Hypothesis Area 1 Enable the pharmacy team to fulfil their professional role
Attract and retain quality healthcare staff • • • Improve quality of life for staff Help manage services provided 'out of store’ Let dispensers manage the day to day dispensary Remove conflict manager v dispensing role Make one of dispensary team responsible for housekeeping (with incentives for efficiency) Must provide support to complete Head Office driven initiatives
Develop most knowledgeable healthcare staff • • Allow time for training of staff to take place Enable sharing of knowledge Effective Performance management Graded drug interactions Capture PMR data and use to give better quality advice Better primary care- store Specialist links Competitors allow branded goods manufacturers to run linking? sessions for their Specialists (XXX act as post box between supplier and Specialist) Review training education processes
Promote XXX to be the employer of choice · · · · Portfolio careers (in-store, committees/PCGs, Uni environments, Freelancing, prescribing support for GPs) Recruitment pack highlighting new tools Communicate on going improvements Demographics of Specialist changing (25 years ago male and ambitious, now >50% women who want flexibility and challenge not just management) Better layout of dispensary Pay the market rate? Introduce flexible benefits package to enable new mix of roles
Reinforce the professional role of pharmacy · · · · · Promote the Specialist as a professional (and charge by the hour) Enable appointment booking for Specialists Generate GP referral forms Work closely with local GPs to promote effective OTC products Stop Specialist pulling forward/sales plan - focus on Pharmacy Provide validation points throughout process - eliminate errors Lobby for change toward salaried remuneration - ensure service focus Clear uncluttered environment Promote the role of dispensers and Healthcare assistants to our customers (make them feel comfortable asking them for advice rather than just the Specialist
Attract and retain quality healthcare staff • • • • Release time for CPD Provide vocational job satisfaction for Specialists Increase use of satelliting Provide appropriate level of support for Specialists (resource levels) Delivering flexible working policies 10% bonus for Specialists who deliver strategic goals (don't just increase everyone's salary) Team leader dispenser in larger stores (responsible for optimising efficiency) Career path for dispensers Make MDS a satisfying job Take MDS out of stores Loyalty schemes/incentives Improve remuneration Provide feedback forum for Specialists to dump baggage (& respond to it) Give people the bigger picture With students having to pay for Uni. fees, company should enter into a sponsorship scheme to ensure Specialists kept for first 2 years of career Sell XXX package (more than basic pay)
Attract and retain quality healthcare staff • • • • Implement loyalty incentives Value all pharmacy staff more highly Right Specialists in right type of store (BF + CSO + dynamic in busy stores, clinical in quieter stores, long term in stores where relationship building is important) Need to improve retention of those just qualified (pay, understanding of career opportunities) Increase quality and quantity of support staff Staffing levels always at bear minimum (no back up, if anyone is sick or on holiday the system falls apart so must provide adequate backup) Reduce travelling for relief staff, keep them local Lock Specialists into contracts Pay more Improve morale Too much pressure on targets More central support ( we demand too much and support little) Student overdrafts are high. Specialist starting salary needs to be much more competitive
Develop most knowledgeable healthcare staff • • • • Consistently communicate priority & vision to staff & get buy in Specialists to understand holistic healthcare offer Support strong pharmacy and halt the decline of pharmacy as a profession Reinforce the commitment to the long term value of pharmacy in the wider business Graded drug interactions Capture PMR data and use to give better quality advice Put BU strategic objectives as header on performance contracts Give 10% bonuses/other rewards to Specialists who deliver excellent performance Increase level of professional understanding at Business Unit (esp. product/supply) Time for the dispensing team to keep up to date must be given high priority (reading, new products etc) Include the whole healthcare team in initiatives (eg Specialists feel that they were left out of DDE, more communication) Better and more training Create “senior dispenser “ role to support Specialist
Promote XXX to be the employer of choice • • • Manage Specialist recruitment blackspots Specialist job share (regional/ central/store on different days) We need to make people proud to work in XXX dispensary Manage Specialists career expectations - don't over promise! Senior management should visit stores more often not to audit but to keep in touch- store personnel to regions, head office Must be clear differentials between ourselves and competitors (what do we offer new Specialists that our competitors don’t? Very little!) Plain English key messages Increase recruitment- over staff now for fallow year Increased Specialist mobility Ringfence Specialist salary budgets More non pharmacy managers
