Warnings that ambitious implementation and funding plan required
The Minister for Health Stephen Donnelly has published the report of the Expert Taskforce to Support the Expansion of the Role of Pharmacy.The Expert Group has recommended that pharmacists should be able to prescribe for a range of common conditions. They have recommended an initial list of eight conditions which can be extended over time as the service evolves. The Group has also recommended the development, over the coming years, of more widespread models of pharmacist prescribing across the health service.
Enabling pharmacists to prescribe for common conditions (often called minor ailments) means pharmacists can provide advice and treat common conditions.
This will enable pharmacists to manage common conditions by offering advice, and, when appropriate, prescribing prescription-only medicines through established protocols.
As recommended by the Taskforce an initial list of eight conditions will be included to allow pharmacists working in a community pharmacy to provide treatment to patients:
1. Allergic Rhinitis (Inflammation of the inside of the nose caused by an allergen)
2. Cold Sores (Tiny, fluid-filled blisters on the face or genitals)
3. Conjunctivitis (An eye condition caused by infection or allergies)
4. Impetigo (A contagious skin infection)
“As the global problem of medicines shortages continue, we look forward to the introduction of a serious shortage protocol which will allow community pharmacists to source a clinically appropriate alternative in the event of a particular medicine being in short supply, thereby ensuring that the patient is looked
“The introduction of a Common Clinical Conditions scheme could be among the most impactful changes in Irish Healthcare in decades. This will allow all people to access pharmacy care for minor conditions in the convenience of their pharmacy”
5. Oral Thrush (A fungal infection in the mouth)
6. Shingles (A skin infection caused by the chickenpox virus)
7. Uncomplicated UTI / Cystitis (An infection in the bladder or urethra)
8. Vulvovaginal Thrush (A genital fungal infection)
Pharmacists will be given the opportunity to undertake training to deliver this new service.
The Pharmaceutical Society of Ireland (PSI) will arrange for the delivery of this training which will delivered over the coming months. Patients will then be able to access treatment in a community pharmacy for these eight conditions to begin with.
Cautious Welcome
The Irish Pharmacy Union (IPU) has welcomed the recommendations of the Expert Taskforce on the future of pharmacy services, stating that these recommendations when implemented could have a transformative effect on community healthcare. The IPU is now calling on the Minister for Health to realise this potential and agree to an ambitious implementation plan that adequately resources pharmacy care.
The Expert Taskforce made a total of 18 patient-focussed recommendations which when operational will provide significantly easier and quicker access for patients through the network of 1,900 community pharmacies across the country. The IPU has for many years been advocating for many of these changes, particularly the introduction of a Common Clinical Conditions scheme.
Welcoming the recommendations, Tom Murray, President of the Irish Pharmacy Union said, “The Taskforce and Minister Donnelly are to be commended for getting the process to this stage however a lot of work still needs to be done before implementation can happen. This will require all stakeholders engaging in a collaborative way and agreeing the various protocols and addressing all funding issues.”
Highlighting initiatives that will deliver a significant benefit Mr Murray said, “The introduction of a Common Clinical Conditions scheme could be among the most impactful changes in Irish Healthcare in decades. This will allow all people to access pharmacy care for minor conditions in the convenience of their pharmacy.”
He went on to say, “As the global problem of medicines shortages continues, we look forward to the introduction of a serious shortage protocol which will allow community pharmacists to source a clinically appropriate alternative in the event of a particular medicine being in short supply, thereby ensuring that the patient is looked after in a timely manner.
“Extended prescribing is another initiative which should make matters more convenient and easier for patients,” Mr Murray added.
Pharmacy Engagement
Central to this is supporting the vision of Sláintecare where access to services is based on clinical need not ability to pay and equal access to healthcare. This requires a sustainable pharmacy service and investment in pharmacy services is a key element to that.
Mr Murray said he now expects engagement with the Department of Health to progress these changes and the outstanding pay claim on the basis that there is an agreement that any new services and the pay claim would be dealt with in the round. “The IPU would recommend to members not to implement any new services until there was progress in respect of the pay claim,” he added.
“Community Pharmacists are effectively being paid less than they were in 2009 and the notion of layering on new schemes to an already underfunded and resourced group of healthcare professionals would not be credible, tenable or acceptable.”
Independent Pharmacist Prescribing
The Taskforce has also recommended the development of models of pharmacist prescribing across the health service. In other countries, this has involved pharmacists prescribing for more complex conditions in specific settings. The Minister has asked officials to examine how best to apply these models in an Irish context.
Minister Donnelly said:
“I established the Expert Taskforce to identify ways in which pharmacists can use their expertise to increase their already significant contribution to our healthcare service. Pharmacists are highly trusted, highly accessible and”
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