Public consultations are coming thick and fast, with several from the PSI and HIQA in the last few months. I must admit to a severe reluctance in responding to PSI consultations. My view is that there are usually some excellent community pharmacists sitting on Council, well capable of expressing the views of the sector. Additionally, after previous submissions, I felt that a string of ‘noted’ comments weren’t what I would normally regard as engaged feedback. There is a suspicion, lurking in the back of the mind, that the outcome is pre-ordained and nothing you say is going to be taken on board. On the flip side, if you haven’t given feedback, then you have little right to grumble about the outcome.

One recent consultation that stirred me to action was the latest incarnation of the electronic prescription, combined with the dispensation dataset. This is an amalgam and update of three previous standards. There is a distinct probability that this will be used as the basis for the upcoming National Electronic Prescription Service (NEPS). This is expected sometime in the next decade, albeit, as good Europeans, there is an actual target date of 2029. I am conscious that this is an area that I have long held a deep interest.

The IPU were first looking at electronic prescriptions in the early 1990s, where a cumbersome EDIFACT structure was in place. This was, and is, an international set of technical standards for the interchange of electronic messages. It was used reasonably widely, commercially. In those early days, there wasn’t even a prescription message, just a standard model called Medruc, short for medicine resource usage cost message. It was like trying to shovel manure into a test tube, messy and not very practical. Eventually a Medpre message was developed as a rudimentary ePrescription and found traction. The IPU participated in a trial, where we proved that high-quality messages could be sent through the Irish phone line system. This was in the days of screeching modems, where extremely slow data was regarded as lightning at the time. A fast exchange was 14.4 kilobits a second — today we have gigabit broadband, about 70,000 times faster. Additionally, the project was doomed from the start. The way the health service was set up at the time was decentralised, through the Health Board system. Every Board had its own IT section, typically under resourced and unable to engage in a project of national scope. The Department of Health, at the time, were shocked at the concept of issuing national guidance for electronic prescriptions. They felt that it would hamper the independence of the Boards.

However, I digress. Back to the HIQA draft standards. They are turgid documents at the best of times, yet they are well structured and contain their own clear logic. Personally, I have a bone to pick about the composition of the advisory group that developed this standard. If you look closely, you can see that, out of 22 members, there were three pharmacists on this group. One was a senior hospital pharmacist. The second was a PSI nominee. The third was an IPU nominee. The footnotes singled out the IPU nominee as being there at the behest of the IPU. Well, excuse me for wanting a subject expert on a working group. Community pharmacists will be, by far, the largest users of electronic prescriptions. They will probably be the largest creators of dispensing records. Yet, HIQA found it appropriate to have only a single community pharmacist representative on its standards working group. I should add that there are, rightly, two separate patient representatives on this group. Personally, I regard this as a fundamental problem in the way HIQA has approached this standard, and it shows. It is reminiscent of the recruitment process for pharmacists on the various national ePrescription projects, where only HSE employees could apply.

This standard is supposed to pave the way for full prescription interchange between EU countries. The only way it can possibly do this is by following the EU, in the XT-EHR project. While this is still ongoing, it is obvious that much of the core work is pretty much set in stone. In the spirit of the modern, I turned to AI. I ran a comparison of the HIQA standard with the XT-EHR, April 2026 version. It would be fair to say that there is some work to be done to align the two. A simple example is allergies. While it might be useful to have these summarily identified on a prescription, it is a complex area. And any pharmacist definitely needs to know if there are no known drug allergies. Not on our spec. I could go on, but I have left that pleasure to HIQA. This is our future. The least that could happen is that working community pharmacists be part of the solution.