Reinforce the professional role of pharmacy · Separate Specialist and manager roles · Allow more time and personal skills to develop links with local GPs /HAs /Nursing homes · Help raise the professional status of the Specialist · Specialist grading scheme (A-D++) compare with hospitals · Redefine Specialist roles · Dispensers are not customer focussed (they are task focussed & hidden away) · Easier registration for clinical diplomas, less red tape · Clinic route for Specialists without bottleneck or over promising- remove emphasis on frequent moving ( encourage stability) · Empower dispensers and reinforce their value to the business- give them a career path, empower, change image e. g. dispensing consultant · Encourage/recruit Specialists who also work relief for other pharmacies (drag experience to XXX) · Uniform to distinguish Specialist, make someone responsible for housekeeping
Attract and retain quality healthcare staff • • • Simple systems to use Pleasure to use Quick & reliable New system will improve motivation Implement diary for management/planningconsistency of appointments • Change systems UI to colour
Develop most knowledgeable healthcare staff • • Provide BNF Provide knowledge network for Specialists Encourage learning with accessible information On-line references e. g. dispensary manual Martindale, Stockleys, BNF- should be available for online queries Interactions should not just be listed but should alert and force recognition of fatal interactions Work with authorised industry sources to create excellent drug database (supports all other elements of hypothesis) Systems must show implicit as well explicit interaction information eg a drug may contain paracetamol
Promote XXX to be the employer of choice • Automated dispensing • Position the I. T. to support or remove the unattractive tasks!
Reinforce the professional role of pharmacy • Produce patient information leaflets • Provide a solution staff can trust • Link to NHS systems and emerging national PMR
Hypothesis Area 2 Promote market leading customer service
Give customers easy access to products & services • • • • Location - access to goods and services is applicable to the customer Fast track dispensing by customer or workload Service - order, collect, deliver prescription Allow repeat medication service with the Specialist ordering the repeat Rx Replace completed Rx shelves with fast track dispensing area Medicine management - lobby for Specialists to perform the repeat Rx order Free envelopes for sending in prescriptions Take in Rx from anywhere on HC counter PCS callcentre - remove hassle for surgery and store - position well for electronic Rx Slicker/quicker process Review customer queuing/reception, greet as they arrive PCS as service centre PCS customers given preferential treatment PCS collection/no queuing Roll out concept dispensary everywhere Open longer hours to match supermarkets
Give customers easy access to products & services • • • Improve lunchtime career? Clearly alarm key interactions (remove dross) Concept process in all stores Must improve efficiency in reception particularly in the top dispensing stores Self selection medicines Find a way of getting XXX offer much more local Provide on line access to Specialist – video conferencing, phone line –walk in/ nursing homes etc If we provide additional services such as blood pressure testing, pregnancy testing etc, we must train our people in general counselling for the above No dockets or minimal for waiters Quick reception process needs to be much more so than now. Dockets slow down MDS as service centre Get rid of dockets- self check in of Rx
Create the optimal experience for each customer • • • • • Eliminate duplication of tasks (e. g. typing in details at reception) Accurately deal with atypical situations (e. g. on demand) Add 'theatre' to pharmacy process and implement DDE Reflect the learning from concept stores and do rapid problem resolution Improve service levels - appear as added value to the customer System is flexible enough to allow local store and customer variations Dispensing process is invisible to customer Maintain security but remove process time for reception - reduce Q’s Customer careline and privacy for counselling Locational mobility (e. g. move near GPs) Lobby against anti-competitive ethical rules (e. g. promotions) Signage to make pharmacy easy to find in large store Flag out of stocks to customer immediately Improve GP end of PCS (ensure 48 hrs met) and do Rx home delivery scheme Reduce unnecessary paperwork e. g. target charts If walk ins are fast tracked then we must ensure slow tracks are done on time – two tier system dedicated teams for walk in and MDS/PCS Return to basic ‘serving customers’- making customer feel served/valued Achieve right balance - pharmacy space and store space& pharmacy loc’n instore Lobby to change to Society rules- Specialist not forced to hand out in all cases. Free up Specialist for counselling and advice
Give customers access to the best professional expertise & information • • • • Allow Specialists to prescribe drugs Produce practice leaflets - opening times, Specialists name, rota, etc Co-ordinate disease management programmes with OTC Patients given the correct amount of information Change the store environment to allow counselling to happen (silent printers, counselling area) Stop dockets Two speed- quick collection and advice and counselling Work truly hand in hand with government, professions, customer/patient groups to identify and satisfy healthcare needs (whether dispensing, OTC, visits, Baby, Skincare) [is this healthcare 2010? ] Accurate, succinct counselling info for Specialist on each dispensed item Change the store environment to enable counselling to happen easily Set expectations and give appropriate advice at reception Coordinated OTC/dispense disease management programs Make effective , appropriate use of PMR information Allow Specialist to prescribe drugs if legislation changes
