This Mother’s Day, let’s spotlight mums delivering HMR care

Behind the flexible appeal of Home Medicines Reviews (HMRs) is a primarily female workforce – many of them mothers – delivering critical care while navigating increasing financial pressures.

Women make up around 70% of the credentialed pharmacists who deliver HMRs, with two-thirds under the age of 40. HMR work is a constant balancing act that involves managing the significant demands of professional practice alongside raising young families. 

With Mother’s Day approaching, the reality of HMR work mirrors a common narrative for women in pharmacy: highly skilled professionals delivering personalised care, while managing significant responsibilities at home. 

These pressures increasingly undermine the sustainability of HMR practice. 

‘There is a reluctance for people to give up permanent employment for a career pathway which is not assured,’ said credentialed pharmacist Katie Phillips MPS.

Critical care for vulnerable Australians

Pharmacists conducting HMRs play a crucial role in supporting quality use of medicines among vulnerable Australians at risk of medication misadventure. 

Credentialed pharmacist Erica Stephenson MPS, told AP that one of the most important aspects of her role is just being there.

‘For an hour, I might have relieved somebody’s loneliness by being in their home and having a chat with them about them and their medication.’

With current HMR caps set at 30 HMRs per month, access can become an issue, particularly in rural and remote areas. ‘No one should have to wait for a review when there are credentialed pharmacists able to provide the service but capped out for the month,’ Ms Phillips said.

Ms Stephenson added that ‘the cap gets you caught. At the end of the month, you might get that emergency, and you’ve already hit your cap and then can’t provide the service.’

Flexibility with hidden costs

HMR work is often promoted for its flexibility, yet the reality is far more complicated. Alongside delivering the service, pharmacists have to grapple with long hours, extensive travel and significant unpaid work – including driving, documentation and reporting. 

For mothers, these demands pose significant challenges when balancing professional and personal responsibilities. ‘When everything related to a HMR is taken into account, the pay rate is unsustainable, especially with many pharmacies/HMR businesses taking a cut of a pharmacist’s HMR earnings,’ Ms Phillips said.

As a mother of two young girls, Ms Phillips describes herself as ‘incredibly time poor and forever on the go,’ with HMRs often scheduled on her ‘days off’.

Ms Stephenson transitioned into HMR work as her sole form of employment to provide a sense of flexibility as a single mum with chronic health issues. And since becoming a credentialed diabetes educator, she is ‘busier than ever’.

When asked what would make HMRs more sustainable, Ms Phillips suggested telehealth as a pivotal follow-up method.

‘There is so much value in a follow-up call to close the loop of care,’ she said.

‘I have had a patient’s daughter text me almost daily, waiting out the month before [an HMR] follow-up, as various dose changes were made by the GP with not so great results.

‘I happily responded to all her texts, but I didn’t really need to see the patient in person again to be able to advise on what should be next, and there is no recognition or remuneration for this time,’ Ms Stephenson said.

The employment model piles on further strain. Most credentialed pharmacists are self-employed practitioners, so there is limited security – ranging from no superannuation, sick leave or annual leave – and time off is typically unpaid. 

Ms Stephenson works 50 weeks of the year, taking time off only over Christmas as the backlog of referrals grows exponentially. 

‘I joke that sometimes I’m on negative $5 an hour because I’m just so buried in admin. It’s a full-time job just keeping on top of the admin, which is, of course, unpaid,’ Ms Stephenson said.

‘I don’t really have any disposable income. I just pay my bills, and that’s it. Which is unfair on my kids who are very independent and have their own jobs, but that’s just the way it is.’

These pressures are compounded by irregular referral patterns, which take a sense of financial stability out of the question. The Australian Health and Medical Research Workforce Audit shows that a lack of funding, job security and work-life balance are the main reasons individuals consider leaving the field.

Ms Stephenson urged younger mums looking to broaden their scope that HMRs are maybe not as clear cut as they seem as ‘You’re actually on the job 24/7 almost’.

Structural barriers

HMR remuneration has not been indexed since 2019 and remains at $222.77 per review, raising consistent concerns regarding long-term sustainability of the practice. 

Funded by the Australian Government under the Community Pharmacy Agreements, an increase in the cost of living has not been met with an increase in fees, meaning that each pharmacist is essentially taking a pay cut each year. 

‘Once you take out tax, provisions for personal leave/annual leave etc., the hourly rate is pitiful. And when appointments are cancelled due to the clinician or patient, it can leave you high and dry financially,’ Ms Phillips said.

Ms Stephenson, a single mum of two teenagers, called for an ‘essential’ increase to remuneration. ‘For every $222, I take $26 out for superannuation, $55 for tax, and $10 if I want to treat myself to catch up with friends. That leaves me with $130 to run my car and pay subscriptions, household bills and mortgage,’ she said. 

‘There is a reluctance for people to give up permanent employment for a career pathway which is not assured.’

katie phillips MPS 

’[The] 200 km limit for travel is too high. I can drive for an hour to see somebody and still not be eligible for the rural travel allowance.’

The lack of employment entitlements further exacerbates the issue. ‘As a young mum, if I have to cancel HMRs because my kids are sick, I don’t get paid,’ she said.

‘[And I] might miss special moments like a bedtime story because [I’m] frantically trying to finish something that the doctor’s waiting on urgently.’

Despite these mounting challenges, many pharmacists remain committed to delivering HMRs, driven by the impact they have on patient care – particularly for elderly Australians and those with chronic and complex conditions. 

Sustainable HMR practice, Ms Phillips said, depends on ‘Being paid appropriately, with appropriately indexed remuneration reflecting the level of skills and experience required, travel costs, and allowances for lack of entitlements’.

With demand for medication reviews projected to grow, driven by an aging population, rising rates of polypharmacy and a need to manage preventable, medication-related hospital admissions, there are increasing calls to address indexation and structural barriers – ensuring the workforce remains viable and patients continue to receive the care they need. 

PSA’s 2026–27 Federal Budget Submission advocates for the government to lift the indexation freeze on the management of medications to ensure the longevity of patient care.