RACGP responds to aged care medication reform

The RACGP has provided a submission to the Australian Pharmacy Council (APC) on the Performance Outcomes for Aged Care and Medication Management Review (MMR) Pharmacists Education Programs.
 
In May this year, the college provided feedback to the APC regarding its then proposed Accreditation Standards for Aged Care and MMR Pharmacists Education Programs, backing measures to improve medication management in residential aged care facilities (RACFs) and stating ‘general support’ for an aged care onsite pharmacists model.
 
However, the RACGP remains concerned about gaps that remain within the accreditation standards and framework itself, with its submission highlighting that quality care in the residential aged care setting relies on ‘collaborative and coordinated multidisciplinary teamwork’ between GPs, pharmacists and RACF teams.
 
Reviews of medication management and safety in RACFs was identified as a key area for improvement in the Royal Commission into Aged Care Quality and Safety, with the final report’s recommendations to include onsite pharmacists in RACFs.
 
In response, the APC was engaged by the Department of Health and Aged Care (DoH) to develop the Accreditation Standards for Aged Care and Comprehensive Medicine Reviews Education Programs.
 
Following stakeholder consultation on the standards, the DoH extended its engagement with APC to develop performance outcomes to complement the standards and provide important context for content and education program outcomes, including an aged care onsite pharmacists consultation paper, of which initial consultations opened in July 2023.
 
In its 2022 submission on the proposed introduction of onsite pharmacists, the RACGP outlined its support for ‘appropriately resourced, fit-for-purpose measures’ to improve medication management in RACFs, while reiterating GPs’ role within multidisciplinary care teams and the need to prioritise integration with general practice.
 
In July this year the APC announced the Accreditation Standards had been approved by the DoH.
 
As both the Accreditation Standards and performance outcomes are critical to the implementation of the measure, the latest RACGP submission recommends a revision to address the following areas.
 
Scope and model
The scope and model for the aged care onsite pharmacist and medication management review pharmacist remains ‘ill-defined’ and further clarification is needed for both the performance outcomes and the Accreditation Standards. The college highlights there is still a lack of clarification/confirmation on the model, employment, management, role, and responsibilities of each pharmacist.
 
‘Current communication available on the funding models for the measure and roles indicate that funds will be to community pharmacies,’ RACGP President Dr Nicole Higgins wrote in the submission.
 
Performance outcomes for specific groups
No specific performance outcomes were identified for older people who identify as LGBTQIA+ and those living with a disability. The college states these are required to ensure that education providers develop learning content and assessments that reflects the competencies that pharmacists will require when providing services to older people who identify as LGBTQIA+.
 
Additionally, managing disability is an ‘integral part of the holistic care provided by GPs’, the college states, and pharmacists working in aged care must collaborate as part of the RACF multidisciplinary team.
 
Clarity on performance outcomes
The college is calling for further clarification on language and statements within the performance outcomes, and key implementation aspects of the role of the aged care onsite pharmacist and medication management review pharmacist, such as funding, conflict of interests, and monitoring and reviewing of their activities.
 
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