Patients to be able to get prescriptions for common conditions directly at pharmacies, bypassing GP visits

After years of talk and reports, pharmacists will soon be allowed to dispense medicine for common ailments without the need for a doctor’s prescription after a task force on expanding the role of pharmacists found they should be able to prescribe medication for “uncomplex” health issues.

From early next year pharmacists will be allowed to diagnose, offer advice and write prescriptions where appropriate for eight common conditions, saving patients the time and money of having to attend a GP clinic.

And from September, patients can ask their pharmacists to extend their prescription from six months to a maximum of one year if they have a prescription dated March 1st, 2024 or later.

The move is being described as among the most impactful change in Irish healthcare in decades.  

The initial list of conditions covered under the new initiative are: 

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 a viral or bacteria infection or allergies)
4. Impetigo (a very contagious bacterial skin infection)
5. Oral thrush (a fungal infection in the mouth)
6. Shingles (a skin infection caused by reactivation of the chickenpox virus later in life)
7. Uncomplicated UTIs/cystitis (an infection in the bladder or urethra)
8. Vulvovaginal thrush (a genital fungal infection)

Treatment for these conditions usually requires the use of antibiotics or antifungals, hence the need for a visit to the GP. However in many other countries like Spain and Portugal a doctor’s prescription often isn’t required. And with GP clinics getting increasingly busy, doctors overworked, and appointments hard to get, there have been calls in recent years to allow pharmacists to prescribe medicines for common ailments to help alleviate pressure on the medical system.      

It’s also expected that the above list will expand in future years, particularly to include asthma.  

Patient benefits 

The biggest benefit to patients is that they’ll no longer need to fork out up to €60 or more for a GP visit nor have to take the time off work to make it to a GP clinic in order to get a prescription for a range of common ailments. Instead they can access care for common conditions in the convenience of their local pharmacy. 

However pharmacists will still charge for the new service and there’s no indication yet what that will be, as it will be up to the discretion of each individual pharmacist. 

There may be a small, nominal charge if it’s clear what the ailment is. And if a brief exam is required along with a weight and/or blood pressure check for example, a higher fee may apply.

However, negotiations have yet to start with the Irish Pharmacy Union (IPU) over the price pharmacists will be paid for medical card holders, who make up about 25% of the population. So this may delay the wider rollout of the new scheme.   

This is all about making it quicker and easier for members of the public to access medicine. It's better for the public, it's good for the pharmacists and it's good for GPs because it'll free up some of their time to see the more complex patients.  

Stephen Donnelly, Minister for Health  

Concerns 

There have been some concerns about what’s perceived as an attempt to replace the important work of doctors. Common conditions can sometimes be symptoms of more serious issues and there is a fear these could go undiagnosed if patients don't see a fully trained GP. 

There is also a fear about excessive or incorrect use of antibiotics and antifungals, especially with drug resistance on the rise. However, Dr Pat O’Mahony, the chair of the task force that looked into expanding the role of pharmacies said there was no evidence it would lead to “any additional use” of these. And the Pharmaceutical Society of Ireland (PSI) will offer training to pharmacists to help deliver the new service and educate on the correct diagnosis and treatment for the ailments. 

And of course, GPs will still be on hand to see patients when required.

So overall, this seems like a good initiative that will help save patients time and money and free up GPs to attend to more serious cases.