From words to action

In line with international trends, the Advancing of Australian Pharmacy Practice credential provides a pathway to improved outcomes for patients.

Across the developed world, a number of unprecedented challenges are looming in health care.

With an increasing prevalence of chronic and complex disease profiles comes a greater need for expert medicines management, guidance and support; it is therefore crucial that pharmacists step up and thrive at the full scope of their practice.

Framework required

There is now more than ever a need to install a rigorous framework to guide the professional development of a highly skilled, flexible and adaptable pharmacy workforce, to fulfil the message from WHO: “There is no healthcare without a (competent) workforce”.

As a profession-wide collaborative forum, the Pharmacy Practitioner Development Committee commenced operation in mid-2014, focusing on the development of pharmacist practitioners through consideration of competencies and scopes of practice.

Throughout 2015, the Australian Pharmacy Council (APC) undertook a Credentialing of advanced practice pharmacists pilot program, which used the Advanced Pharmacy Practice Framework for Australia as a tool for evaluating practitioner performance and guiding development.

International trends

On the international stage, the International Pharmaceutical Federation (FIP) released its global report: Advanced Practice and Specialisation in Pharmacy.

The report, based on the first collection of global data of its kind — from 48 countries — concluded that “professional advancement and the professional recognition of advancement in practice is a developing trend worldwide”.

The following year (2017) saw FIP release its Pharmaceutical Workforce Development Goals (PWDGs) in Nanjing, China.

Central to the landmark Nanjing ‘roadmap’, the 13 international PWDGs are FIP’s primary measurement of 21 countries’ capacity and ability to implement their vision of a global pharmacy workforce that can meet tomorrow’s healthcare challenges.

The 4th WDG is — Advanced and Specialist Development — aligned well with the work being done in Australia, adding impetus to collaborative efforts to put education and training infrastructures in place to advance the pharmacy workforce as a basis for enhancing patient care.

Australian think tank

In February 2017, back in Australia, a one-day roundtable reaffirmed the urgent need for a robust, sustainable, independent process to formally evaluate, provide feedback and recognise the work, scope and impact of the Australian pharmacy workforce above the base line degree and registration.

The Advanced Practice Think Tank, which comprised representatives from Australian pharmacy bodies, universities and leading international advanced practice groups, reiterated a collective commitment to developing a central operational mechanism to advance the national pharmacy workforce, in turn strengthening medicines management and delivering optimal health outcomes to Australians.

The Think Tank confirmed the need for the establishment of a sustainable credentialing process with closer ties with international partners which should implement principles previously outlined and formally tested by the APC pilot.

FIP Director for Education Development Professor Ian Bates, who attended the one-day roundtable, commented: “As in all areas of health care, future service delivery requires a transformative approach to workforce development — in this context, standing still means going backwards.”

The commitment was bolstered by a report, published in the Journal of Pharmacy Practice and Research the same month, contextualising the story so far and reinforcing the enduring need for a robust framework to guide pharmacists’ professional journey and outlining challenges and opportunities around re-establishing an evidence-based, collaborative approach to formalised evaluation, feedback and recognition of pharmacy practitioners in Australia.

The report, Advanced pharmacy practice: Aligning national action with global targets, concluded: “As a profession we have a new and exciting opportunity to develop and implement a sustainable recognition pathway for advanced practice.”

Commitment to progress

In November 2017, the commitment began to take form as the nation’s leading pharmacy organisations united to launch the Advanced Practice Collaborative, a committee working collaboratively to examine and progress drivers for Advanced Practice in Australia.

Involving representatives from the Society of Hospital Pharmacists of Australia (SHPA), the Pharmaceutical Society of Australia (PSA) and the Pharmacy Guild of Australia, the Advanced Practice Collaborative was set up to examine barriers and enablers to Advanced Practice; review and monitor progress and adoption; provide advocacy, leadership and a liaison point for the profession; and develop an action plan for implementation of Advanced Practice in Australia.

Shortly after, SHPA established a body to oversee a process for assessing the individual impact of pharmacists’ experience and expertise for Advanced Practice recognition, leading into 2018 and the launch of Advancing Practice.

Advancing Practice

With round 1 of submissions opening in March, Advancing Practice is Australia’s new pathway for measuring practitioners’ influence on pharmacy practice and patient care. As part of broader efforts to build a more highly skilled, flexible and adaptable Australian pharmacy workforce, the program is overseen by the Advancing Practice Advisory Board, comprising leaders from across the pharmacy profession and consumer health.

Importantly, the Advisory Board includes representation from the pharmacy profession in the UK.

There, more than 3000 pharmacists have started the professional recognition program for advanced practice. More than 500 have submitted their professional practice portfolio, peer-assessment evidence and scope of practice evidence and have been awarded recognised credentials for advanced practice: the model on which the new Australian approach is based.

For all pharmacists, regardless of where they work and the scope of their practice, Advancing Practice provides independent recognition of career progression, achievement and most importantly, their impact both directly and indirectly on patient care. Following four evaluation rounds per year, successful pharmacist applicants will be credentialed as Stage I Advancing Practice, Stage II Advancing Practice or Advanced Practice Pharmacist, continuing the legacy of the 2015 pilot.

In the longer term, the requirement for an Advancing Practice credential at a minimum stage could be used in employment models, and as a basis to improve and expand pharmacy services, but ultimately the process assures Australians that improving outcomes for patients is absolutely central to all pharmacists’ work.

*Kristin Michaels is the Chief Executive Officer of The Society of Hospital Pharmacists of Australia, with a keen interest and experience in health system design. She is a seasoned Board Director in both the primary, acute and aged-care sectors. Kristin holds qualifications in Arts, Organisational Leadership, Governance and Health Service Management. She is a Fellow of the Australian Institute of Company Directors and is accredited as an International Partnership Broker.

Image credit: ©stock.adobe.com/au/Production Perig