When Minister Donelly accepted the recommendation of the Taskforce, and announced the decision to enable pharmacists to extend prescriptions, he said that expanding the legality of prescriptions would both reduce the demand at GP practices, and enhance the pharmacist’s scope of practice. He added that this would ultimately benefit patients, by improving both patient care and access.

In a press release issued by the IPU on 1 March 2024, Acting Secretary General Derek Reilly said; “The use of prescription extension was highly successful during the pandemic and this announcement will be welcomed by patients across the country. This measure will prevent the need for a large number of patients visiting a GP for routine repeat prescriptions. However, the true value of prescription extension to patients will only be seen when pharmacists are given similar clinical discretion. This will facilitate patients to seek an extension of a prescription directly from their pharmacist.”

Mr Reilly also stressed that while the IPU welcomed the introduction of prescription extension effective from 1 March 2024, a government scheme that will facilitate extension of prescriptions under defined clinical criteria would not be implemented until September 2024. The IPU is looking forward to being consulted concerning the rollout and implementation of any new schemes. However, the IPU stressed that funding for these services will need to be agreed as part of ongoing discussions with the Department of Health.

“The use of prescription extension was highly successful during the pandemic and this announcement will be welcomed by patients across the country  

Amendments to the legislation

On 1 March 2024, amendments were made to the Medicinal Products (Prescription and Control of Supply) Regulations 2024 (S.I. No 72 of 2024 and S.I. No 73 of 2024) and the Retail Pharmacy Businesses Regulations 2024 (S.I. No 74 of 2024). The amendments made and implemented from 1 March 2024 enable prescribers to write prescriptions valid for up to 12 months, and for pharmacists to extend the validity of six-month prescriptions for up to 12 months. Pharmacists may also supply up to five-day emergency supplies at the request of a patient for prescription-only medicines including controlled drugs.

Therefore, after the implementation of these amendments, the practice observed at community pharmacies is as outlined below.

Prescription validity

• Prescribers can write prescriptions for up to 12 months and such period is specified on the prescription; and
• Pharmacists have the authority to extend the validity of a six-month prescription to 12-months under specific conditions.

Conditions for prescription extension by pharmacists

• The pharmacist must ensure the medicine’s appropriateness and that there are no signs or symptoms of a possible adverse reaction;
• The pharmacist has spoken with the patient or the patient’s representative to determine:
  • The patient has a continuing need or chronic condition that justifies dispensing after the expiry of the period of six months; and
  • The patient’s history with the prescribed medicinal product has not changed.
• The decision to extend must be documented; and
• The pharmacist who extended the period for dispensing must make reasonable efforts to ensure that the prescriber, or another relevant primary healthcare provider, is informed of the decision to extend within the period of seven days following the decision.

Exclusions for extension

• The medicinal product is not a drug specified in Schedule 2, Schedule 3 and/or Schedule 4 of the Misuse of Drug Regulation 2017 (S.I. No. 173 of 2017); and
• The prescriber has indicated that the medicinal product concerned is not to be dispensed by using the words “do not extend” on the prescription.

Prescription extension record-keeping in community pharmacy

The pharmacist who makes the professional decision to grant the extension of validity of a six month prescription must make an entry in the prescription register and include the following particulars:

• The date on which the decision was made;
• Pharmacist’s name and PSI registration number;
• Details of the review undertaken; and
• Details on how 9A(2) requirements have been met.

Emergency supply at request of a patient

Pharmacists have the authority to supply up to five days’ supply, or the equivalent, or the nearest equivalent minimum dose under the emergency supply provisions. Therefore, pharmacists can supply an emergency supply of prescription-only medicines including controlled drugs specified in Schedule 2, Schedule 3 and/or Schedule 4 of the Misuse of Drug Regulation 2017 (S.I. No. 173 of 2017), once the pharmacist has satisfied themselves that:

• There is an immediate need;
• It is safe, appropriate and necessary for the continuity of care of the patient;
• It is not possible to obtain a prescription without undue delay;
• The medicinal product has been previously prescribed to the patient; and
• The patient has not already been supplied with an emergency supply in accordance with the emergency supply provisions since such previous prescription.

For further information on the prescription extension please visit the PSI and IPU websites. In addition to this, gov.ie provides examples that you may find useful at gov.ie/en/campaigns/87eb1-pharmacy-services.