Academic journal article Australian Health Review

Clinical Networks Influencing Policy and Practice: The Establishment of Advanced Practice Pharmacist Roles for Specialist Palliative Care Services in South Australia

Academic journal article Australian Health Review

Clinical Networks Influencing Policy and Practice: The Establishment of Advanced Practice Pharmacist Roles for Specialist Palliative Care Services in South Australia

Article excerpt


South Australia (SA) has the highest proportion of older people per capita in the nation, with one in six people over 65 years of age.1 In the next 15 years, that population will nearly double as the 'baby boomer' generation ages.1 The SA Health Plan

acknowledges the impact of an aging population on health service delivery and the need to expand palliative care services to make it easier for all people at the end of life to receive care in their preferred place. As part of the State's health reform agenda, SA released its Statewide Services Plan-Palliative Care 2009-2016 (the Plan).2 A key initiative of the Plan is to build the specialist palliative care workforce with the addition of advanced practice roles across disciplines not previously repre- sented within the specialist palliative care team. As part of the implementation of the Plan, a working group from the Palliative Care Clinical Network was convened. A priority for this group was the development of a sustainable community pharmacy network, driven by the integration of new advanced practice pharmacists roles within the larger regionalised palliative care specialist services. This initiative required com- mitment and collaboration and, as such, key stakeholders from pharmacy and palliative care were brought together to advance this work. The two main objectives for this working group were:

(1) Toarticulatethevision ofadvancedpracticepharmacistroles.

(2) To gain funding support for three advanced practice phar- macists positions and a project to develop a 'statewide palliative care pharmacy network'.

Because the advanced practice palliative care pharmacist positions are new roles, it is important that careful consideration be given to how these roles fit with the new national framework for advanced practice in pharmacy and for such positions to align within the broader national Advanced Pharmacy Practice Framework (APPF).3 The APPF defines advanced practice as:

...practice that is so significantly different from that achieved at initial registration that it warrants recognition by professional peers and the public of the expertise of the practitioner and the education, training and experience from which that capability was derived.

There is compelling evidence that the number of therapeutic interventions and complexity of medicine use is increasing as a result of an aging population, increasing chronic disease and multimorbidity. Recognition of advanced practice is an important step in providing pharmacy services that meet the evolving needs of our society.


In July 2010, the Palliative Care Clinical Network Pharmacy Reference Group was convened with support from the Statewide Palliative Care Clinical Network Development Manager. The Committee Chair was the Palliative Care Service Director from a specialist palliative care service. Membership was selected to reflect both the specialist palliative care services and the phar- macy stakeholders from the community setting, as well as from the university, regulatory, workforce and health service planning settings. The first task for the reference group was to assist the discipline of pharmacy to consider the place of advanced practice roles in palliative care. These roles reflect a new direction for the discipline of pharmacy and have been embraced while being cognisant that registration for pharmacists in Australia currently does not have specific endorsement for advanced practice. There is strong commitment and collaboration between pharmacy and palliative care. These positions are community focused and do not duplicate or replace existing clinical pharmacy positions within tertiary hospitals. They have leadership responsibility across the metropolitan and country areas that are aligned with each Local Health Network in the domains of education, research, capacity building and clinical support.

Literature review

The speciality of palliative care is grounded in a philosophy of total patient care to meet the needs that manifest across a range of domains. …

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