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Final word: Charting a course for pharmacy

In previous articles in this series, Harry McQuillan has outlined the clinical pharmacy services of the future and the education and training needed to deliver them effectively. There is still, however, the small matter of how to make space for all those conversations and interventions...

Let me first be clear with regards to the elephant in the room: supply must stay with the community pharmacy network. 

Aside from the income from this activity making the rest of our services possible, that regular patient interaction of prescription handover is the single most important opportunity that we have to improve medicines safety and spread the word about the various other care services available from pharmacies. 

The issue at hand is not how we move away from dispensing, but how we embrace technology and build our teams to move it into the background.

Bold step

We have been working to this end for many years. However, when I speak to practising community pharmacists, I hear that their experience can still be of long periods at the dispensary counter performing combined clinical/accuracy checks and even dipping in and out of assembly tasks from time to time. 

To counter this, I do take heart in that I am increasingly seeing change catalysed by the implementation of independent prescribing services as owners and teams alike realise they have no choice but to take a bold step and reimagine their day-to-day work as their pharmacists are drawn in a new, arguably more fulfilling direction. 

Another game-changer coming down the line for the entire network in Scotland is the Digital Prescribing and Dispensing Pathways programme (DPDP), which aims to move to an entirely paperless end-to-end prescribing and dispensing journey. 

We at CPS are working closely with this project team to influence the programme’s scope and gain support to establish potential dispensing processes that maximise efficiency and accuracy, leaving the safety to pharmacists. 

My team even visited Sweden recently to explore how other countries manage the demands on their pharmacies efficiently.

In my opinion, our aim should be that the only touchpoint for a pharmacist in the dispensing process is the clinical check and any intervention that arises from this. We must design everything else to be run by our trained support teams and the ever-improving IT at our disposal.

“The issue at hand is not how we move away from dispensing, but how we embrace technology and build our teams”

Seamless care

The good news is that most of the components we need to achieve this are either already with us or on their way. 

While robotics is a significant investment and is not the answer for everyone, colleagues who have installed this technology tell me that it releases time that can be refocused on patient care and other activities. 

The newest generation of prescription assembly kit is very impressive and when combined with accuracy scanning, can assist in achieving our goal of seamless supply and care. 

New functions

You may also have noticed that new qualifications have come on stream in recent years, supporting the wider team to take on accuracy checking and transforming operations.

The functions I am most looking forward to coming to fruition and being universally adopted are those being worked on by PMR suppliers. Recent demonstrations include an auto-processing feature that uses trusted directions mapping to save hours on “labelling” time. 

It is my view that utilising scanners and barcode technology to empower any team member to guarantee dispensing accuracy will be what really brings about whole-system change. This is in the works and starting to be deployed across a number of providers. Speak to your PMR partners to hear more about their work to improve your team’s efficiency – you will most likely be as excited as I was to hear what they have in store.

Time to let go

Whatever route each pharmacy chooses to go down, I return to my original point – we must be considering now, in advance of independent prescribing becoming the norm, how we make accurate dispensing as automated as possible so that the future I have described in this series can be achieved. 

Only then can we as pharmacists, practising at the heart of our communities, be comfortable letting go and delegating our (up until now) continual involvement in accuracy – and focus entirely on ensuring the safe and effective use of medicines. It is, after all, our reason for being.

Harry McQuillan is the chief executive of Community Pharmacy Scotland

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