Ms Joanne Kissane, the Registrar, explained that the Minister for Health had accepted the first recommendation of the Expert Taskforce, namely, to empower pharmacists to extend the validity period of certain prescriptions for up to a maximum of 12 months, in accordance with defined criteria, and when in the pharmacist’s professional opinion it was safe and appropriate to do so. Ms Kissane noted that a PSI communication had been sent to all registrants on 16 February to provide an update on upcoming changes to facilitate the first recommendation of the Expert Taskforce. The Registrar also highlighted a webinar delivered by the PSI and IIOP on 21 February regarding the prescription extension. From this webinar the PSI gathered all the questions submitted and they are reviewing them to classify them into themes so as they can create a FAQ that will be available on the PSI website. Ms Kissane also commented on the additional support materials in terms of the guidance documents that they are drafting to support pharmacists.
Phase one of the work of the Expert Taskforce was the extension of prescriptions and phase two is empowering pharmacists to prescribe. This second phase is currently progressing, and the Taskforce will continue to meet for a further six months (to the end of June 2024). Ms Kissane said that the taskforce is “considering the approaches to be taken on how to empower pharmacists to prescribe within their scope of practice”. The proposals for the prescribing pharmacist will be presented to the Minister in June, and Council will be updated on the outcome in September. Council welcomed the Taskforce’s recommendations and agreed that the power to extend prescriptions represented a positive outcome for patients.
Ms Kissane then explained that in 2024 the PSI hopes to operationalise the revised Third Country Qualification Recognition (TCQR) route process leading to registration as a pharmacist. The goal is for the current TCQR route to be closed by quarter four of 2024, and the revised TCQR route commenced. However, no suitable providers have been identified for an adaptation placement service, meaning outsourcing of the adaptation period is currently not a viable option. The PSI is now seeking legal advice regarding other ways in which the revised TCQR route can be operationalised. There were queries from Council members who wondered if this would result in two TCQR systems running in parallel, as one comes onstream and another closes. John Bryan, Head of Community Pharmacy Assurance at the PSI, said the PSI is still reviewing how this transition will take place in practice.
Pharmacist Council member Emily Kelly asked if current activity in terms of TCQR is in line with what would be expected. Ms Kissane admitted it is “a little bit slower than we saw last year”, but there can be peaks and troughs. There are 25 TCQR applicants coming online in the next few weeks, she said, as well as 54 candidates who sat the exam in November 2023. Pharmacist Sean Reilly, however, questioned if this level of activity was adequate, given the need to keep the number of pharmacists stable. Ms Kissane noted that the number of registered pharmacists had increased by over 400 last year, which was the highest number of pharmacists added to the Register since 2007.
Mr Reilly also referenced the need for some form of adaptation for any pharmacist practising for the first time in Ireland: “The various schemes make pharmacy in Ireland ridiculously complicated and you can’t learn that from a book . . . people get overwhelmed.” It was decided that this would be discussed by Council.
Pharmacist Mark Jordan also asked if the Registrar found the language competency requirements sufficient. Ms Kissane noted that the language requirements had been considered by the Regulatory and Professional Committee most recently in 2022, and found to be in line with other regulators — another review will take place towards the end of this year or the beginning of 2025. She also noted that “super scoring” is not evident in the exams — applicants are passing the test, but on the whole not achieving extremely high scores.
The Registrar also told the meeting that a workshop was held with ten pharmaceutical assistants on 15 February at PSI House, the aim of which was to consult with pharmaceutical assistants on the development of guidelines or ‘themes’ to support the introduction of the new CPD model.
Paula Barry Walsh asked if the timeline for the introduction of the new CPD requirements for pharmaceutical assistants is fit for purpose, given it is a strategic objective; “It would be good to know when it might be coming online from a strategic point of view.” Ms Kissane said they had engaged with the Department of Health regarding amending the current legislation but noted regarding the procurement exercise for a new CPD provider, that the PSI are seeking a single provider for CPD for both pharmaceutical assistants and pharmacists; “We will need the new provider in place by quarter one 2025 and will be developing CPD for pharmaceutical assistants at that time.” Once the Regulated Professions Act (Health and Social Care) is amended, it will then be rolled out, “so it depends on when that piece of legislation is enacted”.
The Registrar also noted that the PSI had developed draft guidance on Pharmacy Governance Roles, with four overarching governance principles identified to provide clarity on the differing responsibilities in relation to each governance role, with each principle being supported by concise, outcomes-focused indicators. The guidance also provides clarity to registrants on the legislative interpretation of ‘whole time charge’, with respect to the role of supervising pharmacists.
