Recent engagement between the Pharmacy Contractors Committee (PCC), the Department of Health, and the HSE has resulted in agreement on a new approach to medicines optimisation within the Community Pharmacy Agreement 2025 (CPA25). This follows a period of detailed discussion on the future of phased dispensing arrangements and how best to support patients who require additional assistance in managing their medicines.

The agreed model replaces the previous phased dispensing approach with a structured Medicines Optimisation Support Service, which will come into effect from 1 June 2026. This marks an important development in how medicines support is delivered in community pharmacy, with a clearer focus on patient need, clinical judgement, and appropriate use of resources.

At its core, the new service recognises the role of the pharmacist in supporting patients to use their medicines safely and effectively. Pharmacists are entrusted to determine, based on their professional judgement, when additional supports are required and what form those supports should take. This reflects both regulatory expectations and established practice, where patient counselling and individualised care are central to the pharmacist’s role.

A key feature of the agreement is the introduction of a medicines optimisation fee across all GMS items, alongside an enhanced monthly support fee for patients requiring more intensive intervention. These arrangements are designed to support pharmacists in providing clinically appropriate care to defined patient cohorts, particularly those who may be at greater risk due to the nature of their medicines, their clinical condition, or wider social factors.

Importantly, the new model enables a more flexible and patient-centred approach. Rather than relying on a single mechanism, such as phased dispensing or monitored dosage systems, pharmacists will have the ability to apply a range of supports tailored to individual needs. These may include practical adjustments to packaging, patient counselling, adherence supports, or, where appropriate, more structured interventions.

In line with international evidence and best practice, the agreement also reinforces that monitored dosage systems should be used judiciously and only where clinically appropriate. Maintaining medicines in their original packaging, where possible, supports safety, traceability, and patient understanding, and helps to preserve patient autonomy.

Another important aspect of the new arrangements is the reduction in administrative burden. By reconfiguring existing funding and processes, the model is intended to support a more efficient use of time across pharmacy, general practice, and the wider system, allowing greater focus on direct patient care.

Overall, this agreement represents a considered evolution of existing arrangements. It builds on the strengths of community pharmacy, supports the delivery of safe and effective care, and aligns with a broader direction of travel towards more patient-focused services.

As with any change of this scale, implementation will be important. Further guidance will issue to support pharmacists and their teams, and engagement will continue with all stakeholders to ensure the model operates effectively in practice.

This development reflects ongoing work to ensure that community pharmacy continues to play a central role in supporting patients in the safe and effective use of medicines, in a way that is both practical and sustainable for the future.