The potential benefits for pharmacies and their patients through being able to work to full scope of practice is highlighted at Pharmacy 777 Shoalwater in Western Australia.

The community of predominantly elderly patients and maturing families serviced by the pharmacy presents the pharmacists and staff with unique challenges to meet their patients’ specialised needs in a highly competitive area.

Co-proprietors Julie Ng and Sam Afsar said the community had significant health needs that required specialised support.

“To meet these needs, we provide a wide range of services including compliance support (Home Medicines Reviews and dose administration aids), diabetes services, vaccinations, and integrative health offerings,” Julie said.

“In addition, we offer sleep apnoea services, health checks, mental health service, mobility aids, wound care, compounding, hospital discharge support, transplant support, express deliveries, and Call`&’Collect.

“And while most of these services have been provided by pharmacies before, our innovation has been in their comprehensive and detailed implementation.

“We noticed a big barrier for our patients was the confusion around and the lack of follow up pre and post-hospital discharge. We tailored a comprehensive support service to ease their transition into and out of hospital. Helping to reduce medication misadventure and readmission rates.

“We also offer specialized support for a large number of transplant patients, with a focus to help improve compliance and reduce complications in the short and long term. This was implemented in collaboration leading transplant specialists in WA

“This is a holistic patient-centric approach and focusses on the right service for the right patient, shadowed by adequate follow up.

“Each Pharmacist has undergone specialised training to champion various health services.

“But over and above all of these offerings, I would say our focus on integrative health has been key to our success.

“We have three integrative pharmacists, including the only pharmacist in Australia with a Fellowship in the Australasian College of Nutritional and Environmental Medicine.

“We help patients with gut-health, anxiety, stress, and mental health via paid consults and an exclusive specialised supplement range.

“We also have a network of referring integrative practitioners.”

Close cooperation and collaboration with other health professionals is a key ingredient in the pharmacy’s business plan.

“We have an amazing referral network with our allied health which supports our professional services as well.”

Mr Afsar said Pharmacy 777 Shoalwater was a prime example on how potential full scope of practice in a community pharmacy setting could help a pharmacy’s business performance transform completely.

“We were a struggling business six to seven years ago with our competitors going hard on price,” Mr  Afsar said.

“By establishing an efficient workflow; a united, engaged team; tailor-made professional services for the unique needs of the community; and most importantly giving back to the community that has given us so much has brought us to where we are today.

“Our approach is not only about tailoring our services to the community, but to respect and treat each patient as an individual.

“We have undergone two major renovations to implement an efficient workflow to reduce wait time and allow pharmacist-patient interaction.

“We now have two dedicated consult rooms so all our services can run smoothly.

“We don’t generically market our services but rather target each patient’s individual needs after assessing their barriers to healthcare, risk factors and what services we can deliver to provide the most benefit to the patient in front of us at that moment.

“We follow up with our patients, and when there’s been a gap in our services, we have worked hard to fill that need by creating new services or facilitating referrals.

“Our patients and allied health network all appreciate the changes we have made over the years to have a clear ‘health’ offer.

“The biggest strength will always be the team we have built.

“We started with six staff members, and now we have 17.

“Our team strives to be better on these three critical elements of community engagement, professional services and business development as we continue serving our community.”

Engagement with patients and people in the region underpins all the services and to underpin this approach the pharmacy has developed a loyalty program designed to help support and engage the community’s needs.

“A proportion of every purchase from its members goes back to a local cause,” he said.

“We have supported struggling local sports clubs, the children’s ward in the hospital, and the local RSL to name a few.

“We are part of every local club in Shoalwater and some of the surrounding suburbs.

“We host education seminars every six months on various topics where we bring local allied health professionals together.

“Some topics include pain, immune health, diabetes, and heart health.

“We promote these events via social media, local newspapers and instore and they are very popular, filling up to the capacity of 60 participants every time.”

“We throw a Christmas party for our patients every year to celebrate. We make a special effort to send personalised birthday cards and a small gift to our top 200 patients.

