As part of the five-year funding contract for England – which came into force last month – the Department of Health and Social Care (DH) said the sector needs dispensing to become more efficient to free pharmacists up to provide new services, and reaffirmed plans to change legislation to encourage the use of hub-and-spoke models.
But Mr Patel stressed last week (November 7) that “large-scale dispensing” is not the answer to increased efficiencies across the sector.
He was responding to a question by C+D about what efficiencies Day Lewis may make in the future, at an event held by the Association of Independent Multiple Pharmacies (AIMp) in London.
“For the last 45 years of our pharmacy business, we have been incentivised to make efficiencies,” he said.
However, there are reasons why centralised dispensing is not “operational across the country”, Mr Patel said.
“It looks nice and shiny. Does it work? We don't know.”
The “massive range of products” and the “huge variety of different product sizes” means automating the process on a large-scale “is not easy to do”.
“Then you have the complexity of dispensing at a loss,” he added.
“The spoke is more important”
For Day Lewis, which by 2017 was using a dispensing hub to serve 30 of its 300 branches, the ‘spoke’ aspect of this model is most important, said Mr Patel. This involves looking at the various “inner processes” of a pharmacy, such as medicines deliveries or the payment claims process, to determine “how to make one strand more effective”.
For example, “using barcode scanners to verify things in the pharmacy” could prevent time wasted on “redoing” tasks, he said.
In her response to the same question, Indira Panchal, owner of the four-strong Meiklejohn Pharmacy chain in Bedfordshire, said “making sure staff are multitasking” is important for running an “efficient” pharmacy. It also helps to “make their jobs a bit more interesting, and you retain them as well”, she suggested.
Having “systems in place” to make sure staff can work across pharmacy branches is another way Ms Panchal makes her business more efficient.
“Technology is not the silver bullet,” she said.
“There are people and there are processes. For me, inefficiencies have been caused by the changes to the systems and tools that I have absolutely no control over.”
AIMp to analyse hub-and-spoke
AIMp chief executive Leyla Hannbeck explained that the hub-and-spoke agenda is a “key legislative focus” for the organisation, which is forming a “working group” to “analyse the practicalities” surrounding the model, including costs, workforce and equipment.
“We believe strongly that community pharmacy must speak positively and authoritatively with one voice,” Ms Hannbeck added.