Minister for Health Simon Harris has signed amending regulations to facilitate how prescription-only medicines, including controlled drugs, can be supplied to patients by pharmacists during the COVID-19 pandemic to ensure continued care and treatment for patients.
The changes amend the Medicinal Products (Prescription and Control of Supply) Regulations 2003 (as amended) and the Misuse of Drugs Regulations 2017 (as amended).
The purpose of these changes is to ensure continuity of care and access to treatment for patients during the Covid-19 pandemic and to reduce some of the burden on prescribers and the broader healthcare system.
Joint Guidance
To assist pharmacists and prescribers, the PSI, Medical Council and HSE have published
joint guidance setting out the amendments to the legislation for supply of prescription-only medicines during the Covid-19 pandemic.
Key Changes
- National electronic prescription transfer: The electronic transfer of a prescription between the prescriber and pharmacy is provided for through the use of the HSE Healthmail® system. This will remove the requirement for paper copy of a prescription to be forwarded to a pharmacy once this closed-system electronic service is used.
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Maximum validity of prescriptions: This has increased temporarily from 6 months to 9 months from the date specified on the prescription (some restrictions continue to apply around the dispensing of Controlled Drugs); only where in the pharmacist’s professional judgement, after consultation with the patient, and if needs be the prescriber, continued treatment is required and it is safe and appropriate to do so.
- Repeating prescriptions: The number of repeats which may be supplied for both S1A and S1B medicinal products has been increased temporarily to enable pharmacists’ continuity of patient care without necessarily requiring a new prescription.
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Emergency supply provisions: -
A pharmacist can dispense up to 10 days’ emergency supply of a prescription only medicinal product at the request of a patient, including the Schedule 4 Part 1 Controlled Drugs: midazolam, clobazam and clonazepam for the treatment of epilepsy.
- A pharmacist can dispense up to five days’ emergency supply of a Schedule 2, 3 or 4 Controlled Drug in defined circumstances, at the request of a prescriber or a patient.
- In addition to the existing provisions for emergency supply at the request of a prescriber, a prescriber can also request an emergency supply of the Schedule 4 Part 1 Controlled Drugs - midazolam, clobazam and clonazepam for the treatment of epilepsy.
Full details of the amendments are provided in the joint guidance.
Professional judgement and collaboration
Changes in the legislation enable pharmacists to make additional supplies of prescription-only medicines to patients without obtaining a new prescription from the prescriber, where in the pharmacist’s professional judgement it is safe and appropriate to do so.
Pharmacists should discuss the patient’s treatment with them to ensure that it is appropriate and necessary for their continued care for further supplies to be made. This places significant emphasis on a pharmacist’s professional decision making, and the
Code of Conduct can be used as a supportive framework within which pharmacists feel able to exercise their professional judgement, including in emergency or exceptional situations, motivated only by the core concern to provide safe and appropriate patient care.
Collaboration between prescriber and pharmacist remains vital, and the pharmacist should contact the prescriber to discuss the patient’s care if in doubt as to whether it is the intention of the prescriber for a continued supply of a medicine to be made, or the pharmacist wishes to obtain further information on whether it is safe or in the patient’s best interest to do so.
We have developed
frequently asked questions and answers to assist pharmacists when supplying prescription-only medicines during the Covid-19 pandemic. The HSE has also developed
frequently asked questions and answers to assist pharmacists.
Questions about the guidance or the changes that have been made to the legislation can be sent by email to
info@psi.ie.