Give customers easy access to products & services • Additional staff in pharmacy team • Improve people management of relief staff • Glass cabinet (locked!) display of P. meds therefore removal of physical barrier of pharmacy counter. If in pharmacy area supervision rules should be fulfilled and qualified healthcare assistants could staff
Create the optimal experience for each customer • • • • • Incentivise customer service (not number of interactions!) & allow staff time to do it Select customer focussed staff / People focused staff not system focused staff Free up Specialist time for counselling & advice Acknowledge/greet as soon as patient arrives (even if they have to wait) Staff need to be able to spot different customer types and respond accordingly Improve provision of clinical advice to attract doctor-seekers and non-treaters Recruit Specialists based on customer service skills MDS – Single point of contact in XXX Our staff should be furry, friendly, cuddly creatures Focus on the customer not the process More customer-friendly service esp. reception Incentivise customer service and allow time to do it – all staff Free up Specialist time for counsel/advice Provide an environment to enhance customer service Influence recruitment split into sales and task people Greet repeat customers by name Allow appointment booking with Specialist – disease management and advice Develop unique relationship between Specialist and customer Maintain MDS customer relations Enhance customer service skills of dispensary/healthcare staff
Give customers access to the best professional expertise & information • • Recruit hospital Specialists for clinical expertise Differentiate XXX Specialist in eyes of customer Dispenser in every store Have visiting clinical Specialist – 1 day per store, book appointments • Customer service skills training for healthcare staff and people management skills
Give customers easy access to products & services • Location is key driver of choice – can IT change the ‘definition of convenience” away from “closest to GP” • System support and service levels geared to customer service • Barcode medilink cards • Make the solution open - easy but secure data access • Email link with customers, patients – advice, reminders • Patient record moves when patient moves
Create the optimal experience for each customer • • Service oriented – system invisible and simple to maximise time for customer Use Advantage/medilink card to pre-scan PMR and flag if customer has had out-of-stocks in last few months Easy to operate, Backup when system fails Empower customers – info kiosks, generate/request repeats through card or phone Support registration of patients/customers (if required by legislation or becomes de facto) Match existing speed of systems or improve Ensure high quality of PMR data and ease of access
Give customers access to the best professional expertise & information • If there is a health scare customers should get info from XXX quickly • Enable links to other medical info held by XXX • Maintain up-to-date professional data • Flags – exceptions already communicated to the patient/subscriber • Link to OTC interactions • Produce A 4 compliance charts • NHS-NET – GP links • Prompt relevant info/linked products and services
Hypothesis Area 3 Deliver right stock, right place, right time, right cost
Make stock management easy and trusted by users • • • Intuitive Make stock file accurate Optimise replenishment and instore stock management Reduce quantities of stock held instore Cut date checking time – currently spend ½ to 1 hour per day Minimal receiving functionality instore Communicate clear policy on alternative sourcing arrangements Eliminate out of stocks in warehouse Easy to use Simple set up instore (add-ons of new lines)
Allow visibility and ordering flexibility on a national and local basis with associated management information • • • Automatic stock replenishment but with flexibility for store amendment Don’t let stores amend orders once calculated Maybe different for different types of lines Categorising of stores (supply chain flexibility) e. g. same-day/next-day delivery Supply team to have functionality to amend replenishment e. g. TAF’s, safety stock etc. Align warehouse stock objectives and stores stock objectives Produce a prescription in reasonable timescales therefore Specialist needs to be able to amend Easy inter-store transfers Identify stock availability internally before ordering externally
Lead times to support maximise service levels at appropriate business risk • We need to provide the same level of service as competitors e. g. 4 hour delivery if out-of-stock even if we don’t believe customer really needs it • Required goods at right time in right quantity • Goods always in stock • Tell stores when OTC products being advertised/promoted so store geared up and Specialist has up-to-date info on products • Ensure a stockless supply chain for MDS • Ensure new lines arrive on-time for launch
Have a common look and feel and utilise other company supply chain infrastructure • • Utilise London Shared Stock Room ? Utilise CSR’s? Common coding across the supply chain Maximise opportunities and synergies between store and pharmacy supply chain • Linking to upstream supply chain
