The annual IPU National Pharmacy Conference took place on 22-24 April in the Crowne Plaza hotel, Northwood, Dublin. Over 180 pharmacists joined us over the weekend to attend continuing education sessions, participate in the Panel Discussion and network with colleagues in the pharmacy sector. In this article, Aoibheann Ní Shúilleabháin, Marketing & Events Executive, gives an overview of the weekend’s events.

The theme of this year’s Conference was Community Pharmacy – the Heart of Healthcare,

which highlighted the role that pharmacists can play in the community and the expanded role of pharmacists in the healthcare system. We were delighted to have the acting Minister for Health, Leo Varadkar, in attendance on the Saturday to address attendees and to engage with us on the role of pharmacy in the healthcare system.

The Conference commenced on Friday evening, where, for the first time, pharmacy staff members were invited to attend the Conference. The Tradeshow Exhibition opened on Friday afternoon, with 30 companies present to meet with pharmacists and share their products and services. An educational session, The Science of Retail, was delivered

IPU National Pharmacy Conference 2016

PHARMACY CONFERENCE 2016 Aoibheann Ní Shúilleabháin. Marketing & Events Executive

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on Friday by Darragh Kelly, Retail Director, Uniphar Retail Services, which was suitable to both pharmacists and pharmacy staff alike.

The Conference provided pharmacists with the opportunity to attend five continuing educational sessions over the weekend, with a mix of both professional and business sessions to support them with their continuing professional development (CPD). The wide variety of sessions were tailored for pharmacists and offered attendees the

opportunity to gain an array of knowledge for their day-to-day practice as pharmacists and for sustaining and developing their pharmacy businesses.

Parallel sessions were held on Saturday and Sunday, with business sessions on Saturday focusing on financial advice for pharmacists. Fitzgerald Power, who recently carried out the review of the Irish community pharmacy sector, provided an overview of the financial performance of the pharmacy sector in 2014 and 2015, as well as the use of key performance indicators

(KPIs) for pharmacy sector benchmarking. Moore Wealth Management presented on the importance of financial planning for the future. They highlighted the need to set financial goals and objectives and to ensure you are kept up-to-speed on areas such as pensions structures, risk management, taxation and investment strategies.

Dr Niall Colwell (Cardiologist and Physician, South Tipperary General Hospital) and Prof Donal O’Shea delivered the clinical topics on Saturday. Dr Colwell

provided a clinical perspective on the current therapies used in the management of dyslipidaemias. Prof O’Shea, a member of the Department of Health special action group on obesity, discussed the role of the pharmacist in helping patients lead healthy lifestyles. He highlighted that pharmacists are very well placed to both give lifestyle advice and lead by example within the community.

Sessions continued on Sunday morning with pharmacists hearing from Dr Marie Laffoy, National

“ Many of the new services being proposed [...] represent the growth of professional practice. This is an extension of what you’ve always been doing: clinical advice, referral, providing health information, long-term patient relationships, which cement your place as an early port of call in community healthcare.”

Minister for Health, Leo Varadkar, TD

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Cancer Control Programme, on the topic of skin cancer. With skin cancer being the most common cancer in Ireland, the session educated pharmacists about the various techniques used to identify at-risk patients and the role they can play in skin cancer prevention. Patricia Ging, Transplant and Pulmonary Hypertension Pharmacist at the Mater Misericordiae University Hospital, delivered an informative session on Pharmaceutical Care of the Transplant Patient. She provided valuable counselling points on the range of medications that are dispensed by community pharmacists to transplant patients.

Practical advice on the importance of developing an online strategy for your pharmacy was presented by Elmer Kerr, Director Sales & Marketing, PMM Group, on Sunday morning. The session focused on combining online marketing with standard offline advertising channels

and how to interact with customers through the key online platforms. Your Daily Loyalty Medicine was presented by Gary Brown, Executive Chairman, Target McConnells, and advised attendees on the importance of building and maintaining customer loyalty, with some examples of pharmacies who have excelled in doing this.

