Innovative relationships between pharmacy and general practice 

29 June 2020

Kindly provided by the Pharmacy Guild of New Zealand 

The recent Health and Disability System Review report acknowledged examples of innovation in service delivery, many being developed locally between pharmacies and general practice. 

Maria McIntyre, owner of Christchurch’s Unichem Bishopdale Pharmacy, says her pharmacy has a strong relationship with other health care providers.

“One of our pharmacists spends one hour each week at one of our nearest medical centres, undertaking medicine reconciliation for shared patients as well as being on-site for any queries from the practice team enhancing our working relationship.” 

The Bishopdale pharmacy team and the general practice team deliver Medicines Therapy Assessments collaboratively. The pharmacist, GP and sometimes the practice nurse meet to develop a care plan. 

“Our practice nurse colleagues are particularly good at identifying patients who would benefit from this service. We deal quite closely with at least six general practices, and we recognise that the best form of communication varies between practices, so we work with that.”

Triaging queries with the general practice team is also valuable, Maria says, particularly who they contact at the practice regarding the query. For example, if a query is best handled by the GP or a practice nurse, that is who they contact. They always give a time frame for when a response is required by, and for urgent queries, they speak to the relevant person directly. “This saves everyone time, including that of our patients.”  

Gemma Waterhouse-Perry is the owner of Sanders Pharmacy in Te Awamutu. Co-located at Te Awamutu Mega Centre, the practice and the pharmacy built a big, shared entrance facility together eight years ago. 

“Our relationship really started when I bought the pharmacy 10 years ago, when we were both located separately – and was built through education, and a mutual desire for the benefit of our patients,” Gemma says. 

“It’s pretty important we are on the same page, so we made an effort to get to know them and looked for ways to be as helpful as possible. We started running education sessions for them on PHARMAC hints and tips, we learnt how to use MedTech and gave them hints on that from a pharmacy angle, and also started doing script correction in MedTech when we had noted inconsistencies, details lacking or we had made collaborative changes”.

Pharmacist access to MedTech, on-site in the dispensary for eight years, is used to look up notes, clarify prescriptions, message doctors, correct and update medicine records and read discharge summaries and lab results.

“We have a very positive working relationship with Mahoe Med - we attend strategic meetings and actively look for ways to collaborate, and they go above and beyond to help us as well” Gemma continues. The pharmacy wants to establish a dedicated workgroup for collaborations, to keep this moving. The goal is to initiate a clinical project, likely around gout and lifestyle medicine. 

“We have just led a Prescribing Education session for them where we ran through common clinical and clerical prescribing errors and how to avoid them,” Gemma explains. Additionally, the pharmacy helps train their new staff including rotational GPs, is organising mutual training, and maintains a dedicated two-way phone advice line manned by the Sanders’ pharmacists.

Gemma and her team keep the practice updated each month on key medicine changes in the PHARMAC schedule, out-of-stocks, and best clinical practice tips.

“There is a constant two-way flow of information – the doctors and nurses very frequently come over into the pharmacy to get our advice or discuss patient and medicine issues, and we are often catching up with them in the practice to collaborate on patient care. Working together is very professionally rewarding and a real cornerstone of our model of care”.

Kerri Miedema, co-owner of Greymouth’s Unichem Olsen's Pharmacy, says her pharmacy is also introducing MedTech to communicate with GPs, helping grow the deep, long-standing relationships between local health practitioners. These have endured “for years, decades, generations,” Kerri says.

“One of our pharmacists spends one hour each week at one of our nearest medical centres, undertaking medicine reconciliation for shared patients as well as being on-site for any queries from the practice team enhancing our working relationship,” Maria McIntyre, owner of Christchurch’s Unichem Bishopdale Pharmacy

Trust is high between local health professionals, particularly between prescribers and practising pharmacist owners, Kerri continues. Solid relationships exist between the pharmacy and the two local medical centres, Greymouth Medical, owned by the DHB, and Coastal Health, which is private.  

“We have our fingers in a number of pies,” Kerri says. Multi-disciplinary roundtable meetings link the Olsen’s team in with social workers, practice nurses, general practice, and the local Māori health team, to enhance patient outcomes. They are also working on enabling MedTech access within the pharmacy. “This will help us communicate with GPs”, Kerri says. 

Furthermore, the pharmacy is looking at what it can do for patients with long-term conditions like diabetes, and where the culture of trust and collaboration between practitioners could go into assisting with these efforts.

Olsen’s also shares interns with the local hospital – interns split their time 50/50 between the hospital and community settings, to produce experienced, resilient graduates. Workforce issues loom large, Kerri says, and the key is offering a unique environment where talent can flourish. 

Kerri, Maria and Gemma, would all like to see better resourcing and support to allow these relationships to flourish because better interoperability across our health and disability system allows for enhanced equity and better patient outcomes overall.