Make stock management easy and trusted by users • Easily trained and retrained • Easy to use and understand • Providing service which engenders confidence – trust and reliability • Change negative perception of dispensing supply • Supply management = the poor relation – career development • Importance of using it properly • Staff to understand value of stock/consumables – avoid wastage
Allow visibility and ordering flexibility on a national and local basis with associated management information • Performance management – align supply chain targets
Lead times to support maximise service levels at appropriate business risk • Agreed and fully understood supply chain service levels • Agreed accountabilities and understood by all
Have a common look and feel and utilise other company supply chain infrastructure • Training and support
Make stock management easy and trusted by users • • • Automate OTC - pharmacy stock adjustments Separate MDS and pharmacy stock files More reliable/resilient systems (less downtime) Reliable automatic stock replenishment Better search mechanism for drugs – less TSF errors Include homeopathic products on stock file – electronic order link to suppliers Barcode management of stock in store Replenish pack vs. dispensing quantity Responsive Replenishment system with no store input for faster moving lines
Allow visibility and ordering flexibility on a national and local basis with associated management information • • • Stock visibility and confirmation at time of placing order Global stock visibility to centre Stock visibility can reduce level of stock and increase availability – win/win
Lead times to support maximise service levels at appropriate business risk • Replenishment system must be at least as good as those in the rest of the business • Appropriate supply chain systems and management information – fill missing spaces • Avoid batch processing especially overnight • Improved warehouse replenishment
Have a common look and feel and utilise other company supply chain infrastructure • Use existing (modified) systems • Common systems for pharmacy and rest of store • Linking to other relevant systems and info
Hypothesis Area 4 Achieve step change in provision of and effective use of information
Provide easy access to quality information to support effective management and decisions • Audit payments from the PPA • Central audit of payments from HA/HB and PPA • Give stores value driven information. How can stores be empowered with end to end profit when they do not know dispensing profit figures? • Allow PSO/HBU to know which stores do what and who does what e. g. Specialists providing services • Multi-media self help for busy patients/customers • Audit to confirm information given to get payment from drug companies/NHS • Stakeholders forum – currently no mechanism for impact analysis and how we respond • Dedicated team to field process queries for Head Office personnel • Head Office-Store-Staff communication process sub-optimal • Scan patient registration forms
Make XXX the best-informed pharmacy business • • • Make current data accurate and robust ( not necessarily about more data) Do we really know why we have 30%+ share in OTC markets and 12. 5% in dispensing? Data security to be ‘good enough’ not prohibitively constraining
Enable us to participate in linking to external agencies • Seamless interface with minimum human intervention • Effective quality control/audit of electronic information • Decide to ‘participate’ or ‘drive’
Exploit our information on customers, GP, nursing homes, drugs…. · Read advantage card when customer presents Rx/OTC · Capture accurate and complete patient data · Suppliers see XXX as necessary evil (show suppliers we can add value) through information collected on GPs prescribing habits etc
Provide easy access to quality information to support effective management and decisions • Information to aid performance management • Single umbrella for pharmacy Head Office personnel – PSO, Acquisitions and Dispensing • Promote communication of best practices • Help people make better, more informed decision • Dedicated IS support into categories
Make XXX the best-informed pharmacy business • • Less but more focused information Educate pharmacy team and PSO about the role of professional ethics and volume Information to pharmacy staff Communication must be interactive, not pushed one-way – solicit feedback and ongoing follow-through
Enable us to participate in linking to external agencies • Give people the interpersonal skills to counsel/question of GPs • Work with external agencies (e. g. PPA) to produce ‘win-win’ scenarios e. g. reduce fraud
Exploit our information on customers, GP, nursing homes, drugs…. • More OTC knowledge and skills training e. g. to promote Vitamin sales
Provide easy access to quality information to support effective management and decisions • Easy access data tool with single source of data(consistency) • MDS market information (who/where/%share) • Use intranet to provide online manuals for DDE, returns, guidelines – nobody can ever find them • Allow business to exploit existing IT through dedicated IS support • Current accurate content • Easy access to information at the centre • Enables sharing of local info • Easy access to information Store/Region • Simple mechanism for drug search/information • Effective and timely management information • Consistent definitions • All dispensary management information onto IRIS • Accurate/robust Specialist/dispenser establishment figures
Make XXX the best-informed pharmacy business • Understand impact of Pharmacy on total XXX business