A certificate of attendance will be sent to all pharmacists who attended sessions for their CPD portfolio.

Tradeshow ExhibitionAs well as innovative learning experiences, the Conference provided invaluable networking opportunities and face-to-face contact with peers, with over 30 stands in the exhibition hall. There was a great atmosphere throughout the exhibition hall as pharmacists met with representatives from leading suppliers to community pharmacy.

A competition was held where attendees had to collect a sticker from each of the exhibitors present. Congratulations to Marie McConn who won a two-night stay in the Crowne Plaza.

The Conference could not exist without the support of all our sponsors and exhibitors, particularly Uniphar Group as Platinum Sponsor for the sixth consecutive year. See photos from the Tradeshow Exhibition on pages 52-54.

Minister’s address

The Minister for Health, Leo Varadkar, addressed attendees on the Saturday morning and acknowledged “the IPU’s long history of representing pharmacists in Ireland and engaging with the State to provide community pharmacy services”.

The Minister discussed the ongoing negotiations in forming a new Government before moving on to health matters. The Minister

highlighted the need to look at all aspects of drug spending, including ingredient costs and the supply chain.

The Minister thanked pharmacists for already playing their part in reducing expenditure on drugs through generic substitution and reference pricing. He also recognised the contribution pharmacists had made through savings under FEMPI and stated that some funding had been set aside for pharmacists to begin the unwinding of FEMPI.

The Minister discussed how payment structures are directly linked to services, which they should have been from the very start. He said, “The fact that a pharmacist is paid a fee that is greater than the factory price of a medicine really misses the point in my view. It’s not about the price of the medicine. The value that the pharmacist adds is in dispensing, advising patients, detecting potential adverse drug reactions and correcting prescribing errors and other tasks; the value is in the service, not a percentage mark-up on the medicine.”

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Pictured at the signing of the Relationship Values Charter between the IPU and the HSE were (L-R): Leo Varadkar, TD, Minister for Health; Anne Marie Hoey (Assistant National Director, Primary Care Reimbursement and Eligibility; and Kathy Maher, IPU President.

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The Minister also discussed the future role of pharmacists and how more and better services might be provided. “Many of the new services being proposed, as part of the evolving role of community pharmacy in healthcare, represent the growth of professional practice. This is an extension of what you’ve always been doing: clinical advice, referral, providing health information, long-term patient relationships, which cement your place as an early port of call in community healthcare, allowing pharmacists and pharmacies to improve initial access to healthcare. Such proposals like medicine reviews, emergency contraception supply, screening, managing chronically-ill patients and new medicines services represent a clear advance of clinical practice. And as a profession you’re right to be cautious but also ambitious in testing these steps carefully and bearing in mind where this risk is carried.

“Some of this innovation is already in place; pharmacy-based vaccine is an excellent example of safely making health services more accessible to patients. As you know, it’s anticipated that that will be extended in practice to shingles and the pneumococcal vaccines later this year.”

The Minister also discussed other services that will be provided through pharmacies with an important announcement. He said, “I am very pleased to confirm that the pilot scheme for minor ailments, which is being developed by the IPU and the HSE, that’s due to start in June this year.” The Minister said that if the pilot works that it will be rolled out across the country and extended to more minor ailments, allowing medical card patients to go to their pharmacist as the first port of call, rather than having to make an unnecessary trip to a GP, which a private patient doesn’t have to do.

The Minister called for more collaboration between healthcare professionals, both at a national level, between professional bodies and regulators, and at a local level, between pharmacists and GPs, for the benefit of patients; he hopes this will be the case with the Minor Ailment Scheme.

