In 2017, the PCRS introduced an online approval system for phased dispensing for GMS patients.
According to Circular No. 013/17, phased dispensing is permissible under the GMS scheme when the prescriber instructs on a prescription that they wish to have the total quantity of an item dispensed at intervals. There will be occasions in which, although the prescriber has not recorded a phase dispensing instruction on the prescription, the pharmacist can exercise his/her professional judgment for patient safety or compliance reasons and request through the PCRS application suite for the medication to be dispensed in phases.
The PCRS criteria for claiming phased dispensing fees is:
- At the request of a patient’s physician;
- Due to the inherent nature of a medicinal product i.e. product stability and shelf life;
- Where a patient is commencing a new drug therapy with a view to establishing patient tolerance and acceptance before continuing on a full treatment regimen; or
- In exceptional circumstances where the patient is incapable of safely and effectively managing the medication regimen.
The request for approval of a phased dispensing fee for a patient can be made by the GP or pharmacist:
- GPs can apply directly to the PCRS for a patient, or the pharmacy can apply under reason 1 or reason 4.
- Pharmacist can apply under reason 1 when a copy of prescription is available for submission to the PCRS with the GP’s instructions clearly expressed for phased dispensing.
- Pharmacist can apply under reason 4, the pharmacy needs to provide information as to why the patient requires phased dispensing.
Patients where the following criteria apply are approved in a shorter timeframe for a phased dispensing service:
- Patient is over 80 years old;
- Patient is on one or more psychotropic medicines;
- Patient is on five or more oral medicines in a month.
For reasons 2 and 3 there is no need for a prior approval.
The PCRS will advise pharmacies if the application is approved or not through the Pharmacy Application Suite, under ‘Application History’. If an application submitted under reason 4 for a phased dispensing service is not approved, the pharmacist may wish to appeal the PCRS decision. An appeal can be registered by the pharmacist providing additional information on the patient’s particular circumstances to their local HSE Pharmacist.
When a patient is approved for phased dispensing, the PCRS requires evidence to substantiate that the total quantity supplied has been dispensed and supplied at regular intervals. Patient Medication Records (PMR) should reflect the phased supply dates. The pharmacy must ensure that the patient signs a collection form confirming phased dispensing dates of supply. These records must be retained in the pharmacy for two years.
A phased dispensing service is not currently approved by the PCRS for patients who are utilising a generic GMS number.
