Community pharmacists have a “professional obligation” to adopt automated dispensing processes, according to England’s chief pharmaceutical officer Keith Ridge.
“That type of large-scale technology is both safer and more efficient,” said Ridge, who was giving evidence to the All-Party Pharmacy Group’s inquiry into primary and community care at Westminster on 16 March 2016.
Ridge said the UK government wants to ensure that the infrastructure within community pharmacy is as efficient as possible. “Among that is ‘hub-and-spoke’ dispensing, something that is well established in some other countries,” he said, adding that the government’s planned consultation on hub-and-spoke dispensing would be launched “very soon”, and would create a level playing field for the sector.
Ridge cited evidence from the literature that suggests error rates in community pharmacy in England are far higher than in countries that have adopted automated dispensing. “With the traditional system approach to dispensing, the error rate in community pharmacy is around 3%,” he said. “In other countries, that rate is much lower: you need several zeros before the decimal place. It is so much safer. At that point it becomes a professional obligation to use those systems.”
Speaking to The Pharmaceutical Journal after the evidence session, Gareth Jones, public affairs manager at the National Pharmacy Association, said Ridge’s statement was “highly questionable”.
“We suspect the chief pharmaceutical officer is not comparing like with like. He should publish the evidence to back up the claim he made to MPs about error rates, or retract his comments,” he said.
Also speaking after the APPG event, Duncan Rudkin, chief executive of the General Pharmaceutical Council (GPhC), said that the use of technology could act “positively” to improve efficiency, quality of care and support a focus on outcomes.
He pointed to the GPhC’s Standards of Conduct, Ethics and Performance, which say that a pharmacy professional has a duty to make the best use of available resources. “[Resources] includes technology, data, time and the capacity and capability of all members of the pharmacy and wider healthcare team.”
But Rudkin added that technology could sometimes bring risks, which need to be managed appropriately. “If pharmacy owners use technology to support the delivery of pharmacy services, they must make sure they continue to meet our standards for registered pharmacies, and this includes identifying and mitigating any risks, and working with the pharmacy team to make sure they have the necessary training and skills to use the technology safely and effectively.”
Ridge made clear at the APPG meeting that his focus was for community pharmacy to make use of “large-scale” automated dispensing technologies. He added that he is concerned about the deployment of smaller scale automation in the traditional community pharmacy setting, arguing that the necessary efficiencies can’t be achieved. “We’re taking about tens of [prescriptions] per hour whereas with large-scale automation we’re talking about hundreds of prescriptions per minute.”
Ridge said that, on average, about 60% of a community pharmacist’s time is spent on dispensing, adding that 95% of community pharmacy funding is spent on supply functions, with 5% going to clinical services. “That, in many ways, is what we are trying to address,” he said. “Pharmacists are trained as clinicians and should be allowed to practice clinically irrespective of setting – whether that’s general practice, in someone’s home, in hospital or within a community pharmacy.”
However, Stephen Pound, Labour MP for Ealing North, said that the prospect of losing face-to-face consultations because of the introduction of “robo pharmacies” was terrifying.
Health minister Alistair Burt, who was also giving evidence to the APPG inquiry, sought to reassure Pound that the government considered such consultations as important. “We want pharmacists’ time to be spent on those face-to-face consultations,” he said. “We want the patient who goes to his GP to talk about his medicines to go to his pharmacist instead, because the pharmacist is likely to know more about the medicines. We want face-to-face time to be maximised.”
During the APPG evidence session, Burt confirmed that the Department of Health will extend its consultation on the proposals for the community pharmacy sector until 24 May 2016.
The Department of Health is now expected to hold another round of meetings with stakeholders, including the Pharmaceutical Services Negotiating Committee, Pharmacy Voice and the Royal Pharmaceutical Society.