The PSI tells Irish Pharmacist about the highlights of the report, as well as the mechanics of the Expression of Concern process
The PSI has published its Annual Report and Financial Statements for 2023, outlining the work undertaken by the pharmacy regulator to protect the health, safety, and wellbeing of patients and the public by regulating pharmacists and pharmacies in Ireland.??
The Society says its main activities included:
- Being invited to be a representative of the Expert Taskforce to Support the Expansion of the Role of Pharmacy in Ireland.
- Publishing the Workforce Intelligence Report, the first report of its kind for pharmacy in Ireland.
- Adding 524 pharmacists to the Register, bringing the total number to 7,483, representing the largest ever single-year increase in first-time registration numbers.
- Carrying out 143 risk-based pharmacy inspections.
- Reviewing 135 expressions of concern about pharmacists and pharmacies.
- Receiving 73 formal complaints, an increase of 36 per cent on 2022.
- Hosting five regional roadshows as part of an ongoing commitment to engaging with registrants on patient safety and quality initiatives.
- Launching a revised Core Competency Framework for Pharmacists.
- Publishing a review of the CPD model in place for pharmacists and a report setting out a recommended CPD model for pharmaceutical assistants.
- Launching the next phase of the PSI Business Transformation Project.
Commenting on the publication of the Annual Report, PSI Registrar and Chief Officer Joanne Kissane said: “Last year marked a period of considerable progress for the PSI, as we advanced a number of our strategic objectives, as set out in our Corporate Strategy 2021-2024.
“The establishment of the Expert Taskforce by the Minister for Health to Support the Expansion of the Role of Pharmacy marked one of the most significant developments for pharmacy in Ireland in 2023. The expansion of the role of pharmacists in the public interest has been a strategic focus for the PSI Council and the Department of Health for some time. Our participation in the Expert Taskforce aligns with our objective to expand the role of pharmacy as part of an integrated healthcare system so that pharmacists can make an enhanced contribution to improving patient outcomes and accessibility,” she commented.
Prescriptions
The first recommendation of the Taskforce was accepted by the Minister for Health in November 2023. Under the recommendation, pharmacists are enabled to extend the validity of a prescription from six months up to a maximum period of 12 months if, in their professional judgement, it is safe and appropriate to do so. Prescribers are also enabled to issue prescriptions for up to 12 months.?This recommendation is the first step in expanding the role of pharmacists in Ireland with the aim of improving patient access, streamlining healthcare delivery at the lowest point of complexity, and contributing to better patient outcomes, in line with the principles of Sláintecare, said the Society.
September 2023 saw the publication of the Workforce Intelligence Report, providing a baseline view of the pharmacy workforce in Ireland. The report was commissioned to assess emerging risks to the continued availability of a professional pharmacy workforce in both community and hospital settings. It sheds light on the challenges experienced in relation to pharmacist recruitment and retention, incorporating insights from pharmacists and pharmacy students that will be used to support strategic workforce planning.
The report identified six recommendations, each underpinned by a number of actions, and a commitment from stakeholders, including the PSI, to implement these actions to secure a future sustainable pharmacist workforce.
Expanded role
Speaking to Irish Pharmacist (IP) about the highlights of the Report, the PSI said: “The establishment of the Expert Taskforce by the Minister for Health to Support the Expansion of the Role of Pharmacy marked one of the most significant developments for pharmacy in Ireland in 2023.”
“The expansion of the role of pharmacists in the public interest has been a strategic focus for the PSI Council and the Department of Health for some time. The PSI’s participation in the Expert Taskforce aligns with our objective to expand the role of pharmacy as part of an integrated healthcare system, so that pharmacists can make an enhanced contribution to improving patient outcomes and accessibility.”
It also cited the publication of the Workforce Intelligence Report as notable. “The publication of the Workforce Intelligence Report was also a significant development. It is the first report of its kind for pharmacy in Ireland providing a baseline view of the pharmacy workforce in Ireland. A key priority is the implementation of the recommendations and actions in the Workforce Intelligence Report, which will significantly impact pharmacy and the role of pharmacists in patient-facing settings. The PSI remains committed to working with stakeholders across the system to advance this important work,” the Society told IP.
