As a pharmacy proprietor, I have been looking at automation for a couple of years to improve our business efficiency and build a foundation for growth, says Mohammed Hussain…
 

The pandemic with all its myriad and conflicting demands has accelerated the case for working differently, but does that mean investing more in dispensing or services?

Long before the pandemic and the super deduction announced by the Chancellor, as a business we were already considering a dispensing robot. The main drivers were to create a more efficient working environment, improve staff support, and invest for future dispensing capacity while releasing staff time for more patient-facing activities.

A dispensing robot during the pandemic would have been a godsend to cope with the surge in dispensing volume that started in the first pandemic and has ebbed and flowed since, leaving us with a sustained greater volume than before.

The super deduction announced by the Chancellor has helped make the business case more favourable but it’s not the reason to invest. In any case, I suspect suppliers will quickly adjust their prices to account for this, leading to no real benefit for the customer.

The benefits of an automated solution that does not need to self-isolate are self-evident, as are those of being able to support teams struggling to meet increased demand with diminished staff numbers. Looking at whether the future is to invest in dispensing or services, it’s clear that dispensing is essential to the current community pharmacy model, with services a growing element but not yet sufficient or sustainable for a successful business.

In my own practice we decided we now needed to execute on our plans to get a robot. This was the beginning in opening up a number of considerations that had not previously occurred to us.

There are two main suppliers of dispensing robots for community pharmacies in the UK. One is a long-standing supplier (supplier A) the other is new to the community market, having operated mainly in hospitals until recently (supplier B).

The complexities began when it became clear to us that our building set-up would only accommodate a robot on the first floor above the dispensary. To do so would also require removing two internal walls to merge three small rooms into a space large enough to accommodate a seven-metre long unit.

It would also require the remodelling of the ceiling, re-wiring, and preparing the floor to create an open space ready to receive the unit. There is considerable work needed simply to prepare the site. Once we have prepared the site ready to receive the unit, only then can installation begin.

Supplier A has a ‘build on site’ plan which essentially meant it could bring all the components in through the front door and then assemble on site. Supplier A is also 20 per cent more expensive than supplier B.

Supplier B has some large components that are shipped at full size and therefore cannot simply be brought in through the front door and walked up the stairs. It proposed removing the upstairs windows and lifting the pallets directly onto the first floor, then replacing the windows.

Another option was to bring the components through the rear fire escape, but this would also require temporarily removing an internal wall. Consideration then needs to be given to how many chutes are needed to drop the items to a user for dispensing. Will one suffice or are more needed? If the pharmacy is particularly busy additional robot picking arms will be needed. All of these things ensure additional cost.

Stock loading is also an important factor. How is the machine loaded with new stock? Is there fully automated, semi-automated or manual input of items? There are also options for a patient collection module: supplier A offers this, but supplier B does not. There are, however, third-party solutions such as Pharmaself24 that can be used.

All these options have an impact on the overall efficiency and cost of the system. A dispensing robot will not reduce the staff head count, but it will require staff to work in new ways, and it should improve their working environment and create capacity for additional services.
It should also allow greater headroom for growing dispensing volume and lifts the constraints caused by the number of people who can effectively work in a small space.

The suppliers also have differing levels of integration with the pharmacy PMR systems. This is critical to ensure that the robot works effectively. We’ve visited existing sites using the various robots and have had discussions with the PMR systems to ensure there is sufficient integration to meet our needs.

We’ve now signed a contract with supplier B, in part because they were much hungrier for the contract. We expect delivery late summer, allowing sufficient time for staff training and business processes to be redesigned before demand surges again during the winter.
Deciding on which dispensing robot to go for was the first decision of many and only time will tell if it fulfils its purpose.

I will be posting an update later in the year on how the robot has changed our workflow and business.
 

Mohammed Hussain is a non-executive director at Bradford Teaching Hospitals Foundation Trust and an independent contractor.