2023 minor health conditions service (MHCS) pilot
A MHCS was piloted in 10 of 20 districts in New Zealand from June to September 2023, to reduce demand on general practice, urgent care, and hospital emergency departments. The pilot also aimed to improve access to consultation, advice and treatment for common ailments, reduce inequity of health outcomes, and promote community pharmacy as a first port of call for consultation and treatment.
Conditions covered under the service included diarrhoea, eye infections, pain and fever, scabies, head lice, eczema/dermatitis, and minor skin infections.
Children under 14 years of age (and their family members with the same symptoms), Maori and Pacific people, and Community Service Card holders were eligible for the service.
Nearly 120,000 people accessed the service, some more than once, during the pilot, with over 157,000 consultations occurring.
An evaluation report showed most service users reported receiving high quality care. Patients reported a similar level of satisfaction with pharmacy clinical care as with GP care across all measures.
55% of respondents to the MHCS user survey reported that they would have attended GP or urgent care services for their condition if they had not been able to access the pharmacist and 6.5% of respondents reported that they would have attended an ED. With suitable development, the service has potential to reduce pressure on other parts of the health system.
Recent general practice funding increases and signal for community pharmacy
In March, the Minister of Health made several funding announcements which will increase timely access to primary care.
Additional funding will be available from July 2025 for general practices to increase access, meet key performance targets, and deliver more specialist interventions in primary care settings, along with new workforce initiatives aimed at increasing and retaining doctors and nurses in primary care.
The new access, outcomes, and activity-based uplifts will resource general practices to recruit additional staff, and to expand and modernise their premises, service offerings, and digital infrastructure. This aims to improve access to primary care appointments and reduce growing spending in the hospital sector.
The Health New Zealand Primary Care Development Programme, which covers the above, has also identified work to do to improve access to extended pharmacy services (this includes the minor health conditions service), with steps scheduled over the next nine months including collate current state, develop options, and investment decisions for implementation. This is promising for community pharmacy.
Expert Advisory Group (EAG) work
The EAG is currently undertaking a project reviewing extended pharmacy services, aiming to scale up and spread services that have been locally commissioned or piloted, reducing unwarranted variation in healthcare provision and access across New Zealand.
These include the minor health conditions service, services provided under standing orders, “except when” prescription medicines – those reclassified when provided by a pharmacist who has completed applicable training, and many more.
The project will:
- Consider how services could be enhanced to increase their impact and identify implementation barriers.
- Select and prioritise services from existing or previously commissioned or piloted services.
- Identify changes and improvements that can be made to prioritised services.
- Develop implementation plans and service specifications.
Once complete, this work will be handed to the ICPSA national annual agreement review group for contract variation discussions.
Learnings from Australia
A PGNZ contingent had the invaluable opportunity to attend APP in March and learn more about scope of practice developments in Australia.
While at APP, PGNZ representatives participated in the Australian Guild’s National Council meeting and Branch Assembly meeting, giving us further insight into future goals for full scope of practice in Australia.
We were delighted to witness Queensland’s scope of practice announcement, with Queenslanders gaining permanent access to treatment for acute, everyday health conditions delivered conveniently through local community pharmacies from 1 July. It was also pleasing to see over 50 pharmacists recognised at APP and becoming part of Australia’s first group of credentialled prescribing pharmacists.
We continue to work with our Australian counterparts to better understand the differences between their full scope of practice model and ours. We look forward to delivering further opportunities for community pharmacy thanks to our relationship, and fully support expanding the service offering and scope of practice of community pharmacists in New Zealand.