If MOSS is implemented as intended, there is the possibility of a more manageable working day, writes Áine Mac Grory
As 1 June approaches, so too does a shift in the recognition, remuneration, and reform of community pharmacy. The introduction of the Medicine Optimisation Support Service (MOSS) marks a clear change in how the sector is funded, measured, and ultimately, valued.
It reflects a broader acknowledgement of the true scope of pharmacy practice, the clinical judgement, patient assessment, and individualised care that pharmacists have always provided, but which until now sat quietly within the dispensing fee.
That separation is now explicit. Dispensing remains the foundation, while medicines optimisation is stepping into its own space and, importantly, beginning to attract its own funding.
Our engagement with patients hasn’t changed; it’s the value within those interactions that is now being more clearly seen.
MOSS is one of those moments that feels uncomfortable at first glance. There are those who will immediately calculate the loss. Others who will search for the gains. Most of us will land somewhere
in between, cautiously observing, recalibrating, and trying to make sense of where we now stand. And the truth? It’s not ‘one size fits all’. But where there is change, there is also opportunity, if we choose to see it.
We are no longer being paid for frequency. We are now being paid for judgement. That’s a fundamental shift. The €0.35 per item and the enhanced patient payments are not designed to replicate phased dispensing income. They’re designed to redistribute it. To remove layers of administrative burden that, if we’re honest, have been quietly draining us for years.
And burnout? Still very much a hot topic. We’ve all felt it. The repetition. The paperwork. The chasing. The explaining. The re-explaining. The explaining again because the system didn’t capture it properly the first time. If part of the intention of MOSS is to reduce that administrative weight, then we need to take that seriously. Because time is a currency we have been haemorrhaging. So the question becomes: What do we do with the time we get back? And more importantly, are we set up to use it well? Suddenly, the quiet background conversations about IT integration and digital solutions become very loud, very quickly.
There is also a potential upside here, even for employee pharmacists. For many, an expansion of services can feel like more workload pressure with no added benefit. That concern is understandable. Stress, burnout, and work-related fatigue have become so normalised in pharmacy that we rarely question them anymore, or feel justified in asking for something better. This is a chance to reset that.
The system has been running at full capacity for a long time. But if MOSS is implemented as intended, there is the possibility of a more manageable working day. One that doesn’t rely on staying late after the shutters go down just to catch up and reset for the next morning, and where time off doesn’t come with the underlying sense of dread about what might be waiting on return. The move away from labour-intensive, repetitive dispensing tasks, alongside the integration of digital systems to handle administrative burden, should mean less time spent chasing prescriptions, managing paper trails, resolving avoidable queries, and trying to keep pace with constant interruptions.
It’s worth pausing here, briefly, to remember why conversations like this matter in the first place. Patients like Fran, from December 2025’s article, have not disappeared with the introduction of MOSS. If anything, they remain the very reason services like this must succeed. Fran did not struggle because her medicines were inherently high- risk or complex; she struggled because life had become complex around her. Bereavement, isolation, cognitive decline, and vulnerability shaped her ability to
use even the simplest treatments safely. That reality hasn’t changed. What has changed is the framework through which we are asked to recognise and respond to it. MOSS presents an opportunity to make that recognition more visible.
The challenge is to ensure that we feel empowered and confident in exercising our clinical judgement. Every MOSS interaction should still ask the same underlying question: ‘How is this patient managing their medicines in the context of their life, and are there any supports I can offer to help?’ That is the thread that connects past and present. The systems may evolve, but the patient remains unchanged. If MOSS can capture that complexity, and recognise the ‘Frans’ of our practice for what they are — the rule, not the exception — then it has the potential to deliver on what previous models could not. And if it cannot, then it is our responsibility to shape it until it does.
Rethinking the business model
When a revenue stream reduces, the instinct is to protect it. But what if the better strategy is to replace it? Through redesigning workflows. And building on services that align with where funding
is going, not where it has been. This is where thinking outside the box becomes essential. Future revenue streams in pharmacy will come in ways that highlight the clinical value we bring to patient care. We can resist it. Or we can prepare for it. Because if/when new services land, those who are already operating in a paperless, integrated, digitally fluent environment will flourish.
