A leading high street pharmacy wanted to identify end to end processing inefficiencies and improvement opportunities

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Client Needs

The pharmacy supplied hundreds of Care Homes around the country via hubs or smaller high street pharmacies. Little was known by the organisation about the end to end process, how it functioned and what types of problems were encountered. A number of complaints had been received from both owned pharmacies and Care Homes about the effectiveness of the process, which had resulted in some clients moving to other prescription providers. 

Paloma were asked to conduct an independent assessment of the entire value stream and provide recommendations on a long-term cost effective solution which met legislation requirements, protected margins and provided better on-going customer support.

How we helped

Several dispensaries and Care Homes were identified which would provide a representative view of the end to end process and the issues being faced.  Site visits were conducted by our consultants, and the end to end process was mapped and timed. Interviews were conducted with key stakeholders in each establishment to ascertain issues and identify areas for improvement. To ensure an objective and comparative view was obtained, benchmarking of other providers solutions was also conducted.

The root causes of the errors were discovered within the second week of the four week prescription cycle during the process of raising prescriptions and internal checking within the Care Homes. Potential health and safety implications and the predominantly paper based systems meant that multiple visual inspection steps had been introduced throughout the process to capture any inconsistencies and inadvertent errors. The identified issues often caused extensive delays resulting in prescriptions and medications having to be expedited so that they arrived on time to Care Home residents. Pharmacy layout provided further restrictions to flow and storage which impacted dispensing times.

The solution

A series of recommendations were provided to the board for approval and implementation. They included:

  • Suggestions for a cheaper proven dispensing solution at the pharmacy which would protect and enhance current margins.

  • Introduction of an integrated electronic medication administration record solution to improve compliance, simplify, standardise and mistake proof the current processes, reducing the need for visual inspection. It speeded up the transfer of prescription information, changes to medications and despatch of acute orders.

  • Conducting a pharmacy survey to identify General Practitioner surgeries where delays and issues occurred so that collaborative improvements could be introduced to improve service levels.

  • The pharmacy to become a central repository for CQC (Care Quality Commission) compliant process documentation and training for their Care Home customers.

  • Conducting a competitor benchmarking exercise to identify best practice processes to integrate into future service offerings.

  • Conducting satisfaction surveys within their customer base so proactive improvement measures could be implemented by account managers to reduce customer migration.


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