Enable us to participate in linking to external agencies • Adhere to industry standards • Flexible for early entry to NHS-NET • Link XXX and Medicard (Broad) to GP records and Hospital records • Use world-wide drug reference data • Allow use of NHS clinical terms (“READ” codes) • Use NHS patient record numbers • Electronic links RPSGB to PSO (Registration) • Allow matching with GP held data • Pioneer electronic script • Use industry standard drug file e. g. PPA/FDB – accurate calendar information (29/30/31 days etc) • Provide an interface between GP and pharmacy
Exploit our information on customers, GP, nursing homes, drugs…. • PMR’s – show what services offered and refused in past (rather than asking each time the customer comes in) • Information on customer base to enable stores to target business (via direct marketing and promotional activity – including GP surgeries at local level) • Link OTC/medilink and advantage card information • Leverage existing technology e. g. advantage card • Link every transaction to any other data e. g. advantage card to understand customer • Disease management – identify customers suitable • Integrated with other XXX information • Develop XXX healthcard platform (provide differentiator) • P/L generation from Systems
Hypothesis Area 5 Increase profit
Provide a means of managing healthcare and the store as one business • Linked measures consistent • Consider totality of healthcare service – dispensing + opticians + dentistry + others “The customer view”
Maximise income from existing new markets • • • • • Complete endorsing information online - Maximise/optimise endorsing Win/Win partnerships with e. g. suppliers/NHS – Health Promotion and Disease management Maximise customer loyalty – increase PCS business Full-blown pharmacy – managed repeat Rx mgmt is our blank cheque (workload planning, stock control, opportunity to capture script market share and customer for life, enhanced staff roles Tailor local strategy to local H. A. service opportunities Systems to promote link to OTC sales - OTC “buckling” Identify target services or schemes based on PMR XXX slow to act in new markets – too much bureaucracy Provide trustworthy diagnostic services e. g. smears, blood tests etc. Design toolkit for service delivery – offer new services Area based staff to audit endorsement/stock management Maintain needle exchange records Increase in repeat business Product models for involvement of Specialists in extra service Recruit more PCS customers without compromising levels of service Audit to confirm customer has received goods/services Provide local marketing support for stores
Deploy resources in a way that creates value • • Simplify the DDS process Pharmacy process sequence Centralise MDS in a ‘factory’ Improved process for business unit funding of dispensary activities Do task planning – model week for MDS Tasks focused on delivering prioritised services Optimise MDS delivery schedule/combine with other store deliveries Exploit economies of scale for PCS
Provide a means of managing healthcare and the store as one business • Increase commercial awareness of dispensary team – training and coaching • Higher quality in DSA role • People need to be in tune with business aims
Maximise income from existing new markets • • Reduce Specialist involvement – less admin (e. g. more support staff) Release time for Specialist to work on extra services …if they make money Lobby for fees for non-dispensing services Give healthcare teams targets for profitability of generic supply (incentivising) Incentivise business focus from healthcare staff More useful guidance is required – how to cross sell, how to increase profitability, how to use info Encourage company funded further education e. g. business studies for managers/pharmacy managers Store-Store cooperation not competition
Deploy resources in a way that creates value • Provide more effective use of the scare pharmacy resource • Understand where Specialist adds most value • Dispensing handled by appropriate and cost-effective personnel • Remove Specialist from most of process cf. Hospital • Feed accurate data into CSP • Area/regional pool of nil-hour staff – to deploy them to locations of greatest need • Automatic MDS deblistering • Work for dispenser (final) checking • Use CSP system better to get optimum scheduling of staff and best mix of Specialist/dispenser/dispensing assistant
Provide a means of managing healthcare and the store as one business · Redesign medilink to be NHS record compliant “NHS net +NHS strategy” compliance · Ensure that technology infrastructure works with future EPOS · Keep door open for single view of stock in store
Maximise income from existing new markets • • • • Misfilled/lost Rx processes/report-sale support Keep solution flexible to allow fast … of new offers Use e-link to drug companies to receive payment for information given to patient Travel advice/insurance sold on website Specialist on call on website Automatic electronic endorsement via up to date drug tariff Automatic and optimum endorsement Print EANs on dispensing labels – compliance check On screen pricing to aid decision making ( and is up-to-date and trusted) – remove RPDs Private pricing automated Provide paying internet information services for GPs, nurses, patients Keep records of posted medicines Keep appropriate oxygen records
Deploy resources in a way that creates value • • • Life-cycle IT costs optimised Share store IS resources (KIT)- clear store strategy Assume that the business model will change Make CSP work for the dispensary (improve planning) Insulate the solution from existing legacy
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