Collaboration is key to high quality pharmaceutical services
In addressing delegates at the 2nd National Pharmacy Conference, Niall Hegarty, Director and Partner at Dischem Pharmacies, used the Dischem model of community pharmacy to showcase successful collaboration – the group’s clinics are supported by onsite clinic sisters.
“Clinic sisters were brought in to professionalise the service offered by the pharmacy,” said Hegarty. “They are far better trained to give the patient the service they require. There is an emphasis on mother and child ailments and preventative healthcare.” He explained how the clinic acts as a central point and becomes the focus of health in the community.
“The burden of disease – non-communicable diseases like diabetes, hypertension, cardio vascular conditions – an ageing population, and growing wealth and urbanisation are just some traits characterising the current state of our health in South Africa,” commented Hegarty.
The Dischem model, he elaborated, fosters a synergistic relationship between pharmacists and clinic sisters. This, he says, ‘ties in closely with government and medical funders’ approach to preventative healthcare.’ Clinic sisters and pharmacists working side by side are able to provide the patient with balanced advice on how to maintain a healthy lifestyle.
Member of the Traditional Health Practitioners Council and Adjunct Professor at the Durban University of Technology, Dr Nceba Gqaleni, expanded the theme of collaboration by exploring the challenges and opportunities posed by pharmacy collaboration with complementary and alternative health professions, including traditional healers.
He commented that the National Development Plan (NDP) 2030 is vague on a way forward for traditional/complementary medicine. “The NDP 2030 says that the Traditional Health Practitioners Act No. 22 of 2007 provides for a national policy on traditional medicine, but actual integration of traditional medicine into the national healthcare system and structured relationships with the pharmaceutical industry has been limited.”
Gqaleni said the Traditional Health Practitioners Council is hopeful that “although there is no yet defined action plan on what the NDP vision will translate to, there is a conversation involving the pharmacy council to take it forward”.
He said “if we want to find ways to collaborate between pharmacists and traditional healers, then we need to appreciate that it’s more than products but about varying methods of treatment.” He stated a glaring issue is the lack of dialogue between pharmacists, healthcare professionals and traditional healers, despite their serving the same consumer.
Gqaleni stated healthcare professionals generally focus on the physical self or what the ‘Bantu realms of existence’ call ‘uMhlabathi’, meaning the ‘manifested world where the modes of material nature, time-space, and the various kingdoms of existence interact and evolve.’ He explained that traditional healers focus on all seven spheres within the realms of existence which go beyond the physical self to the spiritual self. Gqaleni asked, “What does that mean for collaboration? Healthcare practitioners have to understand what levels you’re dealing with and how patients see this.”
Omphemetse Mokgatle, representing the National Department of Health, spoke of the department’s goal to ensure an adequate and reliable supply of safe, cost-effective medicine of acceptable quality and the rational use of prescribers, dispensers and consumers to all South Africans.
She explored the role of the pharmacist in primary healthcare services and said this type of collaboration ties in with the ‘success of the National Health Insurance (NHI) and will depend on a well-functioning Primary Health Care System (PHC).’ A challenge for the department is ensuring there is an adequate number of personnel and providers in the system.
This is characterised by the current situation where nurses in the public sector are working as pharmacists but lack the knowledge of a trained pharmacist. Further challenges include long waiting times, sporadic medicine stock outs and limited availability of full-time multidisciplinary health team members, including pharmacists and assistants.
Mokgatle reported that the department is aiming to achieve ‘ideal clinic status’ for 3 477 clinics to address these challenges by 2019. This will effectively mean a ‘clinic with good infrastructure, adequate staff, adequate medicine and supplies and good administrative processes’.
She said these measures would directly impact the successful roll out of the NHI, of which there are currently 11 pilots nationally. The role of pharmacists within PHC will help “promote Good Pharmacy Practice Standards in the multidisciplinary structures, promote good working relationships with the facility managers and increase participation in the health programme meetings to promote rational medicine use,” concluded Mokgatle.