The Irish Pharmacy Union spoke with Irish Pharmacist about how its White Paper contains a plan to revolutionise community healthcare. Pat Kelly reports
Last year, the Irish Pharmacy Union (IPU) published a White Paper titled Key Enablers for a Sustainable Pharmacy Model: Pharmaceutical Care at the Heart of Healthier Communities. In it, the Union provides an overview of the current landscape in community pharmacy in Ireland and key challenges for the sector. The White Paper also offers recommendations for a sustainable future model for community pharmacy, which includes proper resourcing and fostering an environment where pharmacists can utilise their full range of abilities in patient care.
The ultimate objective, says the IPU, is to transform pharmacies into key healthcare hubs in the community, thereby improving access to care and ultimately patient outcomes. The Union also stresses that pharmacies need to be more integrated into our healthcare system and turning them into “dynamic healthcare hubs”.
Practical steps
Irish Pharmacist (IP) asked the IPU how this might be achieved. “The White Paper envisions a future where community pharmacies are fully integrated into the Irish healthcare system, transforming them into dynamic healthcare hubs,” said the IPU. “This can be achieved through several practical steps:
1. Digital integration: Streamlining of reimbursement systems to reduce cognitive burden on healthcare professionals. Establishing shared electronic health records (EHRs) accessible by pharmacists, GPs, and hospitals, and facilitate read and write access that is appropriate to professional function. This ensures seamless communication, improved transitions of care, leading to better continuity of care. It will also facilitate interprofessional collaboration and remove the need for healthcare professionals supporting patients needing to work in the same geographical environment.
2. Policy reform: Develop legislation that empowers pharmacists to practice to their full scope, such as independent prescribing and in the provision of extended primary care services. Pharmacists are medicines experts, and as such are best placed to recommend alternative treatment options when a medicine is in short supply. Facilitating pharmacists to therapeutically substitute supports timely access to medicines and reduces administration for healthcare professionals.
3. Enhanced services: Expand services like health screenings, point of care testing, medication dose adjustment, transitions of care management, expanded vaccination programmes, support for the chronic disease management programmes, and structured medication reviews.
4. Resource allocation: Provide adequate funding and resources to equip pharmacies with the necessary infrastructure and workforce. This would also include that the correct resources across the HSE and Department of Health where in place to enable correct policies to improve pharmaceutical care are in place and implementable plans and cross functional support within the HSE.
“The benefits would include patient accessibility, especially in rural areas, increased efficiency by freeing-up capacity for our GPs and hospital colleagues, and improved health outcomes from early detection through screenings and preventive care, which can significantly reduce long-term healthcare costs,” the IPU continued.
Admin workload
The White Paper calls for increased “healthcare resilience and capacity building.” IP asked the Union to elaborate on this, and how it can be achieved. Once again, onerous administrative burdens are seen as a barrier to pharmacists working at their full scope of practice. “The IPU’s White Paper emphasises the urgent need to reduce the heavy administrative workload on pharmacists,” the Union commented. “In community pharmacy, 82 per cent of professional service dispensing fees are State-funded and reimbursed. The White Paper seeks to set a vision for interoperability to maximise the potential opportunities for pharmacists to provide care to patients rather than time spent on administrative tasks.”
The IPU also pointed out that it advocates for the implementation of modern ICT systems and streamlined processes to automate routine tasks. “These changes would facilitate pharmacists to dedicate more time to direct patient care, enhancing the overall efficiency and effectiveness
of the services they provide,” the spokesperson responded. “By freeing- up pharmacists from excessive paperwork, patients would receive more personal attention, create a professional environment to support the future expansion of pharmaceutical care services, ultimately leading to better health outcomes and a more accessible service in community pharmacies.”
The White Paper also proposes a continued expansion of pharmacists’ role in healthcare, and an expansion of prescribing responsibilities. The Expert Taskforce recommended expanding the illnesses that can be prescribed for in the pharmacy, including:
- Allergic rhinitis.
- Cold sores.
- Conjunctivitis.
These changes would facilitate pharmacists to dedicate more time to direct patient care
- Impetigo.
- Oral thrush.
- Shingles (early-stage, mild cases).
- Uncomplicated urinary tract infections.
- Vulvovaginal thrush.
Common conditions
The IPU was also asked about its position on a common clinical conditions service in community pharmacies. “Many countries have expanded pharmacists’ scope of practice through nationwide pilots and dedicated service programmes, such as prescribing for common clinical conditions, to increase healthcare access,” the IPU told IP. “These clinical services have improved public health when supported by legislative and policy changes, appropriate remuneration models, accredited training and qualifications, and the integration of information technology across care settings.
“The IPU have long highlighted the benefits of a community pharmacy common clinical conditions service and we welcome the development that, in Ireland, the Expert Taskforce on the Expansion of the Role of Pharmacy have recommended that a common conditions service be introduced, with pharmacists provided with prescriptive authority linked to the service and its parameters.”
Concluding, the Union stated: “Pharmacists are at the heart of community healthcare, and the proposed changes outlined in the White Paper represent an opportunity to reimagine their role in line with modern healthcare needs. By addressing systemic challenges and empowering pharmacists, we can create a patient- centered healthcare system that is accessible, efficient, and resilient.”
