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Pharmacy inspections

Inspection reports and learning from inspections

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Using automation to support the safe and efficient preparation of multi-compartment compliance packs.

Pharmacy type

Internet / Distance Selling

Pharmacy context

This is a distance selling pharmacy which is situated in an industrialunit. The pharmacy is not open to members of the public, so it deliversprescription medicines directly to people. And it also acts as a ‘hub’ anddispenses medicines in multi-compartment compliance packs for collection oronward supply from other pharmacies within the same legal entity.

Relevant standards

  • 1.1 - The risks associated with providing pharmacy services are identified and managed
  • 1.2 - The safety and quality of pharmacy services are regularly reviewed and monitored
  • 4.2 - Pharmacy services are managed and delivered safely and effectively
  • 4.3 - Medicines and medical devices are: obtained from a reputable source; safe and fit for purpose; stored securely; safeguarded from unauthorized access; supplied to the patient safely; and disposed of safely and securely

Why this is notable practice

The pharmacy invests in automation to support the pharmacy team in assembling compliance packs. The system is risk assessed regularly and has in-built safety checks to reduce the risk of human error.

How the pharmacy did this

The pharmacy had relocated into a larger industrial unit and had upgraded its dispensing robot so that it had a higher capacity for assembling multi-compartment compliance packs.

The pharmacy manager had carried out risk assessments for the dispensing robot and for the hub and spoke model. These risk assessments were ongoing and regularly reviewed. The pharmacy made changes to its standard operating procedures (SOPs) and working practices to reflect the risks identified in the assessment.

Once the pharmacy team had settled in its new location and team members had familiarised themselves with the new robot, they started to take workload from the company’s other pharmacies. There was an ‘onboarding’ process for moving the workload across and the SOP documented what part of the process the hub and spoke pharmacies were accountable for. Consent was obtained from the patient before the packs were dispensed at the pharmacy. The onboarding process had been amended based on feedback and experience. The hub and spoke gave feedback to each other so that they could improve their processes and use any issues as learning opportunities.

The team used barcodes to manage stock. The barcodes from the canisters placed into the robot and the original stock boxes were scanned before the canister was put into the robot as an accuracy check. The computer system that accompanied the robot contained photographs of the medicines and, if they were available, printed them onto the labels attached to the packs so that people could differentiate between the different medicines in there. The computer system used quick reader (QR) and barcode technology as an additional accuracy check throughout the process. Each of the compliance packs had a barcode assigned to it which was scanned throughout the dispensing process.

The robot was serviced regularly, and some team members had been trained to undertake cleaning and minor maintenance. The team had telephone numbers for technicians, and specialists if there was ever a problem.

What difference this made to patients

Well managed automation processes help support a safe and efficient dispensing process. The hub and spoke model for dispensing compliance packs reduces workload at the spoke pharmacies. This provides additional time for these pharmacies to provide other pharmacy services which benefit people. And supports pharmacies in managing staff absences which have risen during the pandemic.

Highlighted standards

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:

  1. 1.1 Risk management
  2. 1.2 Reviewing and monitoring the safety of services
  3. 4.2 Safe and effective service delivery
  4. 4.3 Sourcing and safe, secure management of medicines and devices
  5. 2.2 Staff skills and qualifications