None of this happens in isolation. No system, strategy or service redesign works without the people implementing it. And we need to be honest about that. Community Pharmacy Agreement 2025 (CPA25) offers a much improved training grant, which I was truly delighted to see. Let’s make use of it. Invest in yourself or the team. Upskill. Create confidence around new systems and workflows.
We cannot expect progress if the people driving it are exhausted, disengaged, or unsupported. If anything, this transition is an opportunity to reset systems and environments where efficiency replaces chaos and constant firefighting.
Sustainability: An unexpected win
There’s another angle here that’s worth acknowledging. Sustainability. Reduced dispensing frequency. Less packaging. Less single-use plastic. Whether intentional or not, MOSS nudges us toward a greener model of pharmacy. Maybe it’s time to bring patients on that journey with us? Reframe the conversation. Extend them an invite. We’re not just changing how medicines are supplied, we’re improving how they are managed, for both patient and planet.
Let’s make MECC count
Making Every Contact Count isn’t a new concept in pharmacy, it’s something we’ve been doing instinctively for years. The difference now is that there is a growing structure around it, and an option to be more intentional in how we use each patient interaction. A MOSS consultation creates the ideal setting for this. While reviewing medicines and supporting adherence, there is a natural segue to widen the conversation. Not in a forced or scripted way, but in the way community pharmacy has always operated.
Take a patient collecting medication for persistent, ongoing gastrointestinal complaints, the Scheriproct, the loperamide, the Colofac. The conversation is already happening. And if there’s one thing we know, it’s that patients rarely need encouragement to share the finer details of their bowel habits. That interaction creates a natural opening to ask about BowelScreen. ‘Have you received your kit?’ becomes part of the flow, not an added task. It’s standard counselling, just with a slightly wider lens. Supporting public health initiatives while also improving rapport and trust between you and your patients.
Or consider the 70-year-old COPD patient collecting their inhalers. A routine inhaler technique check paired with a ‘Did you know?’ ‘You will be eligible for the new pneumococcal vaccine soon?’ The conversation is already clinical; expanding it slightly can have a meaningful impact while aligning with existing funded services.
Then there’s the patient with type 2 diabetes, juggling multiple medicines at different times of the day and struggling to keep everything straight. What starts as a conversation about adherence quickly becomes something more practical. This is where simple solutions come in a dosette box, tailored to their routine, reducing confusion. Take that a step further and get the right entrepreneurial mind involved!
They could completely modernise and ‘trendify’ dosette boxes. Think about it. We are entering into a space of patient empowerment and sustainability. Reusable boxes are environmentally friendly and practical. But what if they were trendy too? It would just take a viral TikTok post and some funky/ personalised designs. Colour-coded systems. Morning meds — yellow. Noon — green. Evening — orange and Bed- time… black? Don’t forget those ‘High- risk meds?’ Red box and segregated. For carers managing multiple patients: Betty is Blue, Patricia — Purple. Empower the caregiver. Reduce risk. Add clarity. Offer a solution and collect the full set!
When these meaningful interventions are delivered consistently across the sector, they begin to translate into measurable, quantifiable outcomes. The very thing that underpins future service development and funding. That is what this scheme has the potential to deliver. It can build momentum, to demonstrate value, and to pave the way for what comes next.
Not all of these adaptations will be easy. Some will challenge how we’ve always done things. Some will require uncomfortable adjustments. Some will take time to show their worth. We need to embrace it with the right strategy, the right mindset, and the right support around us.
Change is inevitable. We can resist it, or we can learn to work with it in a way that works for us too.
Áine is a Superintendent Pharmacist and pharmacy owner with over 18 years of experience working in community pharmacies across Ireland. In 2014, she earned her Master of Pharmacy (MPharm) degree in the UK. Her career journey has encompassed a variety of roles, including locum, support, and supervising, culminating in her recent transition to pharmacy ownership. She is deeply committed to upholding the integrity and vital role of community pharmacy in Ireland, combining her extensive experience with a passion for patient care and professional excellence.
