Health Service Focus

19.01.16

Northumbria tackles pharmacy challenges through automation

Source: NHE Jan/Feb 16

NHE talks to Steven Campbell, pharmacy technical services manager at Northumbria Healthcare NHS Foundation Trust, about how pharmacy automation is delivering financial savings at the trust.

Last year the Carter Review suggested the NHS could save £1bn by improving hospital pharmacy and medicines optimisation by 2019-20. At Northumbria Specialist Emergency Care Hospital, the first purpose-built dedicated emergency care hospital in England, significant efforts have been made to do just that. 

Automated storage 

Before the new hospital opened in June 2015, Northumbria Healthcare NHS FT and partner Omnicell Ltd trialled a few different automated medicine storage and ordering systems across four departments in two of its general hospitals. 

During the 18-month trial, the trust managed to reduce the average drug spend by 6% on average per patient. This saved £30,000 across departments, and freed up stock and medicines for other patients. 

The new medication cabinets include fingerprint access, an electronic CD register enabling a keyless and paperless system and a full audit trail. 

Steven Campbell, pharmacy technical services manager at the trust, said there were “immediate” benefits. “We no longer have to locate cabinet keys, so it is far quicker to access medicines. Everybody has their own individual log-in, as it is fingerprint technology. And even from an audit trail perspective, we are far better able to monitor and track than we were able to before,” he said. 

“The stock holding is also more relevant to need. This is all about trying to help staff do the right thing. We weren’t able to do this with the traditional paper system.” 

Big change 

Campbell added that the technology was a big change for people at the trust, but a lot of time was spent with the nursing teams to change the way they work. It has even led to pharmacy assistants replacing stocks – historically this was done by nurses. 

“Using a Band 3 pharmacy assistant is far more cost-effective and patient-focused than a Band 5 or 6 nurse putting them [medication] away,” he said. “We’ve re-engineered a process and used people more appropriately. Therefore, it generates a saving. 

“It is a big change for a lot of people. We had to spend some time to get the nursing teams to think about doing things, like a drug round, differently. 

“We’ve also been working with people to understand the flow and how it will impact on how they work. It has also been about replacing the mindset on certain things. Drug trollies, for instance, are not a familiar sight on our wards [with these cabinets].” 

Roll-out at emergency hospital 

Following the trial results, the trust installed 24 Omnicell medication automation cabinets across emergency care, theatres and admission units at the new hospital. 

“We are now coming up to seven months in our new hospital, so there has been a period of normalising that has been gone through. With that you get a lot of changes to stock requirements as we start to understand the flow and type of patients we are getting,” said Campbell. 

“We have gone through a big process of reviewing stock levels, and that will continue in a cyclical fashion. In terms of efficiencies, we are looking to ensure we have the right product, in the right place, in the right number at the right time.” 

While noting that the trust isn’t going to be “perfect”, Campbell is confident that the cabinets will help Northumbria “get it right” more often than not, when compared to the old paper-based system. He added that automation will also help cut down on ad hoc orders, which can increase the risk of stock outs. 

Further automation expansion 

Campbell told us that the medication cabinets form one part of a “big jigsaw puzzle” in trying to improve the trust’s systems and making sure the right treatment is available quickly for patients. 

Following the early results, Campbell hasn’t ruled out installing additional cabinets across the trust. 

“We have put a lot of hard work in to extract as many benefits as we can, but we know we’ve got more to come. We will continue along those lines,” he said.

“So long as it [automation] is used to reduce risk and improve the services that we provide, that is what it has all been about.”

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