the PSA, calling for $82.1 million to target additional WIP funding to pharmacists working in general practice and a doubling of planned investment in the WIP-Practice Stream to $712 million.
 
‘Studies show general practice-based pharmacists contribute to significant reductions in medicine-related harms, reduced emergency department presentations and lower hospital readmissions,’ the RACGP plan states.
 
‘An independent economic analysis found that integrating pharmacists into general practice could deliver an estimated $545 million in net savings to the health system over four years.’
 
Buoyed by the spirit of the Melbourne conference, Associate Professor Sharma hopes there will be more rapid progress than when her practice participated in those pilot schemes around a decade ago.
 
However, for any future model she is clear that task substitution must be avoided – and stresses the importance of putting in place a system that works for the varied needs of general practices around the country.
 
‘We should develop our own model of general practice pharmacist care in Australia,’ she said.
 
‘We need to own and design it, fit for our own circumstances.’
 
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GP Pharmacists Pharmaceutical Society of Australia PSA scope of practice