New regulations came into force on 1 March 2024. These regulations aim to enhance the role of pharmacists in the delivery of community healthcare. Under the new measures, pharmacists can extend the validity of certain prescriptions to a 12-month maximum period. The regulations also permit doctors and other prescribers, such as nurses and dentists, to write prescriptions for up to 12 months where it is clinically appropriate. Additional recommendations now suggest that a pharmacist’s role should be expanded further, to allow for prescribing for common conditions, with a view to eventually expanding their role to “Independent Pharmacist Prescribing”. The expansion of the role would involve pharmacists prescribing across the health service.
The measures introduced in March 2024 allow prescriptions to be written by the prescriber, including doctors, dentists, and nurse prescribers, where appropriate, for a period of up to 12 months. Where the prescription provided is for more than six but less than 12 months, a patient may ask their pharmacist, from 1 September, to consider extending it up to 12 months, where the prescription was issued on or after 1 March 2024.
The pharmacist’s role in this process ensures that an assessment of appropriateness is carried out before the prescription is extended. The measures enhance the need for collaboration between the healthcare professions involved to discuss and collectively consider how best to manage the patient’s care. Prescribers can also indicate on prescriptions that an extension would not be in the best interests of the patient at the time the prescription issues. The measures do not apply to all medication. For instance, controlled drugs are not eligible for extension. However, many standard medications will be included.
Following this expansion concerning prescription time limits, it has now been recommended by the Taskforce established by the Minister for Health that pharmacists should be able to prescribe for a series of common conditions, or minor ailments. This will allow community care to be practiced through pharmacists where patients would otherwise have to attend at their General Practitioner to obtain prescription-only medicines. Eight medical conditions have been identified for inclusion:
- Allergic rhinitis
- Cold sores
- Conjunctivitis
- Impetigo
- Oral thrush
- Shingles
- Cystitis, and
- Thrush
Training will be offered to pharmacists by the Pharmaceutical Society of Ireland (PSI) to allow them to deliver this service, which will then be available to patients in community pharmacies. It is anticipated that this service will be available from early 2025. Minister for Health, Stephen Donnelly has also asked Department officials to examine the implementation of broader models of pharmacist prescribing within the Irish health system, as already occurs in other jurisdictions. This would involve pharmacists prescribing more complex conditions in specific circumstances.
Conclusion
The extension of both prescriptions, and the ability of pharmacists to prescribe, is to be welcomed by patients and healthcare professionals. However, it imposes a separate burden on those professionals affected to ensure that they exercise their professional judgement appropriately. It is important for those healthcare professionals to consider issues such as:
- The necessity for ongoing treatment
- Patient safety
- The appropriateness of a new, or extended prescription for the patient concerned, and
- The views of others involved in the patient’s care
The PSI, the pharmacy regulator, is developing updated guidelines and providing training to support pharmacists with these developments. We expect that guidance will also issue from other regulatory bodies. Time should be taken to review the details of this guidance and to engage fully with the training available to ensure compliance with it in both the interests of the patient, and the profession to work within their scope of practice.
For more information and helpful advice, contact a member of our Public, Regulatory & Investigations team.
The content of this article is provided for information purposes only and does not constitute legal or other advice.
