IPN 2022 December

End of Year: IPU

2023: A Year to Utilise Pharmacy

On the evening of Friday 21 January Taoiseach Micheál Martin stood on the steps of Government buildings, as he had many times before, to make an announcement regarding COVID-19 regulations. This time to the nation’s collective relief it was to confirm the removal of the majority of the restrictions that had dictated our daily lives for much of the previous two years.

Written by Dermot Twomey, President, Irish Pharmacy Union

For pharmacists too it brought collective relief, providing our sector with a welcome return to ‘patient care as normal.’ Community pharmacists across the length and breadth of Ireland went beyond for their patients over the previous two years. We kept our doors open, provided deliveries and worked hard to fulfil our duty of getting medicines to those who needed them.

2022 therefore can be characterised as a year in which we returned to providing the full range of patient care services that our sector is so adept at delivering. Although there was one vital pandemic function, administering COVID-19 vaccinations, that has continued throughout the year.

In the first ten months of 2022 pharmacies have administered no less than 520,000 COVID-19 vaccines. The role of pharmacy at the centre and forefront of developing community immunity through vaccinations is now here to stay. It is our hope that we build upon this in future years and that the expertise of pharmacists is utilised to provide communities with vaccines for other conditions such as monkeypox and HPV as well as routine travel vaccines.

There were many other changes, often unseen by patients, brought in during COVID-19 that we hope can be learned from. Emergency measures such as allowing 9-month emergency supply of CD medicines have been hugely successful. Where a pharmacist has determined in conjunction with a patient that it is appropriate, there is no reason to discontinue this practice.

We also welcome the moves towards electronic prescribing; while the limitations of Healthmail are well established, so too is its potential. 2023 should be a year where these COVID-19 lessons, many of them positive, are learned to improve how care is delivered in our communities.

A major milestone was reached in 2022 with the implementation of free contraception for young women and its planned expansion announced in the recent Budget. Removing the barrier of cost for those requiring contraception is extremely welcome and pharmacists are proud to be playing a central role in the dispensing of contraception. However, we continue to call for pharmacists to be able to supply oral contraception without a prescription directly from a pharmacy to increase the accessibility of these safe medicines for patients.

Pharmacists are experienced in providing contraceptive care services through emergency hormonal contraception. Oral contraception is freely accessible in pharmacies, over the counter, in over 100 countries around the world. The WHO is supportive of pharmacists supplying contraception without a prescription. With GP waiting lists growing this is a needless bottleneck for women who should be given the choice of where to access their contraception.

A standout achievement of 2022 for community pharmacies is the launch of Safe Pharmacy. This new programme offers any person who is experiencing domestic abuse or coercive control a safe and secure location to seek support. Launched in July the initiative now has over 1,000 participating pharmacies. The designated Safe Pharmacies have trained staff and will provide access to a phone in a private consultation room and contact details for local support services.

Pharmacies have always been an important part of their community, and now with Safe Pharmacy, they can play a crucial role in supporting the safety and wellbeing of some of the most vulnerable in our society. 2023 will be the European Year of Skills – which is apt when you consider the most pressing priorities the pharmacy sector will face next year. The biggest concern is a growing shortage of pharmacists working in the sector. The impact of this shortage is increasingly apparent with research by the IPU showing it is now taking an average of five months to fill a pharmacy position.

We need a concerted set of actions by the government to address the chronic lack of university places for pharmacists in this country. Immediate steps also need to be taken to make it easier for non-EU pharmacists to work in Ireland. There is also much that could be done in tackling red tape that adds nothing to patient care but reduces efficiency and brings frustrations that in turn impacts retention. Also, linked to skills is the everpresent desire of pharmacists across the country to have their unique skillset utilised to the greatest effect. Community pharmacy is the standout success story of Irish healthcare. It is convenient, easy to access and affordable. Over half the population lives within one km of a pharmacy, with 85% living within five km. As a result, with 1.5 million visits to pharmacies each week, they are the most accessed part of our health service. Yet pharmacies are ready willing and waiting to do more for our patients.

Critical to maintaining our high level of services is the delivery of a fair fee for the items we dispense. Pharmacies are doing a lot more work for a lot less income while experiencing dramatically increasing costs. On average the current fee for dispensing a medicine is ¤4.74 per item. It was ¤6.00 an item in 2009. What we are proposing is a flat fee of ¤6.50 per item. The role of pharmacies as a key part of community primary care health must be recognised by government through the

provision of a fair dispensing fee for pharmacists.

The New Year marks the effective halfway point of this government’s term in office. The Programme for Government makes clear commitments to expanding the role of pharmacists and it is my profound hope that 2023 is the year in which meaningful action is taken to achieve this.

If properly resourced there is a range of new clinical services which we believe should be introduced by pharmacies and could be implemented quickly which would be a great support to the national health service. A key priority amongst these is the development and roll-out of a national Community Pharmacy-based Triage Programme including a Minor Ailment Scheme, use of Emergency Medicines, and Minor Injuries.

There is huge potential in community pharmacy and much more the sector can do to deliver on the Sláintecare vision of one universal health service for all, providing the right care, in the right place at the right time. Despite this community pharmacy is often not recognised in policy decisions or in service developments and there is currently no vision for the future of pharmaceutical care for patients in Ireland. What we urgently require is the immediate recruitment of a Chief Pharmaceutical Officer (CPO) who would be tasked with developing a new vision to realise the full potential of the community pharmacy sector, which could deliver meaningful and rapid change to benefit patients.

Pharmacy has done so much to support our communities and deliver excellent care throughout the pandemic and throughout 2022. I am so immensely proud to work as part of this truly unique sector and as President of the Irish Pharmacy Union immensely proud of the dedication shown by each and every one of my colleagues. I look forward to 2023 with optimism that the huge potential of our sector can be utilised and that our position at the centre of providing excellent patient care in the heart of Irish communities will be enhanced long into the future.