Pharmacists say a lack of funding is preventing them from providing vital blood tests in the community for thousands of people.
People who get their blood-thinning medication managed at a pharmacy just need a pinprick test and get their results quickly. Photo: 123RF
An estimated 25,000 to 30,000 New Zealanders are on warfarin, most managed by their family doctor. It can involve both GP and lab visits, and these can be painful for some.
That was the case for a Wellington woman Huia Hutana.
She has been on warfarin for more than 20 years following two heart operations. The drug reduces the risk of a stroke, but like others, Mrs Hutana needs regular blood tests to ensure she is on the right dose.
It used to involve a visit to a lab, a bit of a wait, and a lot of pain.
"I have very small veins, so they've got to go in about five times before they get anything, or they have to put it in my arm under hot water and all sorts of things. But they do have a terrible time."
She has since moved on to having a fingerprick test at a local pharmacy.
"The best thing that ever happened. No more pain and it's so quick. You get the results straight away."
Photo: 123RF
Mrs Hutana is one of 6800 people who have their warfarin managed by a pharmacy. The scheme was piloted in 2010 and rolled out nationally in 2012 using a special computer software programme.
One hundred and sixty pharmacies receive $45 per patient a month.
Miramar pharmacist Ann Privett said it had 50 patients during the pilot, and has been funded by Capital and Coast District Health Board to monitor 60 patients since 2012.
Ann Privett Photo: Supplied / Ann Privett
She said it was not enough and there was a waiting list.
"We go to our doctors and say, 'We have a place, one place, for our warfarin service'.
"There's big discussions [among] the local doctors as [to] whose patient [will] ... actually go on the service. So it's sought after."
Mt Maunganui pharmacist Daphne Eagles agreed saying it was a convenient, one-stop process for many patients.
"It probably takes all of five minutes."
Health Minister Jonathan Coleman said in September the number of patients being managed by pharmacists has risen by 500 in the past year.
An expectation of New Zealand's health system was that care should be delivered close to home where possible, he said.
Pharmaceutical Society chief executive Richard Townley said some DHBs would like to be able to offer contracts to pharmacies but were constrained by funding.
"We need to have a reallocation of funding in the primary care area. And the district health boards, on a local basis, need to be allocating and reallocating funding accordingly," Mr Townley said.
"The big picture is that this service prevents strokes, it does prevent hospitalisations."
DHBs have confirmed the issue was part of discussions under way in a new community pharmacy services contract, from next July.
But the DHBs' spokesperson, Carolyn Gullery, said enabling more pharmacists to provide anti-coagulation medicine management was not simply a funding issue and was far more complex.
She said the real constraints were around bringing together general practice and pharmacists and different IT systems and processes.
"To make this happen, so pharmacists can have a greater role in patient care, is the subject of the new contract that everyone is working on."