Pharmacists should be first call for people in the health system

PHARMACIST DANNY WU is the interim wayfinder for Te Whatu Ora’s northern region, leading commissioning teams for health services from Ōtāhuhu to Cape Reinga.

Speaking at the PSNZ ‘Just Breathe’ conference, Mr Wu joked he’s often asked, ‘Where exactly are we going?’ He then spent an hour outlining just that, focusing on how pharmacists’ roles will continue to be expanded as the reforms roll out.

People would be encouraged to see their pharmacists before entering other points of the health system, Mr Wu said.

“We’re making sure that people see our pharmacists as a point of entry in the health system. We know that people are often incentivised to use hospitals because they’re open 24/7, but we’re looking to change the behaviour of some of our communities.”

He pointed to the recent ‘Choose Well’ public health campaign, where people were asked if they could manage their healthcare by using Healthline or pharmacy services before seeing a GP, going to A&E or calling an ambulance.

The minor ailments ‘proof of concept’ prototype is another way Te Whatu Ora is encouraging people to see pharmacists. The scheme will be monitored to see if it improves health inequities and helps keep people out of GP surgeries and hospitals. If it ticks the boxes at the end of winter, it might be continued and rolled out to other areas.

Pharmacists were the shining stars of the health system during the pandemic and since, Mr Wu said. Te Whatu Ora had seen the value of their expanded roles and was looking to build on that, although a full picture of how that would look would take time.

“I don’t have all the solutions yet – this is the start of a much longer journey.”

Te Whatu Ora wants all healthcare professionals, including pharmacists, working at the top of their scope. Mr Wu said pharmacists would be a part of comprehensive primary care teams (CPCTs), a wraparound healthcare service integral to the wellbeing-focused health system.

He said $100 million would be invested in the teams over the next three years, combining traditional primary care workers with physiotherapists, advanced paramedics in rural areas, social workers, care coordinators and kaiāwhina (nonregulated health roles).

The teams mainly would be in general practice. Mr Wu conceded there weren’t enough pharmacists for every practice but said technicians would be an important part of freeing them up from dispensing.

Other service pilots are happening, with Mr Wu mentioning an anti-D immunoglobulin pilot for pregnant women in an Auckland community pharmacy.

Wellbeing is “at the guts” of the health reforms, with community- and whānau-led healthcare services being driven from localities, which are replacing DHBs and PHOs.

There are now 12 localities in Muriwhenua, Ngāti Tūwharetoa, Whanganui, West Coast, Hōkonui, Ōtara/Papatoetoe, Hauraki, Eastern Bay of Plenty, Te Tairāwhiti, Wairoa and Horowhenua. More would be discussed from September this year, with the intention of a nationwide rollout at the end of June 2025, Mr Wu said.

He said localities gave communities ownership of wellbeing plans and would include all voices, especially those from priority populations. The communities would have decision-making authority over allocated funds as a “powerful expression of tino rangatiratanga”.

Mr Wu said Te Whatu Ora was also considering how to involve private enterprises in the localities. “There are lots of social enterprises out there who are funded through the commercial sector.”

These “once in a generation” health reforms were being rolled out carefully and cautiously and would take time, Mr Wu said.

“People have asked us, “What’s taking so long?’ This is going to be a marathon; it won’t be a sprint.”