The Minister talked about IT and eHealth, highlighting the key leadership role for pharmacists in this area. “Community pharmacists have a vital role to play in every community across the country and I fully recognise the invaluable role you play as a trusted advisor to your patients. This role will continue to develop and evolve no matter what Government we have, in my opinion, and you’ve shown your selves to be very open to change, to innovation and to improving services to your customers.”

The Minister concluded by thanking outgoing IPU President Kathy Maher and the IPU’s Executive Committee for his invite to the Conference and for the pleasure of working with them for the last number of months, and welcomed Daragh Connolly as the new IPU President.

Kathy Maher responded to the Minister’s address and thanked him for attending the Conference. Kathy highlighted how, despite the improvements in the economy, the dispensary part of the pharmacy business is not recovering to the degree it would seem. She stressed that State cuts to pharmacies have been challenging but that pharmacists have remained adaptive and resilient, while providing the same very high level of service to patients, despite yielding cuts of €2.4billion since 2009. Kathy pointed out that, on average, pharmacies are losing €7,000 a month because of reference pricing.

Kathy welcomed the Minister’s comments on the unwinding of FEMPI, but expressed concern that there has been no movement on this yet. She called for pharmacists to be treated “fairly, reasonably and equally to any other sector”.

Kathy highlighted that pharmacists are the heart of healthcare in the communities and that pharmacists have to be properly resourced for continuing to provide services to patients. With the shortage of GPs, “it is incumbent on the Government to look at where we can utilise skills”, she said. “We

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want to work in partnership, in collaboration with all healthcare professionals. Irish pharmacists want to deliver the best healthcare service that they can for their patients.”

The Minister’s support of the Minor Ailment Scheme pilot was welcomed and Kathy highlighted the IPU’s determination to work with the HSE on the implantation of the pilot.

Kathy reflected on her two-year term as IPU President and the progress that has been made in that time. “In the pursuit of a broader self-care agenda, we’ve advocated that a wider range of safe and effective range of medicines be available without prescription.” We are delighted to announce that two new products have been approved for non-prescription sale: Dovonex Psoriasis Ointment and Voltarol 2%. “This is but a small step in the right direction, but it is a step nonetheless.”

Kathy highlighted another step in progress, which came from the 2015 IPU National Pharmacy Conference, where the Minister agreed to examine the reimbursement of non-prescription supply of Emergency Hormonal Contraception to GMS patients, allowing women with

medical cards convenient and equitable access to emergency hormonal contraception from their pharmacist. Kathy expressed our delight that the Health (Miscellaneous Provisions) Bill 2016, which has now been published will, when passed, allow for this.

“We want, as a profession, to extend the care and services we provide to patients beyond the dispensing of prescriptions and medicines to patients,” she continued. “There are ways we can add value, and value is a key theme, Minister. Pharmacy-based services such as Medicine Use Reviews, new medicines services and health check services have been show internationally to improve patient health outcomes.”

Kathy concluded saying that pharmacies want to continue working in the heart of communities and called on the Minister, the Department of Health, the HSE and other State bodies to “support us in developing our profession and allowing us to reach our full potential in the delivery of a first-class healthcare service that Irish patients deserve.”

Panel DiscussionOne of the highlights of the weekend was the engaging

Panel Discussion. The Panel Discussion was held on Saturday morning with a great line-up of speakers: Gavin Jennings chaired the discussion and facilitated a lively debate, with much interaction from the audience.

Gavin Jennings, as MC of the Panel Discussion, introduced the panel members; Kathy Maher, Anne Marie Hoey (Assistant National Director, Primary Care Reimbursement and Eligibility), Derick Mitchell (CEO, IPPOSI) and Sue Sharpe (Chief Executive, PSNC). He began the discussion by asking if ‘Community Pharmacy – the Heart of Healthcare’ is true and if it can be strengthened; what more can pharmacists do to continue to play a central in helping people live healthier, longer lives; can pharmacists help relieve overstretched GPs; will more medicines be available directly from the pharmacist, and more.

