The Pharmaceutical Journal
Vol 275 No 7360 p139
30 July 2005

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· Mental health
· Emergency supplies (2)
· CPD
· Hospital pharmacy
· Hospital sterilisation
· Reciprocity

Letters to the Editor

Hospital pharmacy

One-stop dispensing warrants further debate

From Mr L. A. Goldberg, FRPharmS

Amanda Storey raises an interesting issue (PJ, 23 July, p113) which warrants further debate. One-stop dispensing was introduced so that patients being discharged from hospital were not held up waiting for their take-home medicines to be dispensed. The Audit Commission report “A spoonful of sugar” endorsed this practice, basing its findings on a review of the limited amount of literature available at the time and consultation with advocates of one-stop dispensing. The report did not consider the manpower costs or the wastage resulting from such a service. Patients’ prescriptions are changed frequently during the acute phase of the hospital stay. What happens to the partly used packs of discontinued medicines returned to the pharmacy? Are they recycled or destroyed? In either case there are cost implications. Have they been evaluated?

One could argue that one-stop dispensing met the needs of a bygone era. With the introduction of electronic prescribing and pharmacy automation, dispensing has become more streamlined. Discharge prescriptions can now be processed automatically, the product selected and the patient-specific label attached in one operation. The speed and accuracy of this operation mean that there is no delay in supplying discharge medicines.

With the introduction of electronic identification for patients and medicines, new, safe systems of working are on the near horizon. These provide the opportunity for the pharmacy managers to re-engineer inpatient drug distribution systems in a more efficient manner.

Mrs Storey is right to question the wisdom of this practice. If hospital pharmacy services were to start with a clean sheet would anyone come up with one-stop dispensing?

Laurence A. Goldberg
Bury, Lancashire

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