At Project7, our mission is to drive meaningful change that enhances operational efficiency and delivers tangible results. One of our previous projects involved a significant transformation in the pharmacy department of a UK Learning NHS Trust. This reflection explores the challenges, solutions, and outcomes of this pharmacy service improvement initiative.
The UK Learning NHS Trust, serving areas such as East Surrey, North-East West Sussex, and South Croydon, was facing significant operational and financial pressures. With an annual budget of £300 million and a £20 million overspend, the trust needed to find ways to reduce overall costs while maintaining or improving service quality. The pharmacy department, in particular, was underperforming, with high levels of patients being discharged without their necessary medication. This issue led to increased costs, inefficiencies, and low staff morale.
The challenges in the pharmacy were multifaceted. There was difficulty in processing a high volume of prescriptions, especially those arriving late in the day after ward rounds. Often, medications were delivered to wards after patients had already been discharged, leading to unnecessary waste and storage issues. Additionally, the pharmacy operated without a “first in, first out” system, causing significant delays in processing prescriptions. There was also no tracking system in place, which meant that staff often had to search for prescriptions manually, leading to further inefficiencies.
To address these challenges, Project7 took a comprehensive approach. We began by reviewing the pharmacy’s staffing levels and competencies to ensure they were aligned with the volume of work required. Through process mapping with professional staff, we identified areas for improvement and implemented a range of solutions.
One of the most impactful changes was the introduction of a “first in, first out” processing system, which significantly reduced wait times and improved overall efficiency. We also implemented short interval control to manage the variation in demand throughout the day. Additionally, a Plan, Do, Check, Act (PDCA) confirmation system was introduced to ensure that medications were only delivered if the patient was present to receive them, thereby eliminating unnecessary storage on wards.
The results of these interventions were substantial. The pharmacy saw a 59% reduction in turnaround time, bringing it down from an average of 3.4 hours to within the trust’s target of 2 hours. The department’s establishment was redefined with a plan for implementation, leading to a reduction in headcount by three substantive posts and a 70% reduction in locum spend. Moreover, a tracker system was introduced, providing better oversight of prescription processing and ensuring a more efficient workflow. The standard delivery route and times for porters were also formalised, further streamlining the process.
Reflecting on this project, several key lessons stand out:
- Process Standardisation: Implementing a “first in, first out” system and standard delivery routes drastically improved efficiency and reduced turnaround times.
Effective Use of Resources: Aligning staffing levels with the required workload and reducing reliance on locums not only saved costs but also improved overall service delivery. - Continuous Improvement: The introduction of a PDCA confirmation system ensured that improvements were sustained and that medications were delivered only when needed, reducing waste and inefficiencies.
- Collaboration and Communication: Engaging staff in process mapping and decision-making fostered a sense of ownership and commitment to the improvements, leading to a more motivated and effective team.
This project demonstrates the transformative impact that targeted operational improvements can have on service delivery within a healthcare setting. At Project7 Consultancy, we remain committed to helping our clients achieve operational excellence through innovative solutions and continuous improvement strategies.
For more information on how Project7 Consultancy can help your organisation achieve similar success, contact us directly. We can help you maximise your business change potential.
