A New Way of Working in Community Pharmacy

We have developed a new and exciting way to work in Community Pharmacy.

As a pharmacy owner, we know that our most valuable assets are our pharmacists. They are highly trained and are the most accessible healthcare professionals available without registration or appointment.

However, most are mainly tied up in the dispensing process, where they can only add value in 2 places. At the beginning, clinically checking prescriptions and at the end speaking to the patients ensuring they are getting the most from their medicines. Everything else should be delegated or automated.

Why are pharmacists processing prescriptions, labelling, ordering stock, and generally running the dispensary when other staff are perfectly capable of doing so?

It doesn't have to be this way. Currently most pharmacist workflows are governed by their PMR system. Most of these systems were developed more than 10 years ago and have just been tweaked or had additions bolted on as the pharmacy landscape has evolved (Recording services, partial integrations with other software, Hub & Spoke, etc). This has limited their ability to help pharmacists create slick, efficient, cost-effective workflows and are not really fit for purpose.

Things needed to change.

We took a step back and designed the most efficient and lean dispensing process and then we used the latest technologies to automate it, creating Pharmacy-X

Here’s our process for dispensing repeat prescriptions coming directly from the surgery

Prescriptions are downloaded (in England) or scanned in (in Wales) to Pharmacy-X and the process becomes paperless.

The pharmacist performs the clinical checks. The system will remember that the pharmacist is happy for that patient to take that combination of drugs, therefore there is no need for a pharmacist to view and check that prescription next time unless there is a change or an addition to the prescription. But they can also decide that they do want to see it again at every dispensing if for example high risk drugs are involved.

The stock is now ordered. An order is generated and transmitted to the suppliers using a cascade ordering system, so that each drug is sourced from the most cost-effective supplier and therefore maximising margin. This “Just-in-Time” ordering method has led to a 70% reduction in stock holding. The only stock needed to be kept on the shelves is that needed for walk-in patients.

When the stock arrives from the suppliers, it’s scanned directly into patient baskets. Once all the stock has been scanned, the baskets are complete, and dispensing can begin.

The stock in each complete patient basket is scanned. A label for that product is only produced if that product is needed for that patient. If an incorrect product is scanned a label will not be produced and therefore can’t be dispensed by mistake. When all products for the patient have been labelled, the dispenser has the option to print a bag label. The order doesn’t need to be accuracy checked by a pharmacist or ACT if all the packs are full original packs as a mistake couldn’t have been made. If a split pack was produced, an accuracy check is needed as an error could have been introduced, therefore a bag label can’t be printed until an accuracy check has been performed.

The completed package can be added to a shelf. The exact shelf location is recorded for easier retrieval when the patient calls in, and the patient is sent a text to say their medication is now ready for them to collect. If the prescription is to be delivered, it can be scanned directly into a delivery app.

This new process improves customer satisfaction because of it being quicker, and they are being fully informed of the progress of their prescription. It also means that incoming phone calls from patients wanting to know if their medication is ready are significantly reduced.

This safer and more efficient process means pharmacists need to do 90% fewer clinical checks and 70% fewer accuracy checks.

The pharmacist is largely freed from dispensing and is therefore able to take advantage of generating extra service income.

Our pharmacies are seeing increased prescription volume at the same time as generating £1500 of extra service income each week

Our pharmacists have much better job satisfaction as they are spending more time on patient care and have a more clinical role.  Our dispensers and technicians do too as they relish the increased responsibility of running the dispensary.

At a recent pharmacy event a fellow contractor approached me to tell me that a locum that we both use finds Pharmacy-X fantastic and really enjoys working in our pharmacies. High praise indeed!

With patients having a better experience, staff being more fulfilled and service income significantly increased, everyone wins.