Published by Computachem Services

P.O Box 297.
Alstonville. 2477
NSW Australia

Phone:
61 2 66285138

Last month I wrote about my experience with implementing the Quality Care Pharmacy Program and the difficulties involved.
In that article I took the view that despite the whole QCPP accreditation process being onerous and unnecessarily difficult, I still believed that it was a worthwhile exercise for the profession as a whole.

When I wrote my article, I honestly believed that I was trying to be constructive in highlighting the shortcomings of the program.
However, I was not prepared for the response that I received.
It started me thinking.
Why is the Pharmacy Guild so defensive about the program?
Why aren't they prepared to acknowledge that some problems exist?

After having gone through the whole accreditation process, I now belive that the program is no longer being run only for the benefit of our industry.
I feel that the program has been high-jacked by all those who have turned it into a lucrative business and who now are making a large amount of money out of it.

Because of this, certain organizations and people have too much to lose if any changes were to occur:

The Pharmacy Guild
The annual cost of the QCPP is $1.5M.
However The Guild does not disclose to us the actual breakdown of this expenditure.
The annual membership fees contribute $675,000 towards the cost of the program.
The shortfall is currently made up of the following:

· Pharmacy Fridge sales.
Up until recently Rolex had a monopoly on the sale of "Compliant Fridges".
The Guild got a portion of each sale.
This led to the over-inflated price of these fridges.
· The issuing of the cold chain compliance certificates.
Each refrigerator test costs $100.

Accreditation assessment fees.
The Guild receives a portion of the accreditation fee the assessors charge.
They would justify this on the basis that QCPP assessors need to be "licenced" by the Guild.Ultimately all these kickbacks are paid by QCPP accredited pharmacies.

QCPP Assessors
Assessors charge around $700 for assessing a pharmacy.
The process takes about three hours.
Generally they can do two to three assessments daily.
These people are booked solid three months in advance.
Much of their assessment time is spent trying to "sell" you the other training services that they offer.
Pre-assessment training can cost anywhere from $600 up.

Fridge manufacturers
A QCPP approved refrigerator retails for several thousand dollars as apposed to a regular refrigrator which sells for only a few hundred dollars.
A QCPP approved vaccine refrigerator will become compulsory after 1st January 2004.

Shop-fitters and designers
The QCPP is quite specific in how a pharmacy should be laid out.
To comply most pharmacies need to make quite expensive alterations.

So in whose interest is the Quality Care program ?

Pharmacies get $10,000 to implement the program.
But once you start to add up the costs of implementation, you can find yourself substantially out of pocket.
That's even before you factor in your own time and effort.

The Guild discloses the cost of the program at $1.5M.
This money goes towards the various administrators and committees whose job it is to oversee the program.
But it seems as though their main aim is to maintain their own jobs with no regard to the workload that they impose on pharmacists.
What may seem a small change to the program, for Tim Logan and others sitting on one of these committees, is a huge task for a pharmacist already burdened with so many demands on his time.

A specific example of one of these problems was recent changes which abolished the "8 hour rule".
The 8 hour rule previously exempted staff who worked less than 8 hours per week from certification.
This has meant that all casual staff are now required to fill out staff certification workbooks.
It is almost impossible to get a locum pharmacist to complete a workbook, particularly if he or she works in several QCPP accredited pharmacies.
As such you are denied accreditation, because you are not able to comply with a mandatory standard.

Recent changes to the workbooks, have also meant that staff, who had previously completed the old books, now have to also complete the new books.
Inevitably your staff begin to become irritated at the extra work, as well as the extra responsibility the program places on them.

Despite these problems the QCPP committee is talking of "raising the bar again" in the near future.
At some point pharmacists are going to say "enough is enough", and are simply going to refuse to get accredited.
The February 2003 edition of the QCPP newsletter talks of funding for pharmacy re-accreditations.
In November 2001 the Guild managed to obtain approval for a $2500 government re-accreditation payment.
The article also talks about how the Guild will siphon off most of this money, in the form of re-accreditation fees and charges.

Pharmacist's, like most people will do things for the common good up to a certain point.
When they start to realize who is really benefiting from all the work they are doing, perhaps they may decide that it is no longer worth the trouble.