Reform Proposals for Emergency Pharmacy Services

The ongoing challenges faced by pharmacy teams during emergency service hours have prompted discussions about improving these essential services. Patients often find themselves traveling long distances to obtain necessary medications, highlighting the need for reform. In some regions, such as Bavaria, a new software system utilizing geodata has been introduced to enhance service distribution; however, it has faced criticism.

In response, the Baden-Württemberg State Pharmacy Chamber has released a comprehensive document outlining proposals for reforming emergency pharmacy services. Key recommendations include a significant increase in compensation, a needs-based distribution of both full and partial emergency services, and enhanced collaboration with healthcare professionals, potentially through telemedicine consultations.

The document emphasizes the vital role of pharmacies in providing accessible medication and professional healthcare advice at all hours, including weekends and holidays. As health professionals with extensive training, pharmacists are crucial in addressing the unique challenges patients face during emergencies.

Despite the importance of their role, the financial viability of emergency services has become increasingly precarious. The closure of 88 pharmacies in Baden-Württemberg in 2023 alone has intensified the burden on remaining pharmacies, leading to an increase in required emergency service hours. This has inevitably raised economic concerns regarding the sustainability of such services.

Currently, the average cost for a 24-hour emergency service, with one pharmacist on duty, is approximately EUR1943.48. Given the emergency service fee of EUR465.98 and an average gross profit of EUR480.63, the costs are not covered, resulting in an average loss of EUR1069.24 per emergency service (including trade tax). This financial strain necessitates urgent government intervention to address the issue effectively.

The Board of the State Pharmacy Chamber advocates for a systematic overhaul of emergency service operations, suggesting that the future of emergency care should be conceived holistically and interprofessionally.

Among the critical adjustments proposed is the need for compensation for emergency services to be at least cost-covering. This could be achieved by increasing funds allocated to the Night and Emergency Service Fund (NNF) and implementing an innovative distribution mechanism for both full and partial services. Such a solution would accommodate the disparities present within the decentralized emergency service system.

Another significant suggestion is to raise the current emergency service charge from EUR2.50 to EUR10. This measure aims to regulate patient flow while contributing to cost coverage.

Furthermore, the distribution of emergency services should be optimized based on distance, infrastructure, and time constraints. By intelligently combining partial and full emergency services, pharmacies could be scheduled more effectively during peak hours, such as pre-midnight, to ensure adequate coverage.

Additionally, the introduction of telepharmacy and telemedicine concepts is recommended. Pharmacies offering emergency services could utilize video consultations with medical professionals, reducing the need for patients to visit emergency medical services. This approach not only saves time for patients but also alleviates pressure on the healthcare system. However, it is imperative that the additional workload in pharmacies is compensated appropriately.