Sue Sharpe discussed her role in negotiating fees with

the NHS for the services provided by pharmacists. She said that, from a patient perspective, community pharmacy is the absolute heart of healthcare but that a lot of the work pharmacists do is not documented and therefore not valued as it should be.

Kathy Maher agreed that pharmacists are always there for patients to talk through any issues and offer healthcare advice. She stressed that community pharmacy is the first port of call for healthcare needs but that “we need to ensure we have a viable and secure pharmacy sector” to continue to provide services to patients.

Anne Marie Hoey agreed that pharmacists have an important role in the community. She stressed the invaluable relationship that pharmacists have with their patients, which is evident in the amount of people who have availed of the

PHARMACY CONFERENCE 2016 /continued

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PHARMACY CONFERENCE 2016 /continued

pharmacy flu vaccination service over the last few years. She welcomed the Minister’s announcement of the Minor Ailment Scheme pilot and the potential expansion of it.

Derick Mitchell commented that if community pharmacists are to provide new services, patients will have to change to become more informed and more proactive.

Gavin Jennings asked Kathy Maher what these new service might be. Kathy discussed services that have worked well in other jurisdictions to alleviate pressure on GPs, such as the New Medicine Services, which has been successful in the UK, Medicine Use Reviews (MURs) and health check services. Kathy referenced results from a recent Behaviour & Attitudes survey, which showed that patients want more services provided through pharmacies. “89% of respondents want to see new services introduced in community pharmacy; 93% responded positively to a Minor Ailment Scheme introduction.” Kathy stressed the importance of engaging with all stakeholders in order to deliver new services.

Sue Sharpe discussed the services provided in the UK, starting with MURs, which was introduced in 2005. Sue highlighted that research showed that patients really valued it and helped them understand; they felt more involved in their own healthcare. The New Medicine Services developed from this, as the first few

weeks are important to assist patients with adherence to medicines. However, Sue said, “the initial response of the medical fraternity to MURs veered from outright hostility to indifference”. When the New Medicines Service was brought in, there was more collaboration among all healthcare providers.

Ms Hoey said the expansion of pharmacists’ role is possible but duplication of work and effort must be avoided. She stressed that “we need to make sure that we explore what’s possible, we evaluate it and that the communication channels are kept open”.

Derick Mitchell commented that the level of trust patients have in pharmacists is massive compared to other healthcare professionals so an expanded role is something IPPPOSI would be advocating for. However, he pointed out that the speed in which new services are provided is not good enough.

Gavin Jennings queried the current pharmacy contract, which does not include additional services provided by pharmacists. Kathy Maher stated that the current contract is 20 years old and precludes the Pharmacy Act. She called for a new contract that “is fit for purpose. We need one that reflects the needs of the patient and reflects the needs of the pharmacy practice.”

The discussion moved on to the topic of extending the range of medicines available without prescription. Mr Jennings asked Sue Sharpe

what impact reclassification of medicines has had on care of patients in the UK. Sue replied, “It works for patients; it works for General Practice. We have not had a single complaint or concern about the clinical aspect of the programme.”

Ms Sharpe reiterated that there is so much experience in so many other countries and stated that if the new services work in the UK, they should work in Ireland also. She received a round of applause when she commented “there’s something about just looking at the evidence from other jurisdictions and getting on with it”.

Kathy Maher commented on some of the obstacles that have prevented this from happening, including the size of the Irish market; it may not be attractive for manufacturers to apply for a reclassification of a medicine. Kathy discussed the research carried out by the IPU on this issue, where a global expert examined a model in New Zealand where the molecule was switched and pharmacists could provide the medicine under certain conditions.

Derick Mitchell supported the reclassification of medicines and felt the initial list was underwhelming and wondered why a lot more haven’t been added. Anne Marie Hoey said that “anything that can help and enable access [to medicines for patients] has to be explored and welcomed”.