As she outlined progress on the Service Plan as of quarter one, Ms Kissane said she was happy to report that it was “all good” at this early stage of the year, with all projects on track as of the end of February. This does not discount the volume of work ongoing, with 12 strategic projects for delivery in 2024, as well as nine ongoing regulatory and strategic work programmes.
PSI Council President Katherine Morrow then offered an update on the development of the PSI’s 2025-2028 Corporate Strategy. She explained that the Strategy functions as a “blueprint in order to ground us in how we focus our energy and resources”. The Strategy must be ready for Ministerial review by September 2024, so there is a “busy six months ahead”, she said. Many activities have already taken place, including an internal discussion with the Council steering subgroup as well as a very productive Council away day. Significant consideration is being given to the “big questions” relating to the role of the Regulator and this engagement will continue, with Council regularly updated on progress.
This was followed by the report to Council from the Business Transformation Project Programme Board. This update was positive, with Gráinne Power explaining that phase two of the project is on track and the relationship with the vendor remains good. She also sought approval of the revised Business Transformation Project Board terms of reference, which was granted by Council.
“ The Minister for Health had accepted the first recommendation of the Expert Taskforce, namely, to empower pharmacists to extend the validity period of certain prescriptions for up to a maximum of 12 months, in accordance with defined criteria, and when in the pharmacist’s professional opinion it was safe and appropriate to do so.”
The President returned to report on two recent meetings of the Special Purposes Committee. Approval was granted for changes to the performance appraisal process of Registrar, while a number of appointments to advisory committees were also approved, as were updated terms of reference for the SPC.
Ann McGarry, chair of the Performance and Resources Committee noted that the Committee is due to consider its treasury management policy at their next meeting but sought approval of the committee work plan for 2024, which was granted, as was approval for the updated PSI procurement policy. In relation to the latter, the rules have been updated, noted Ms McGarry; there had been discussion as to whether oversight should be reduced to €25,000 or kept at €50,000 — “for now we are leaving it at €50,000,” she said.
Approval was also sought for the Updated PSI Corporate Procurement Plan 2021-2024. Ms McGarry noted that some metrics were previously difficult to deliver, therefore it has been agreed that both quantitative and qualitative reviews will take place this year to see how the PSI performed against the plan in order to see if any changes are needed for the following year. Council member Cyril Sullivan asked what advice the PSI receives on procurement and was assured that the PSI “consults extensively” on procurement.
The new ICT strategy for 2024-2027 was also approved. It was noted that ICT within PSI is of a “generally high standard relative to other regulators”, but while there is maturity in certain areas there are other areas where improvement is needed.
In Rory O’Donnell’s absence, Grainne Power led the report from the Regulatory and Professional Policy Committee, requesting approval from Council of the draft PSI Guidance on Pharmacy Governance Roles, as referred to in the Registrar’s report. Dr Denis O’Driscoll asked if the guidance in relation to the supervising pharmacist role would be clarified further, noting “it feels a little bit vague for supervising pharmacists . . . will a supervising pharmacist still take up that role given the way it is written?”
Emily Kelly said she had in fact welcomed the clarity around the supervising pharmacist role, finding it “empowering”: “It allows the supervising pharmacist to know they can take the time off . . . it is more like a job description or induction tool rather than replacing what’s already there.” This was echoed by Richard Hammond who said the principles had an “empowering message”. However, the wording was also criticised by Sean Reilly who said it was like “rearranging deckchairs on the Titanic”.
Geraldine Campbell agreed with Mr O’Driscoll that it wasn’t immediately clear, adding that the supervising pharmacist role is “the pressure point”. The goal is to “make it a job that is doable and attractive”, agreed Grainne Power; “If these principles are implemented then the supervising pharmacist should feel very confident they do not need to be in the pharmacy.” Ms Kissane asked would a line similar to this ensure that everyone was happy with the final document, and Council were found agreeable to this.
Approval was also granted by Council for the draft MPharm Accreditation policy and standards. Prof Laura Sahm asked if sufficient thought had been given to those accessing programmes with neurodiverse challenges and struggling with reasonable accommodations; “we don’t want to set people up to fail”.
Approval was also given by Council for the proposed changes to the IIOP Practice Review Policy, including the suspension of practice reviews, as discussed in the previous Council meeting.
As the meeting ended, the Registrar acknowledged the hard work done by PSI staff in recent months as they prepared for the legislative changes that would allow pharmacists to begin extending prescriptions; “We have been phenomenally busy to get prescription extension to this point. There was a huge amount of work done by our team across all departments and I want to thank them.”
Danielle Barron
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