Embedding community pharmacists in rural health services

Fran Vaughan is an experienced pharmacist who has devoted her career to improving the health of people in remote areas through the provision of remote pharmacy services, education, advocacy, leadership and the development of clinical guidelines.

Fran currently works as a project officer for the National Aboriginal Community Controlled Health Organisation (NACCHO), providing support for policy and programs related to medicines and pharmacy. She is a strong advocate of the value of embedding a pharmacist into member Aboriginal Community Controlled Health Organisations. Pharmacists working with Aboriginal Health Services can provide patients with access to information about their medicines, provide education and training to existing staff on appropriate use of medicines, and assist in managing medications at transitions of care (such as discharge from hospital).

In collaboration with a Darwin community pharmacist, Fran supported the implementation of a full-time pharmacist position in a large remote community in the Top End, a position that is now seen as an essential part of the healthcare team.

With a background in hospital and community pharmacy and Home Medicines Reviews, Fran has been able to transition these skills to onsite clinical pharmacist practice roles in remote Aboriginal and Torres Strait Islander communities of the Northern Territory and Queensland.

‘Pharmacists have an established role in pharmacies and hospitals in Australia. It’s sad that people living in remote areas should miss out, especially those with chronic health conditions and multiple medicines.’

Fran is a qualified and experienced educator and has helped to prepare health professionals, including pharmacists, nurses and Aboriginal and Torres Strait Islander Health Practitioners (AHPs) and Workers (AHWs) for remote and rural practice at the Centre for Remote Health, Flinders University.

She has played a key role in the development of the Remote Primary Health Care Manuals (RPHCM) which guide healthcare delivery in remote areas. Her involvement spans more than fifteen years and includes being a member of the Editorial Committee and leading the initial development of the Medicines Book for Aboriginal and Torres Strait Islander Health Practitioners. The most well-known of the manuals, the CARPA Standard Treatment Manual was developed to cover ‘what to do’ in remote settings for conditions that are common, high risk, unfamiliar or dangerous – ‘the daily, the deadly and the daunting’.

It was involvement in the review of the CARPA manual, along with her use of the manuals in practice and teaching, that highlighted to Fran the need for AHWs to have a source of information about the medicines in the CARPA manual that was in simple language, illustrated and gave reliable, important messages that did not overwhelm with technical language.

‘The Medicines Book was developed from a team of pharmacists, AHWs and an artist to portray important messages. The second edition was even better than the first because, after using it, AHWs were very engaged in amending it to further suit their needs.’

Health professionals including pharmacists, AHPs and AHWs, with experience in remote or Indigenous health, can apply to contribute to the RPHCM review process. Pharmacists have roles in reviewing the medicines in protocols and updating the Medicines Book. All reviewers are acknowledged on the RPHCM website, as well as receiving a certificate of involvement for inclusion in their CV.