This was a community pharmacy close to a GP practice in a town with a population of 50,000 of which the pharmacy served around 10,000. It had recently had a complete refit and was dispensing around 12,000 NHS items each month. The NHS items included supply to around 350 patients in monitored dose devices. Dispensing was highly automated using 2 robots. Other NHS services provided were the standard Scottish pharmacy contract services – CMS, eMAS, smoking cessation and the gluten free food prescribing service. A substance misuse service was provided. An extensive range of other services were delivered including independent prescribing for respiratory conditions, and pain management for common clinical conditions.
- 5.1 - Equipment and facilities needed to provide pharmacy services are readily available
- 5.2 - Equipment and facilities are: obtained from a reputable source; safe and fit for purpose; stored securely; safeguarded from unauthorized access; and appropriately maintained
Why this is notable practice
Dispensing is highly automated using 2 robots which are maintained and serviced regularly and providing an efficient dispensing process. There is a range of high specification equipment for extended services which is calibrated and PAT tested annually. These are used in consultation rooms protecting the privacy and dignity of patients.
How the pharmacy did this
The retail offering was limited to medicines and medical devices with the emphasis on service delivery including dispensing using robotics. The pharmacy dispensed a high volume of prescriptions including many compliance aids. This number had increased following automation as this was a very efficient and accurate process. The business continuity plan in place also had appropriate contingency arrangements in the event of robot malfunction. The dispensary portrayed an image of calm, with a long dispensing bench in front of a robot. Its appearance was uncluttered as all medicines were stored within the robot and were not visible to the public. A bench facing the public was used for prescription reception and the pharmacist checking area slightly off to the side to minimise distraction. Only walk-in prescriptions were dispensed in the dispensary, with a second rear dispensary used for all other dispensing except compliance aids. Compliance aids were dispensed in a dedicated room which was self-contained, including a robot, all sundries and all medicines required. The refit had included enlargement of this room, a consultation room and a treatment room. There was a dedicated waiting area that included comfortable seats and a television screen showing relevant healthcare information. The premises were observed to be clean, hygienic and well maintained.
There was a small room for the delivery of substance misuse services which also had a closed door. This was discreet and had a hatch opening through to the dispensary - care had been taken to ensure that no patient identifiable information or medicines were available from this hatch. There was a camera installed in this room for security and safety of patients and staff and all patients had been informed of this. No consultations or examinations took place in this room – it was only used for supervised consumption of medicines. An extensive range of diagnostic equipment was available and stored in the consultation and treatment rooms where it was used with patients. This included blood pressure meters, cholesterol testing equipment, diabetes testing equipment, a range of respiratory diagnostic tools such as phenol testing and spirometry, an otoscope, personal weighing scales, emergency adrenaline, and equipment and sundries required for vaccinations. The diagnostic equipment was calibrated in accordance with requirements and all portable electrical equipment was PAT tested annually. Crown stamped measures were kept by the sink in the dispensary, and separate marked ones were used for methadone. There was a ‘methameasure’ pump available for methadone use and this was cleaned after use each day and test volumes poured before use each day. Clean tablet and capsule counters were also kept in the dispensary, and separate marked ones were used for cytotoxic tablets.
What difference this made to patients
All equipment and facilities used, including new technology such as robots were properly maintained to ensure the safety of pharmacy services provided.
We have identified the standards most likely and least likely to be met in inspections, and highlighted examples of notable practice for each of these standards; to help everyone learn from others and to support continuous improvement: