National Stakeholder Forum for Integrated Pharmacist Services in the Community, Wellington

Introduction
Thanks Ian. It’s a pleasure to join you this afternoon. I know you’re all busy people and it’s great you’ve set aside these two days for this forum.

Your meeting is very timely with the work on the updated New Zealand Health Strategy and the draft Pharmacy Action Plan.

I know this forum will help to build on previous discussions on how to deliver more integrated, innovative pharmacy services with the patient at the centre.

Overview
I believe health is in good shape. The feedback I get from the sector is that while there are challenges, we’re heading in the right direction.

Delivering better health services is a top priority for this Government. We obtained $400 million extra to grow health services this year. Health received the largest share of new funding in Budget 2015 - $15.9 billion.

We’re investing around $1.7 billion over the next four years for new initiatives and to meet cost pressures and population growth – including more funding for elective surgery, palliative care, and free doctors’ visits for children under 13.

Priorities
In terms of key priorities, I want to see a greater focus on prevention and earlier intervention. This includes early access for people who need healthcare.

I’ve made it clear to DHBs that I expect more services to be delivered in the community. We need to continue to change the way healthcare is delivered, with more people getting the care they need away from hospitals.

I want to see continued progress on NCDs. Our largest health burden stems from people suffering from chronic conditions.

Tackling obesity, particularly childhood obesity, is another key area – we’re now one of the first countries in the OECD to have a target and a comprehensive plan to tackle Childhood Obesity.

Health targets continue to be a focus. They are not just about numbers – they are about delivering better, faster access to services.

Health Strategy
Clear strategic direction for the health sector is important.

The Health Strategy update is a good opportunity to develop a more integrated cohesive health system, better able to meet the demands of the future.

The Strategy covers five strategic themes – people-powered, closer to home, value and high performance, one team, and smart system.

These themes signal a focus on prevention and wellbeing, more integrated services, support for innovation, better collaboration, new ways of working to reach our most vulnerable, giving every child a healthy start, and ensuring information and services are more accessible.

I expect to take the revised Strategy to Cabinet in the coming weeks.

Role of pharmacists
Everyone here agrees pharmacists are very much at the frontline of health.

Each month over 1.3 million people visit a community pharmacy. The community pharmacist is often the most regular and easily accessed point of contact people have with the health system.

That’s why New Zealand’s highly skilled pharmacists have a key role to play in helping people understand their medicines and use them wisely.

Further utilising pharmacists skills
If we’re going to have a sustainable health system we need to work differently to meet changing health needs.

Our aging population and the growing burden of long-term conditions such as diabetes, heart disease and dementia will put pressure on the system.

I am keen to see how we can further utilise the capacity, capability and expertise of our pharmacy workforce.

Our current system does not make the best use of the skillset of pharmacists.

Many pharmacist roles focus on the supply of medicines, yet their profession has much to contribute to the safe and effective use of medicines and the reduction of medicines-related harm.

There are a number of projects that could be more widely used - for example, having more pharmacists routinely providing flu vaccination or helping more people manage their long term conditions, as well as better use of technology like e-prescribing.

Pharmacy Action Plan
The draft Pharmacy Action Plan aligns closely with the work to update the Health Strategy.

As you all know, the draft Pharmacy Action Plan which has been developed over several months, offers an opportunity to define the future direction of pharmacist services and the range of settings in which they are delivered.

The consultation process has provided useful insights into the future of pharmacist services and opportunities to expand the role of pharmacists.

We know that consumers are increasingly taking more responsibility for their own health. They also want transparency, not just around costs but also on what services are available for them to make informed decisions.

Closer integration of pharmacist services into healthcare teams in primary, secondary and tertiary settings is a unifying theme in the Plan, and aligns with the Health Strategy.

The Plan will set priorities for actions that can be implemented at national, regional and local levels over the next five years.

It sets out how we can make better use of the knowledge and skills of pharmacists in a number of ways:
• We want to see pharmacists providing public health interventions that enable people to stay well.
• We want pharmacists working collaboratively as part of an integrated team to deliver a range of medicines management services.
• We want patients to have timely access to self-care advice, treatment of minor ailments, acute demand and appropriate referral.
• We want to see more effective use of the workforce and technology to streamline the dispensing and supply process.

Prescribing pharmacists can contribute to better health outcomes by improving medicines management.

In summary, the Plan clearly signals the intent to maximise the skills of pharmacists for the benefit of all New Zealanders.

Pharmacy Steering Group
I know the Pharmacy Steering Group has provided valuable input to the draft Pharmacy Action Plan. I would like to acknowledge the work that they have done.

The Group supports an approach to make better use of the capacity and capability of the pharmacy workforce.

Pharmacy technicians
Better use of the pharmacy technician workforce, including implementation of the Pharmacy Accuracy Checking Technician role, is also a key area.

This has the potential to further free up pharmacists time.

Innovation
I know that lots of innovative pharmacy projects are taking place across DHBs.

One example is the Bay of Plenty mobile clinical pharmacist services that have been developed in response to increasing concerns about medication errors, medication-related harm, and the increased morbidity and costs associated with less than optimal use of medicines.

I know there’s also fantastic work taking place in Hawkes Bay and Canterbury and these are just a few of the innovations taking place.

E-Health solutions
E-Health solutions are an important enabler of providing care closer to home, driving efficiencies in our supply model, and freeing up pharmacists time.

In the future, the wider healthcare team will be able to access, contribute to, and share, relevant clinical information that will form part of each individual’s personalised electronic health record.

Pharmacists will be able to use available technology to provide flexible solutions and services.

For example, the use of robotics for dispensing activities and other smart technology to provide timely advice and services. This can considerably improve access and how we deliver care in remote areas.

CPSA
One of the aims of the CPSA when it was introduced in 2012 was a move towards a more patient-centric model.

While good progress has been made, there is more that we can do.

One lesson that we’ve learnt is the need for engagement.

Whilst discussions can be difficult at times, I want to acknowledge the collaboration that has taken place between pharmacists, their representative bodies, DHBs and the Ministry.

I look forward to the outcomes of your current CPSA negotiations.

Closing remarks
It’s important that the sector continues to works together to further utilise the expertise of our health workforce to benefit all New Zealanders.

It’s an exciting time as we look to better integrate pharmacy services with other health professionals in multi-disciplinary teams.

ENDS

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