Registration figures are also noteworthy. Of particular interest is the year-on-year increase in the number of pharmacists added to the PSI register. In 2023, 524 pharmacists were added to the Register, bringing the total number to 7,483, representing the largest ever single-year increase in first-time registration numbers.
Of those newly-registered pharmacists, just over one-third received their qualification from Irish universities, with one-fifth graduating in the UK. Additionally, there was a 165 per cent increase in pharmacists registering from EU countries compared to 2022. The total number of pharmacies registered was 1,985, an increase of four from 2022.
“Implementing the recommendations and actions in the Workforce Intelligence Report will significantly impact pharmacy and the role of pharmacists in patient-facing settings. Achieving these recommendations will require extensive collaboration, and we remain committed to working with stakeholders across the system to advance this important work,” said the Society.
ePortfolio
The ePortfolio reviews have also been a matter of interest since The Irish Institute of Pharmacy (IIOP) was established by the PSI in 2013 to oversee the development and management of the Continuing Professional Development (CPD) system for pharmacists in Ireland.
The PSI told IP that engagement with the system remains high. “ePortfolio review first commenced in 2017 and has operated every year since then. The guidelines that support ePortfolio Review are set out in the IIOP ePortfolio Review Policy, which is reviewed annually by the IIOP and approved by the PSI Council thereafter. Standards for ePortfolio Review are updated and developed in consultation with peer pharmacists.
“The standards incorporate two elements; System Based Standards, and Review Standards. All submitted extracts are reviewed against the System Based Standards by the IIOP ePortfolio System, and a sample of extracts are also reviewed against the Review Standards by a reviewer. The IIOP updates the supporting resources and information on ePortfolio Review for pharmacists every year on the IIOP website.
“Engagement levels with the ePortfolio Review process continue to remain high, with 97 per cent of selected pharmacists meeting the standards for ePortfolio Review 2023/2024. The outcomes of the process were communicated by the IIOP to all pharmacists on 30 April 2024,” the Society told IP.
Expressions of concern
A robust and transparent process to facilitate the public and pharmacy profession to raise concerns and bring forward complaints is a key pillar of the pharmacy regulator’s work, the PSI added. During 2023, a total of 135 expressions of concern were received, a 14 per cent increase from 2022. Of these, 39 per cent related to pharmacy practice issues. The majority of concerns (78 per cent) were raised by members of the public, while 16 per cent were raised by other pharmacists. Additionally, 73 formal complaints about pharmacists or pharmacies were received, marking a 36 per cent increase on the previous year.
The PSI shares information and learning from complaints and the outcomes of inquiries. This is done in the interest of maintaining and upholding professional standards, raising awareness around patient and public safety matters, and promoting compliance with pharmacy and medicines legislation.
“The public is entitled to a high standard of care from pharmacists, and pharmacies must operate at high standards of quality and safety. We continued to uphold these standards through significant registration, inspection and enforcement activities carried out throughout the year. These activities are at the core of what we do and are delivered by highly committed and skilled colleagues from across the organisation,” stated the PSI.
On Expressions of Concern, the PSI was asked by IP to explain the process. “An expression of concern is whereby a person brings a matter to the attention of the PSI but does not want to make a formal complaint. In 2023, 79 per cent of all concerns received were from members of the public, while 16 per cent were raised by pharmacists.
“Once received, a multi-disciplinary team in the PSI assesses what regulatory action may need to be taken with these, if any. In the event of a concern becoming a complaint, it is at this point that it will be processed under Part 6 of the Pharmacy Act 2007. Of the 135 concerns received in 2023, (a 14 per cent increase on 2022), 39 per cent related to pharmacy practice issues, and six resulted in formal complaints. These are made in writing to the PSI. Formal complaints are processed strictly in line with the provisions of the Pharmacy Act 2007.”