“We love the bond we have built with a lot of the elderly patients living alone.”

Like many pharmacies COVID-19 brought its own challenges.

“During the pandemic we opened a COVID hotline, so our vulnerable, elderly clientele could reach out with any enquiries or for support.

“We also send our team to specialised training on sleep, geriatric health, integrative health.”

Co-proprietor of WholeLife Pharmacy and Healthfoods Pease Street Cairns, Frank Pappalardo, says being a critical provider in the Far North Queensland health services sector has significantly broadened the pharmacy’s scope and reach.

Mr Pappalardo, who owns the pharmacy with his brother Vince, said the vast geographical area serviced by the pharmacy and its team meant its patient base was diverse and the pharmacy had adapted to meet their needs.

“We work with a range of patients including disadvantaged, remote and challenged groups. We have partnered with health professionals and the community to ensure that no one goes without the health services they need and deserve,” Mr Pappalardo said.

“We are very community focussed and examples of this engagement include our partnering with Wuchopperen Health Services to support the health needs of Indigenous peoples with medications, onsite Imprest, first aid needs and patient care advice.

“We are also supporting remote communities in Far North Queensland, Torres Strait and other islands with fly-in pharmacy deliveries, while also aligning with medical professionals to support remote communities with telehealth prescriptions and other products.

“In addition, we also support the customised medication needs of more than 500 Cairns prison inmates and have an opioid substitution program for more than 100 patients across two locations, including providing electronic methadone dosing.”

Mr Pappalardo said the pharmacy’s current structure was a direct result of patient demands which, coupled with extensive research, helped the pharmacists and staff better understand that its customers wanted more from their local pharmacy.

“The result is that we now support our customers in achieving a balanced and individualised approach to their health and wellbeing by combining traditional pharmacy services, contemporary health services and complimentary products,” Mr Pappalardo said.

“Also, as a result of this focus on our patients, our store is home to a collaborative team of 13 pharmacists, a specialised oncologist pharmacist, two naturopaths, a dietician, and a sports nutritionist all providing integrated medicine and preventative health services.

“And all of this is found in a single destination stocking more than 12,000 products.”

Mr Pappalardo said the pharmacy’s innovative offering included one of the largest robot dispensing systems in Australia which provided efficient dispensing to support its pharmacists in prioritising patient care.

“We also have in-house local medication packing connecting patients with the packing team as opposed to outsourcing to major cities,” he said.

“In addition, we have an in-house compounding laboratory that provides specialised and individualised medication including vet, paediatrics, female pessaries and troches, creams, capsules, hormone replacement therapy, and bespoke products such as baby teething gels.

“Collaborative compounding with local skin clinics for cosmeceutical and dermatology creams, anaesthetics and creams for local dentists is another feature of the pharmacy.”

Mr Pappalardo said these services were further expanded by dedicated pharmacists to manage medication for multiple eye specialist clinics.

It also boasted one of Australia’s largest medicinal cannabis clinics including compounded THC and CBD oil blends with same-day despatch Australia-wide.

“And to further provide an holistic approach to patient care, we have two naturopaths including a herbal dispensary with personalised patient programs, one dietitian and one sports nutritionist on staff supporting health and wellness needs of our customer base,” he said.

“Members of our team with specialised qualifications undertake further study to ensure they have the latest knowledge to service our patients’ needs.

“Our pharmaceutical team hold additional accreditation in medicinal cannabis dispensing requiring training to be undertaken and renewed in a capital city each year.”

Teamwork is a central focus of the pharmacy.

“Being a united team is critical and our 65 employees have a unified approach to providing the best possible service,” Mr Pappalardo said.

“We have a robust training program for new employees and a continuous education program through our Sharepoint library that comprises a professional services program across key dedicated areas including eye care, smoking, weight management, pain management, respiratory health, sleep health. Plus, we have a broad level of expertise across our team including other accredited allied health professionals; two naturopaths, one dietitian and one sports nutritionist.

“We top this off with collaborative management and our management team hold monthly review sessions to understand performance and store optimisation opportunities.

