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Will hub-and-spoke make dispensers expendable?

"As someone whose bread and butter consists of dispensing, I fear hubs"

How could dispensers survive in an automated future, asks Benjamin D'Montigny

Dispensing medication from a central hub is undeniably the most efficient way in terms of cost, logistics, space, accuracy and speed.

And as a dispenser, someone whose bread and butter consists of dispensing, I fear hubs – much like how the weavers of old feared the loom. It would put me and hundreds of other dispensers out of work. Dispensing and checking could soon become redundant skills that will be overtaken by robots.

I urge those interested to read a German research paper on the subject. The study looks at how dispensing robots affect business; using sales volume, acquisition costs, stock value, over-the-counter (OTC) sales, and space in pharmacu as measures.

Their conclusion? Savings. And further savings could be achieved on top of these if pharmacies reduced their staff to reflect their actual need, as well as reducing the space required to store pharmacy medicines to make room for more OTC products.

We should be mindful that this study was published seven years ago. Costs of fitting these machines have gone down loads since then. The technology has been improved in quite substantial strides.

Focus on other skills

So where does this leave us dispensers and technicians?

Well, at this point, the government certainly seems to have accepted that job losses are inevitable, considering the damage that the 6% funding cut in England is going to do to pharmacy businesses nationwide.

For us non-robot dispensers, perhaps it is a question of retraining to compliment the inescapable changes that are about to take place. Much like how pharmacists are moving to a service-driven application of their skills, dispensers and pharmacy technicians will need to adapt their skills, too.

Technicians and dispensers are in the best location for making efficiencies in their pharmacies in a magnitude of different ways. Personally, I’ve always held the opinion that they are arguably the most suitable people to manage the day-to-day running of a pharmacy.

Prescription collection, arranging delivery of medication, stock management and acquisition, HR management  these are all aspects that can be done by a technician or experienced dispenser without wasting the clinical expertise of a pharmacist. I have seen this working very well in a number of locations throughout England that use non-pharmacist managers.

A while ago I spoke of prescription optimisation in terms of prescribing appropriate quantities for patients and how bulk prescribing (a prescription for anything over 28 days’ worth of medicine) is ultimately a death sentence for pharmacy as a business.

Using the technician’s professional skills could also be invaluable in increasing efficiencies in this regard. Synchronising medications and standardising quantities through liaising with local surgeries could slash the workload of both the pharmacy and surgery.

Losing the human touch

But what do we lose when we make the shift to using more advanced technologies? When the electronic prescription service (EPS) becomes the norm and pharmacy realises that no-one else has used a fax machine since the 90s? We lose the human element to our profession.

For many elderly people I have served, visiting the pharmacy is the one social interaction they have. By making the entire process automated – removing your local dispensers, technicians, pharmacists, and healthcare assistants  you effectively remove that interaction. What was originally a place of compassion and caring for our fellow men and women, becomes the cold environment of efficient tablet distribution.

Sure, we may be addressing their medical needs. But are we addressing their social ones?

Benjamin D’Montigny is a locum dispenser working in the south of England

 

Do you agree with Mr D'Montigny?

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4 Comments

Chris ., Community pharmacist

You are wrong about non-pharmacist managers. I have worked with 4, all useless. One even wanted us to attract more paid prescriptions instead of exempt as we didn't make any money from exempt ones and it was good money if we got the prescription charges in the till....

Leon The Apothecary, Student

Our vastly different experiences perhaps shows that it is down to the individual, rather than their training, that makes good management material? It applies to both pharmacist and non-pharmacist managers. What do you think?

Harry Tolly, Pharmacist

""For many elderly people I have served, visiting the pharmacy is the one social interaction they have.""

 

His Royal Excellency, "The Chief Pharmaceutical Officer for England", hiding under his desk (used more as a bunker than a desk it seems) in SW1, seems not to place any value on this essential yet conveniently forgotten aspect.

 

Note that functional illiteracy affects 5 million people in the UK. How are they served with the warehouse model and no interaction with the pharmacist who can simply explain and answer questions ??????????

 

One wonders why His Royal Excellency was placed in this job. Note word placed.

Leon The Apothecary, Student

Social Relationships and Health: A Flashpoint for Health Policy written by Debra Umberson and Jennifer Karas Montez illustrates the importance of social interaction perfectly. What we may have as a result of the predicted closures of pharmacies across the UK, is a major increase in mental health issues caused by an increased level of social isolation. And with mental health services having had some severe reduction over the last couple of years, the UK would have a new and additional health crisis on their hands. 

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