What Will Enable the Next Phase of Pharmacy Practice in Ireland?

Pharmacy in Ireland is shifting beyond its traditional dispensing-centred model toward a more holistic, digitally enabled and patient-focused role, encompassing prevention, management of common conditions, and expanded support for patient care, underpinned by stronger systems, better data, and sustainable workforce planning.

In brief

• Pharmacy in Ireland is no longer being asked whether it should do more, but how quickly the system can enable expanded clinical roles.
• Expectations have risen faster than infrastructure, exposing structural weaknesses across community and hospital settings.
• Expanded scope will not be delivered without parallel action on system design, digital enablement and workforce sustainability.
• Digital capability will be a critical foundation for safe, sustainable expansion of pharmacy services over the next decade.

Pharmacy in Ireland is entering a period of significant change. Over the past five years, the profession has navigated disruption, rising demand and evolving policy expectations across community and hospital settings. As the health system continues to reform, questions are increasingly being asked about how pharmacy’s role might develop - and what capabilities will be needed to support that evolution over the next decade.

Ireland has approximately 2,000 community pharmacies and approximately 7,000 registered pharmacists. Over 90% of the population lives within 5km of a pharmacy, making pharmacy one of the most geographically distributed and accessible parts of the health system.

During COVID-19, this accessibility proved critical. Pharmacies remained open while many services shifted to remote delivery, absorbing significant additional workload - from emergency supply of medicines to the delivery of COVID-19 vaccination. Hospital pharmacy teams, in parallel, continued to develop and deliver increasingly complex clinical and safety functions inside hospitals, with safe and appropriate medicines use at the core of their contribution.

However, emergency measures during the pandemic also exposed long-standing inefficiencies in prescribing, dispensing and medicines reconciliation. Digital stopgaps - including expanded use of Healthmail - highlighted the absence of a national, interoperable prescribing infrastructure. At the same time, policymakers gained real-world evidence that pharmacists could deliver expanded services at scale, while the public’s expectations of pharmacy’s role continued to rise.

That public mandate is now clear. A national survey commissioned by the Irish Pharmacy Union (IPU) in 2025 found strong public support for expanding pharmacy services in Ireland’s community pharmacies, with 97% of people trusting the advice they receive from pharmacists and 94% supporting pharmacist prescribing. While this public confidence is an asset, it also raises the bar: expectation is increasing faster than the enabling infrastructure.

Fortunately, the final report (2024) from the Expert Taskforce to Support the Expansion of the Role of Pharmacy set out a structured roadmap for expanded services in primary and secondary care, including

• independent prescribing by pharmacists for defined conditions
• extension of prescription validity beyond six months for stable patients
• expansion of pharmacy-delivered services aligned with Sláintecare objectives
• reform of contractual and reimbursement models to support service delivery.

These recommendations sit alongside the Community Pharmacy Agreement 2025, which explicitly positions pharmacy as a delivery partner for integrated care rather than solely as a dispensing contractor. Taken together, these developments mark a shift from whether pharmacy should do more, to how quickly the system can enable it.

While these developments have been welcome, the underlying operating model for pharmacy has changed far more slowly. Across settings, pharmacists face similar challenges:

• rising clinical and governance expectations
• evolving patient expectations, shaped by increasing access to health technology, data and information – but often also guided by prevalent health misinformation
• increasing demand driven by ageing, multimorbidity and polypharmacy
• workforce shortages and retention pressures
• digital systems that often add rather than remove complexity.

In community pharmacy, this tension is particularly acute. High-volume dispensing models, tightly controlled reimbursement and limited capital headroom make it difficult to absorb expanded clinical responsibilities without redesigning how services are funded and delivered. The IPU has been direct on this point: the future may be “busy”, but it must also be viable - economically and operationally - if expanded services are to be delivered safely and sustainably.

In hospital pharmacy, the challenge is different but closely related. Pharmacists are deeply embedded in clinical care and central to medicines safety and governance, yet their effectiveness is constrained by workforce pressures and fragmented digital infrastructure - particularly at transitions of care. These handovers are consistently identified as one of the highest-risk areas in the medicines pathway, where medicines information is still frequently incomplete, delayed or manually transcribed. System design matters: without safer, more connected information flows at transitions of care, the risk of error - including unintended prescribing and reconciliation problems - remains unacceptably high.

Workforce sustainability cuts across both community and hospital settings. In 2022, the Pharmaceutical Society of Ireland (PSI) published its Emerging risks to the future pharmacy workforce project. This sought to establish a baseline view of the key challenges and opportunities across the pharmacist workforce.  Key findings, as set out in the PSI’s Workforce Intelligence Report, included capacity pressures, changing career intentions and growing demands on scope of practice, with 27% of pharmacists indicating a likelihood that they will leave the profession.