The price of medicines was then discussed. Kathy commented that with

reference pricing, the price of medicines has reduced significantly in recent years. However, she stressed that we can’t compare our drugs bill to other countries, who may not include the cost of high-tech drugs in their drugs bills as they are supplied through hospitals.

She continued to say that the value of the healthcare spend is what’s important and that we need to work on keeping people out of hospitals. “The most expensive medicine is always the one that’s not taken. So for any intervention that we can make, whether it’s a New Medicines Service, whether it’s a Medicines Use Review, structured consultations and a properly-resourced service, to make sure that those patients take medicines and their outcome is as best as it can be, then we can stand over the cost of our drugs.”

Sue Sharpe discussed the cost of medicines in the UK and the reason for being cheaper is due to scale and the reimbursement system, as well as the result of pharmacy interventions. However, she said that they have real problems with access to medicines. She warned that it’s also a risk for Ireland, as a smaller market, and cautioned against a race to the bottom for medicines prices. Sue commented, “Learn from us in some respects, I would say, look carefully at the pitfalls of learning from us in terms of the pricing structures”.

Kathy stressed the importance of remembering that 80% of medication in

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Ireland is dispensed through State schemes, where the cost is controlled by the State. Derick Mitchell discussed how savings could be made by using biosimilars.

Gavin Jennings brought up the issue of the Prescription Levy and asked Kathy Maher why the IPU is calling for it to be abolished. She responded saying, “28% of people are now beginning to think twice about whether to have the prescription filled or not”. She said that it should begin with certain vulnerable patients being exempt from the levy, including homeless patients, palliative care patients and psychiatric patients.

Ms Hoey discussed the management of the drugs budget and the importance of any savings that can be made by avoiding wastage. Gavin Jennings questioned Ms Hoey on issues faced by pharmacists in being paid and communication issues between the central PCRS office and Local Health Offices. She discussed the work that is going on in improving things, including a new interface project in conjunction with the IPU. “We’re continually listening to what are the bug bearers and continually trying to work as to how best do we resolve those, either through our electronic communications or through our communications with the IPU, but on a continuous improvement programme.”

The questions were opened up to the floor and started with the ‘bureaucratic tsunami’ that is taking away from pharmacists’ day jobs of looking after their patients. Kathy Maher responded that more streamlined processes will help with this and announced that Anne Marie Hoey and herself will sign a Relationships Value Charter after the Panel Discussion, which will help eliminate some of the issues, help pharmacists get paid when they should be and includes a dispute resolution procedure.

Another issue raised from the floor was the lack of a Chief Pharmacist in the Department of Health. The need for a strong advocate to drive change, which is not happening at the moment, was highlighted. Sue Sharpe agreed that a Chief Pharmacist is required but highlights that it needs to be a Chief Pharmacist who understands community pharmacy, not just a clinician.

Other issues raised included the issue of crime in pharmacies, the recent draft regulations published by the PSI which looks at restricting the rights of Qualified Assistants, some inefficiencies in the HSE PCRS and healthcare system and the slow pace of communication between people in the healthcare system.

Gavin Jennings thanked all the Panel members and attendees, and brought the discussion to a close.

President’s Dinner & BallThe President’s Dinner & Ball was held on Saturday night. It was a full house with 270 guests, including representatives from other organisations such as the HSE, Irish Medical Organisation, National Pharmacy Association (UK), PGEU and many more.

IPU Vice-President Daragh Connolly was MC for the night and welcomed everyone to the dinner. He thanked all the sponsors and exhibitors of the Conference. Kathy Maher addressed guests and thanked those she had worked closely with over the previous two years during her term as President. Kevin Filan from Uniphar, who were Platinum Sponsors for the sixth consecutive year, also gave a short speech. IPU Trustee and Past President Tony Walsh made a presentation to Wendy McGlashan, IPU Publications and Corporate Affairs Manager, who is retiring at the end of the month after over 30 years working with the IPU.