Breakdown
“Once a complaint is received, the PSI process it and refer it to the Preliminary Proceedings Committee (PPC) for consideration in accordance with the process set out in the Pharmacy Act 2007. The PPC, upon review of the complaint, advises the PSI Council whether there is sufficient cause to warrant further action being taken in relation to the pharmacist/pharmacy, the subject of the complaint. The PPC can then refer the complaint to either mediation or for hearing before a statutory Committee of Inquiry.”
The PSI also broke down the nature of the Expressions of Concern for IP, of which there were 135. These were categorised as:
- 4: Behaviour.
- 11: Behaviour (manner/attitude).
- 16: Commercial/advertising/employment issues.
- 6: Dispensing error (incorrect medication).
- 5: Dispensing error (incorrect dose).
- 2: Dishonesty.
- 3: Emergency supply issues.
- 14: Failure to supply.
- 19: Other.
- 54: Pharmacy practice issues.
- 1: Professionalism.
CPD model review
As part of its remit to ensure pharmacists are engaging in continuing professional development (CPD), the PSI commissioned an independent review of the CPD model for pharmacists and developed a proposal for a CPD model for pharmaceutical assistants. A revised Core Competency Framework for Pharmacists was also published.
“Patients and the public expect and deserve high-quality care and service from their pharmacists. The PSI supports this by setting and ensuring standards for education, training, and CPD. We were pleased to launch a revised Core Competency Framework for Pharmacists, which outlines the range of competencies expected of pharmacists in the early stages of their career,” said the Society.
“This framework also supports a number of statutory functions and provides structure and guidance for all pharmacists when reflecting on their continuing professional development needs. The review of the current CPD model for pharmacists was a significant achievement, containing a number of recommended changes in line with both emerging developments and international best practice in this area.”
The PSI told IP: “Following an independent review of the CPD model for pharmacists in 2022/2023, the PSI Council at its meeting of 14 December 2023 accepted the findings of the Review of the Continuing Professional Development (CPD) Model for Pharmacists in Ireland Report (2023) (The Mazar’s Report) and approved the recommendations therein.
The review of the current CPD model
for pharmacists was a significant achievement
“To further inform and elaborate on the Council’s consideration on the scope of the revised CPD model for pharmacists, an implementation proposal was developed to provide an evidence-based framework to implement the recommendations contained within the Mazar’s Report. This implementation proposal was approved by the PSI Council at its meeting of 25 April 2024. Work continues on implementing the approved changes to the CPD model for pharmacists. Further information is available on the PSI website.”
Technology
The annual report highlights and commends the participation of pharmacists in both public health and information and awareness campaigns, with more than 1,300 community pharmacies participating in the autumn/winter vaccination campaign. In 2023, progress continued on the PSI Business Transformation Programme, aimed at enhancing ways of working across the PSI and ensuring it optimises use of technology and colleagues’ time and expertise in the best way possible. This multi-annual project is delivering a new digital platform for the PSI to provide a single customer view of all relevant registrant and risk-related data. In 2023, as part of this initiative, an online registration platform for completing Internet Supply List applications and an updated searchable Internet supply list were launched.
“Our work to assure continued trust in the safety and quality of pharmacy is a central part of all activity,” the PSI told IP. “Core to this is the operation of a robust, fair and transparent service to facilitate the public and the profession to bring forward complaints. In addition, registration, inspection and enforcement activities carried out throughout the year ensure that high standards are maintained across the profession and that the public are provided with a high quality and standard of care, which they are fully entitled to and expect.
“To this point, the completion of 143 risk-based pharmacy inspections, coupled with the review of 135 expressions of concern about a pharmacist or pharmacy and the processing of 73 complaints, were important developments, demonstrating our commitment to ensuring the highest standards are maintained. It is important to highlight that we share information and learnings from complaints and from the outcomes of inquiries, with the objective of ensuring learnings are applied, to enhance future care, and crucially for the benefit of patients and the public.
“This past year has seen the progression of several strategic projects which will continue to shape the future of pharmacy in Ireland,” the Society stated. “We are pleased that advances have been made under our strategic objectives to assure continued trust in pharmacy. We look forward to delivering on our commitments in 2024 and to engaging positively and constructively with all stakeholders.”