This work reflects wider evidence from Irish and international surveys, which point to increasing workload intensity, stress and concerns about long-term viability among pharmacists. These trends matter, not only for workforce planning, but for patient safety and service continuity, particularly as policy ambition continues to expand the role of pharmacy.

A key recommendation of the Workforce Intelligence Report was to establish a multi-agency Pharmacy Workforce Working Group. A joint initiative of the PSI and Department of Health, this Working Group has oversight for the implementation of other recommendations, including in relation to Strategic Workforce Planning, Leadership of and for the Profession, Innovation and Technology, and Career Sustainability and Working Conditions.

Digital: the foundation for the next phase

Across these different initiatives, digital capability has been repeatedly identified as a critical enabler of the future role envisaged for pharmacy in Ireland. The Expert Taskforce, for example, highlighted the need for digital infrastructure to underpin expanded scope, while the Community Pharmacy Agreement 2025 recognised the importance of data, interoperability and digital systems in supporting pharmacy’s contribution to integrated care. Similarly, the PSI’s Workforce Intelligence Report was explicit that innovation and technology must form a core pillar of the response to emerging workforce risks.

Today, pharmacy practice across both community and hospital settings remains heavily reliant on manual and semi-digital processes. As scope of practice expands, this model becomes increasingly unsustainable.

But there are many reasons for optimism. 

The National ePrescribing Programme, alongside the ambitions set out in Ireland’s wider digital health strategy, Digital for Care, has the potential to serve as a core enabler of system-wide change. Properly implemented, ePrescribing will do far more than replace paper or scanned prescriptions and can instead establish a single, structured and authoritative source of prescribing information - supporting safer dispensing, reducing administrative burden and enabling pharmacists to practise with greater clinical confidence across care settings.

Critically, ePrescribing is a prerequisite for many of the changes now being asked of the profession -

• pharmacist prescribing at scale, supported by structured workflows
• reduced administrative burden and less re-keying of prescriptions
• safer medicines reconciliation, particularly across transitions of care
• data driven insights to support safer care, quality improvement and population-level medicines oversight
• meaningful integration between community and hospital pharmacy through shared medicines information
• creating the conditions for patients to better understand and manage their medicines.

Without ePrescribing, expanded scope risks being layered on top of already fragile processes, increasing risk and workload rather than improving care; with it, pharmacy practice can be redesigned around safer, more efficient workflows.

However, ePrescribing does not operate in isolation. Its value will only be fully realised when embedded within a wider pharmacy-focused digital architecture.

Access to the National Shared Care Record, the HSE App and the Community Care Record and, in time, the Electronic Health Record will build directly on ePrescribing by enabling pharmacists to see how medicines are initiated, modified and discontinued across care settings. For pharmacy, this is particularly important at admission, transfer and discharge – those points of highest risk for medicines-related harm.

The National Medicinal Product Catalogue (NMPC), meanwhile, will provide the structured medicines data - identifiers, strengths, formulations and relationships - required to support safe digital prescribing, dispensing and clinical decision support. Without this foundation, alongside the adoption of open healthcare standards, interoperability is limited and decision-support tools are unreliable. The NMPC is therefore a core enabler of safe pharmacy practice in a digital environment, not simply a technical dataset.

These developments are also aligned with the broader direction of travel at European level through the development of the European Health Data Space (EHDS). For pharmacy, the EHDS reinforces the importance of standardised medicines data, interoperability and the responsible reuse of prescribing and dispensing information for patient safety, pharmacovigilance and real-world evidence.

Looking ahead, this foundation also creates the conditions for the responsible adoption of artificial intelligence in pharmacy practice. As the IPU has recently highlighted, AI’s role in pharmacy is not to replace professional judgement, but to support it — through clinical decision support, medicines optimisation, workload prioritisation and population-level insight. The International Pharmaceutical Federation (FIP) AI Toolkit for Pharmacy (2025), provides pharmacists with a structured roadmap for integrating AI into daily practice, while the PGEU Position Paper on AI outlines seven key enablers for responsible use. Importantly, AI in pharmacy is only as safe and effective as the data and systems that underpin it. Structured medicines data, ePrescribing, the National Shared Care Record and the other digital initiatives under the Digital for Health plan are therefore prerequisites, not optional extras.

Taken together, these initiatives should enable a shift in the underlying model of pharmacy practice, one which supports not only safer dispensing, but the evolution of pharmacy towards more clinically focused, team-based and digitally enabled models of care. While the current state remains challenging, the direction of travel is clear. If delivered coherently, this digital foundation can reduce risk, release professional capacity and enable pharmacy - across both community and hospital settings - to practise at the level now expected of it, safely and sustainably.