The
Pharmaceutical Journal
Vol 275 No 7356 p18
2 July 2005
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DispensingAutomation and workloadsFrom Mr R. Gartside, FRPharmS What an excellent and interesting paper from Fitzpatrick et al (PJ, 18 June, pp763-5) and how gratifying that their results so closely parallel those found in Welsh hospitals. Participants may recall that I summarised this Welsh work for the Pharmacist’s Defence Association conference earlier this year, reaching the conclusion that installation of dispensing robots in hospitals brings work output (expressed as dispensed items per man hour) up towards that achieved in community pharmacy without the aid of robots. This also proves to be the case in this study. Before automation, the work output in the subject hospital was measured as 5.82 dispensed items per man hour (2,669 items per week, requiring 458 technician hours). After the robot was installed and run up this output increased to 8.55 dispensed items per man hour (3,175 items per week, requiring 371 technician hours). The best Welsh hospital achieved circa 10 dispensed items per man hour. It should be noted that this work did not include any pharmacist time for clinical checks, which were carried out separately. It was, presumably, simple assembly, labelling and accuracy checking of containers of medicines. An implicit assumption of the new contract for community pharmacy is that one person will be employed for each 3,000 items dispensed per month. Since general medical practice effectively moved to a five-day week under the new GMS contract, most community pharmacies now do little dispensing on Saturdays. On the basis of a 4.3-week month, a five-day week, and an eight-hour day this implies a work throughput of 17.44 dispensed items per person per hour and it should be noted that this includes pharmacists’ time in carrying out clinical checks. Even assuming a five-and-a-half day week and a nine-and-a-half hour day this figure is still 13.35 dispensed items per man hour. It is notorious that higher work levels are achieved in practice and that a reduction to 3,000 dispensed items per man month would be welcomed by many. The discrepancy between workloads in hospital and community practice demands an explanation. It is unlikely that differences in the actual work can be great since the mechanics of the dispensing process are essentially the same in both cases. Indeed, the greater division of labour in hospital practice would be expected to lead to greater efficiency in working. At the very least, the profession has a right to expect a detailed inquiry by Dr Jim Smith’s successor. I have not mentioned patient safety in this letter since the reported rate of dispensing errors is heavily dependent on the definition of “errors”. However, British work published on the internet suggest from an examination of 125,000 items dispensed in the community that a patient-threatening dispensing error occurs in four of every 10,000 script items although the incidence of minor errors might be cause for concern anyway. Robert Gartside |
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