Professor Tom Fahey:

I thank the committee for inviting me. To provide the committee with some background, I am a clinically and research-active GP who trained in epidemiology and public health. I have been based in the UK for 14 years, working in Oxford, Bristol and latterly Dundee. Since returning to the RCSI in 2006, I have led the Centre for Primary Care Research, which is nationally funded by the Health Research Board, HRB. To give the committee a brief idea of what we have done in that time, our research group is active in the area of prescription medicines and drug safety. We work with colleagues in the school of pharmacy in Queen's University Belfast, and this has enabled us to examine the quality and safety of prescribing in Ireland both North and South and to benchmark Irish prescribing practice to other countries.

The current challenges in Ireland are that prescribing in many hospitals remains a paper-based activity; communication regarding medication for patients between hospitals, general practice and pharmacy is also predominantly paper-based. This means that transcription, dosage and monitoring errors are more common and patients are at greater risk of adverse drug events. Electronic prescribing and dispensing are the standard in general practice and pharmacy practice, but electronic prescribing and dispensing systems do not interact effectively, meaning the process of prescribing and dispensing is disjointed and poorly integrated across the health sectors. Lastly, access to prescribing data for research, education and quality improvement purposes is very limited in Ireland. The solution to all these issues is to develop an e-prescribing platform in Ireland with appropriate training and education for all health professionals involved in prescribing. Enhanced transparency in respect of prescribing practice will enable a culture of professional reflection and engagement with nationally established quality improvement initiatives, such as the medicines management programme.