A raffle was held in aid of the Pharmacy Benevolent Fund (PBF), which raised over €4,000. The money raised is vital to continue the good work of the PBF and is greatly appreciated by those involved. The raffle was followed by a live band, bringing the dinner to a close.

Pictures from the dinner will appear in the June issue of the IPU Review.

AGMThe AGM reports were held on the Friday evening and the motions were taken on the Sunday morning of the weekend. Eight motions were passed:

1. “That this AGM calls on the Government to recognise pharmacy as a crucial element of primary care and to allocate the necessary resources to developing pharmacy services in order to alleviate pressures caused by the persistent GP manpower crisis and ensure easy access for patients and the public to safe, convenient and cost-effective healthcare.”

2. “That this AGM calls on the Department of Health to commence negotiations with the IPU on a new Pharmacy Contract that is fit for purpose and which reflects the needs of patients and the practice of pharmacy in the 21st Century.”

3. “That this AGM calls on the Minister for Health to review the Medical Card Prescription Levy; initially by exempting all vulnerable patients – including homeless patients, palliative care patients and others who require their medication changed on a daily or weekly basis, patients in residential care settings, patients with intellectual disabilities and patients receiving treatment under the Methadone Treatment Scheme in respect of other medication that they may require – and ultimately by phasing it out over a three-year period.”

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PHARMACY CONFERENCE 2016 /continued

4. “That this AGM calls on the Minister for Health to engage promptly with the IPU on the recommendations of the Joint Committee on Health and Children on expanding the role of the pharmacist, namely:

n Establishing a New Medicines Service;

n Introduction of Medicine Use Reviews;

n Consideration of what other steps could be taken to enhance the role of the pharmacist in the provision of primary care to patients;

n Assessment of a financial incentive mechanism for pharmacists to supply biosimilars;

n A detailed analysis of the potential of community pharmacists to expand their role by delegating prescription authority to them;

n The reclassification of a wider range of medicines from prescription-only to non-prescription.”

5. “That this AGM calls upon the Department of Health and HSE to immediately roll out a national Pharmacy Minor Ailment Scheme following the completion of the three-month pilot scheme.”

6. “That this AGM calls upon the HSE to roll out a pharmacy-based anticoagulation service in areas of the country where such a service is not easily accessible.”

7. “That this AGM calls on the Department of Health and the HSE to implement the recommendations of the Joint Committee on Health and Children on medicine shortages, namely:

n Maintain strong surveillance on the impact of national medicine price policy on the medicine supply;

n Prepare a contingency plan to consider certain export controls should medicine shortages arise;

n Examine the feasibility of introducing concessionary pricing where medicine supply is an issue;

n Commission a future-focused assessment of the challenges posed by pricing, supply and demand for pharmaceuticals in Ireland.”

8. “We wish to propose that the IPU encourages further member engagement prior to making submissions to the PSI, Department of Health or any other relevant bodies.”

New President takes officeThe incoming President, Vice-President and Honorary Treasurer took up their new positions at the close of the Conference. Kathy Maher presented Daragh Connolly with the President’s Chain at the close of the AGM on Sunday afternoon. Daragh Connolly was previously Vice-President of the IPU and his term as IPU President will last for two years. Vice-President Carmel Collins and Honorary Treasurer Stephen Nolan also took up their positions for their two-year terms.

Thank you to everyone who took the time to complete the online survey. The IPU aims to provide the best benefits and services for members, and we hope that those of you who attended felt we did. If not, please tell us. Or, if you did not attend the conference, we would also love to hear why. You can email feedback to conference@ipu.ie.

Log on to www.pharmacy conference.ie to see photos from the weekend.

Save the date for 2017If you weren’t able to attend this year’s Conference, make sure you have 5-7 May in your diary for 2017. From the heart of healthcare, to the heart of Irish sporting life, Croke Park will be our destination for next year’s Conference.

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