Introduction

The profession of pharmacy is being challenged to play a key role in healthcare provision. A recent government publication "Pharmacy in the Future-Implementing the NHS Plan" focused on certain key areas such as helping patients get the best from their medicines, access to services, re-designing services around patients and ensuring high quality services.^[1] However, to expand into new professional roles which require more time to be devoted to the patient as opposed to the dispensing function, new models of practice must be explored. Documentation of work patterns within community pharmacy are required to inform development of such new models of practice, and the provision of new professional services.

Methodology

A randomised stratified sample of approximately 10% of community pharmacies in Northern Ireland (n=49) was performed, involving 23 independent pharmacies, 18 small multiple and 8 large multiple pharmacies. All members of staff in each pharmacy participated in the survey (n=268) including proprietor pharmacists, full and part-time pharmacists, pharmacy assistants and counter staff. Over 10,000 observations of activities performed in community pharmacies were recorded at random intervals using a multi-dimensional work sampling methodology. Data was entered into an SPSS^® spreadsheet for statistical analysis.

Results

In total 268 members of staff were surveyed, 124 in independent pharmacies, 79 in small multiple pharmacies and 65 from large multiples. Fifty-one separate categories relating to contractual, private and non-pharmaceutical related activities were identified. Over 80% of total man-hours (for all categories of staff) were spent engaged in the provision of contractual pharmaceutical services and over 1,162 episodes of counselling were documented during the study period. The largest proportion of pharmacist time was spent on the assembly and labelling of products (16.25%±10.41%), followed by handing out the prescription product and counselling (14.86%±12.26%) and other dispensing related activities such as collection of the dispensing fee, or coding and endorsing of prescriptions (8.55%±6.50%). As would have been expected, a high proportion of time was spent by counter assistants, and to a lesser extent dispensing assistants, on sales transactions, stock control and inventory. There was a trend for the proportion of time spent on contractual pharmaceutical service related activities to increase as the number of prescription items dispensed increased.

Discussion and Conclusion

According to Rutter et al (1998) documentation of work practices is necessary if pharmacy is to demonstrate its worth and justify its place in both primary and secondary care.^[2] Work sampling is in essence is a form of audit, allowing work practices to be closely examined which has the potential to improve efficiency and result in productivity gains. Such gains are necessary if value-added services are to be routinely offered by community pharmacists in the future.

References

1. Department of Health. Pharmacy in the Future - Implementing the NHS Plan. London 2000.

2. Rutter PM, Brown D, Jones IF. Pharmacy research: the place of work measurement. Int J Pharm Pract, 1998; 6: 46-58.