I have been put in my place. I simply asked who asked for the law to be changed to allow sub-contracting of dispensing and I was told – representatives of community pharmacy. So I now know that all of the community pharmacists want this. I am perplexed.
I understand the value of robotic dispensing. It is faster and a whole lot more accurate than standard dispensing under the usual ridiculous pressure that pharmacy teams find themselves in – accuracy up to 99.9+% and the robots don’t get bored or distracted. It may reduce the inventory and reduce the staff costs in both pharmacists (90% reduction in checking time) and technicians. In situations, like hospitals, where time is money and in insurance based systems like the USA – it all makes great financial sense.
I also understand some of the costs – hospital systems don’t give you much/any change from half a million and then there are the additional costs to remodel the dispensary, link up to the clinical system and altering the workforce and the procurement. So community pharmacy will have to buy their own or sub-contract to robotic dispensing factories.
It will be a difficult decision for single shop or small chain independents and there are a whole heap of little niggles to be sorted out – EPS and PMRs for example. It may represent a major change in which community pharmacy is provided. There is no doubt that it has worked brilliantly in the US and has been introduced throughout Europe. There is also no doubt that there are examples in the UK and some of the larger chains, for example McKesson have huge experience in making this system work (they also build the robots).
This does not seem a simple question to me – so the put down was a little surprising. If you are in a large chain – perhaps 20+ then investing a million in a robot and associated systems may make great financial and clinical sense. Perhaps half of the prescriptions could be picked up in the robotic centre and dispensed, some being returned to the pharmacy local to the patient for collection, the rest simply posted out. But some local dispensing will always remain – well that is my assumption.
Personally I can’t wait for the opportunity to order my medicines on line and have them popped through my letterbox. And I don’t really mind who dispenses it – the NHS England default low cost dispensing factory would suite me fine. Actually I am trying to work out what happens to the tariff and clawback if your factory dispenses 50million items a year?
In hospitals, when robots freed up staff time, those pharmacists and technicians were quickly swallowed up in clinical work. Will this be the same for community pharmacy? Will clinical and service contracts follow? Has anyone projected the effect of sub-contracting dispensing services on the current community pharmacy workforce and pharmacy viability?
So what it the agenda here? I am told by C and D that it is simply making the option available to all community pharmacies. But is it to drive patient safety through increasing dispensing accuracy, to create more time for clinical interventions at the front line or to reshape the model of community pharmacy including the funding routes (contract).
I will wait to see the white paper.