“We encourage staff to participate with ideas for continuous improvement, striving for best in class across our offering.”

With more options available than ever before, it aimed to provide a market-leading pharmacy for changing customer needs.

“Part of our business strategy is focused on being customer-centric and so we have a dedicated buying team who research the latest products including those that are local, Australia-made, sustainable, and innovative. We have a focus on speed to market for new concepts,” he said.

“We are also innovation-led and we continually implement innovative solutions to increase efficiency and free up staff time to focus on patient care.”

At Thursday Island Pharmacy in far north Queensland, the pharmacist and staff all recognise a very important fact – that their community is the reason for their very existence, and their success.

And according to the ownership team Caitlin Davies, Carli Berrill, Mick and Luci Delaney it is also a matter of huge pride to everyone in the pharmacy.

“Our place within the community is something we are very proud of,” Ms Davies said.

“We have a great relationship with James Cook University and often get asked by students from there about what it’s like working in remote community pharmacy and it’s not simple for us to answer because we are so much more than just a pharmacy.

“As a pharmacy we define our community as the health professionals we work alongside, the community organisations we support, and how we help our local community.

“We think about this a lot, and it comes down to how our pharmacy operates, communicates and sets a standard for us to uphold.”

Ms Davies said she and the staff are in constant communication with doctors, nurses, allied health workers, Aboriginal Health Workers including mental health teams to ensure they were providing the best outcomes for the 15 remote island health centres and the community of Thursday Island.

“We also love to push ourselves to offer something better within our community like visiting the elderly to provide medication information and support, community information events, educational events at the primary and high schools, and the implementation of an annual TI Pharmacy iPad Science/Maths award to all schools in the region to encourage local children to invest in their education and hopefully pharmacy as a future. “

Ms Berrill doesn’t believe in standing still and sees that the pharmacy needs to be continually evolving, not only to grow as a business but to grow with its staff and their community. She proudly points to the fact it is achieving these aims.

In addition, being a leader in the community in general is critical.

“For instance, in the past two years we have identified and implemented many changes to fill gaps in our community,” she said.

“These have included minimising our environmental impact, improved efficiency in how we operate and improved professional services and collaboration.

“One area we identified was the lack of recycling and sustainable options within the community.

“Not only did we start to offer reusable products like coffee cups but we started the conversation to change people from disposable incontinence aids to washables by becoming a Continence Aids Payment Scheme (CAPS) provider and working with our continence nurse.

“We have also started to use the Terracycle program to reduce our footprint through recycling our medication foils from our 900-plus blister pack patients.”

Ms Berrill said she and the pharmacy’s staff were also continually on the lookout for ways to improve. “We have also been able to implement a very successful incontinence service in conjunction with a specialised nurse, install an Alpaca to support our 900-plus dose administration aids patients, and we are starting the process of implementing a full sleep apnoea service to help patients access a service they currently need to travel to Cairns for,” she said.

“When looking at innovation, nothing compares to supporting the development of new software, and that is what we have done. The MedRoutine program, which was designed and developed by our Pharmacist David Paulmert, lets us pull data from multiple programs to create a platform for our outer island clinics to easily order medication and blister packs and is now linked to our local Hospitals to improve the process and safety of discharging patients back to the community.”

Co-proprietors Mick and Luci Delaney said the most important aspect of the business side of operations at Thursday Island Pharmacy, is its team, and they are always looking for chances to offer training and growth.

“We have also implemented a staff bonus structure that allows all of our staff from after-school juniors to full-time staff to share in the success,” they said.

“Why? A business is as successful as its employees, sharing that success will create happier and more committed staff.

“We are in a unique position of being the only pharmacy in a geographically isolated region, however, we remain competitive and adaptable to the world of online shopping.

“How has this shaped our business? It has made us conscious of value and range. It has made us select areas to develop such as sports nutrition, whole foods, specialised hair care and baby. The success of these departments has allowed us to stock more small and local businesses and see them thrive.”