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Jun 22, 2023 Risha Bhuwad

Hub and Spoke Benefits Stores, Staff and Patients

Medipharmacy are one of the innovators shaking up community pharmacy. They understood early on that technology would play a key role in shaping the future of pharmacy. Here their Director of Pharmacy, Risha Bhuwad, explains how their approach is benefitting their stores, staff and patients.

Success for us means streamlined operations that result in improved workflows and efficiencies. It’s about enhancing safety and compliance and freeing up time for pharmacy staff so they can focus on what matters most – the patient.

We made the decision very early on to embrace technology as we knew that automating laborious tasks in store would be crucial to us achieving that success and growing as a business. We were right and our approach has since won multiple awards. We were one of the first pharmacies in the country to install the Synmed XF blister pack dispensing robot which won us two industry awards in 2018. More recently, we became one of the first community pharmacies to introduce Centred Solutions FLOWRx Hub technology for our original pack repeat prescriptions and this won us the Association of Independent Pharmacies Innovation award in 2022.

One of the biggest wins for us has been the benefits in our stores as a result of moving to a central fill model for repeat dispensing. With both blister pack/ MDS trays and original packs fulfilled by our hub, staff in store are free to focus on our patient as well as their own personal development. That’s really important to us as a business.

We’re family-run with 25 pharmacy branches across London, Kent, Surrey and West Sussex, yet our entire company’s repeat prescriptions are done by a team of around 10 people at our hub in East Grinstead. That is only possible because of the technology we use.

What this means is staff in branch have the time and space to process all the other things they need to do. By moving to a hub and spoke automated model, we’ve noticed the improvement in capability across our stores which has really helped boost our team morale and maintain our excellent workforce. That’s refreshing to know given the most recent C+D salary survey found 82% of respondents had suffered from stress due to work over the past year. Even when we do get shops struggling with sickness we know we have it covered and we’re able to catch up on any backlog rather quickly. I’ve noticed that there is now a lot more capacity within the teams and by ensuring all of our branches operate in a uniformed way this really helps if we ever need to move staff around to support.

Automation has enabled us as a company to ensure that our dispensary teams aren’t spending time completing monotonous tasks such as labelling boxes day in and day out. In these present times the number of drug shortages have significantly increased and therefore our branches now have more time to liaise with GP’s to amend prescriptions etc. to benefit our patients.

That being said, it’s no surprise that the increase in dependence of locum pharmacists is also on the rise. By implementing hub and spoke we’ve managed to retain our locum pharmacists because they prefer working in our branches which are perceived as “luxury” compared to traditional manual dispensing pharmacies. We also now have a much smoother operation and where pharmacist managers are not in place we do not have a disparity in performance compared to those with pharmacist managers in place which is a big win for us. We’ve used the benefits of automation to ensure all of our branches stay up to date and use their time to become more organised.

Our Centred Solutions line at the hub is currently dispensing an average of 13,500 items per week for an average of just over 6,000 patients. The workflow starts off at the spoke where our pharmacy teams receive the prescriptions, and the pharmacists carries out the necessary checks before sending it through to the hub. Once received at the hub we get patient specific pick lists which are aligned with our warehouse bay locations. Our colleagues will go and pick the stock and put it in the totes in accordance with that picklist. Each medication is then scanned in and labelled by the FLOWRx Hub automated labelling unit before colleagues are guided by the software to sort the medication into patient specific baskets at the sortation shelves. Anything that the system flags up as needing a double check goes to the quarantine station where it is cleared by a pharmacist/ accuracy checking dispenser. Anything that is completed moves onto be bagged before being scanned using a handheld toting app and placed back in the relevant tote to be delivered back to the store. Our cut off for orders from branch is 4pm and then we guarantee a next day delivery. The only exception is any owings that we might need to order in so that can sometimes mean a 48-hour turnaround time. That is because the feedback from our branches was that they would rather have a complete patient bag rather than a partially filled patient bag.

However, we find our owings are few and far between. That is because we now centrally buy everything at the hub so we can bulk buy up to six months in advance. It means that if something goes out of stock in branch we have contingency at head office and we avoid unnecessary waste and out of date medicines. It also means that in branch the stockholding on shelves is immaculate and we have clear work benches rather than huge stacks of baskets everywhere waiting to be checked.

Our throughput at the hub is growing in line with our business. Because our shops are now more efficient, they have been able to take on more patients and more demand. They are no longer limited when it comes to what they can fulfil. Even at the hub, when we do reach capacity we have the option to scale and invest in another quarantine shelf or sortation shelf. Having the hub has also allowed us to grow as a business and we are now in a great position to acquire more branches as the on-boarding process is much more simpler with Hub and Spoke. For example we purchased a branch last year which was in approximately 3 months of backlog, we were able to clear all of this in two to three days by utilising the Centred Solutions capability

My advice to anyone thinking about hub and spoke automation is definitely do it, but plan your on-boarding in branches and utilise existing groups who are currently operating a model similar to yours so they can give you helpful tips on how to implement automation. I would be lying to say the first few weeks there are some late nights involved! That being said, as we are now up and running I can definitely see the benefit automation has bought to our company whenever I go into branches. Everything is clear and everyone is calm. It has allowed us to give more promotions to our staff and grow capability in leadership as well as allowing my pharmacist managers more opportunities to develop and deliver more clinical services.

Published by Risha Bhuwad June 22, 2023
Risha Bhuwad