The most effective use of the skill mix within any team is to delegate tasks to the lowest level of staff that is qualified and competent to undertake them. This creates more time for more qualified team members to provide higher value services.

In the pharmacy, this involves the pharmacist removing him or herself from the technical dispensing process – the labelling and assembly of prescriptions. The clinical check is the only part of the dispensing process that the pharmacist must be involved in.

For this to be effective, technicians need to backfill the role of accuracy checking and dispensers or pharmacy assistants need to take on a greater role in dispensing. This might require team members who have traditionally worked on the pharmacy counter to move into the dispensary to take on dispensing roles. This will free up the pharmacist to spend time on the pharmacy counter, selling medicines, receiving prescriptions and undertaking the clinical check and handing out prescriptions after they have received a final check. It will also facilitate more open access to the pharmacist for patients who suffer from long-term conditions.

Completing tasks

To ensure re-engineered processes are undertaken effectively, you need to be clear about who is doing what. When processes change, it is easy to allow important things to be left undone.

A useful tool for ensuring tasks are completed is a RACI (Responsible, Accountable, Consult, Inform) chart. This lists the tasks that need to be undertaken as well as the following:

• Responsible – who will be doing the task?
• Accountable – who needs to ensure it is done?
• Consult – who will you need to speak to, to ensure that it is being done properly?
• Inform – who needs to be kept in the loop?

In the operation of the pharmacy, the Responsible Pharmacist is legally accountable for all activity. It is therefore easy to write a RACI chart where the pharmacist is accountable for everything. Obviously, this approach does not succeed in creating time for the pharmacist.

The aim is to delegate accountability to ensure that a task is done. For example, you might delegate accountability to one member of staff to ensure that prescriptions are endorsed and filed effectively and that the end of month return is completed properly. That individual will not be required to do everything, but will be expected to ensure that it is done.

If this is done effectively and delegated to an individual with appropriate knowledge and skills then the pharmacist will not need to be involved in this process. This idea can be extended to any task that the pharmacist is not legally required to carry out.

Working smarter, not harder

If you are to take on a greater role in the support of patients with long-term conditions, you have to change your processes and work smarter, not harder. This will usually involve extracting yourself from some of the other activities you undertake in the pharmacy. 

Changing the way you work is difficult and requires some focused effort. It also requires you to examine what you do and challenge the processes you undertake to ensure that they are still needed and current.

Some activities will be redundant, while others may not need to be undertaken by the current level of staff, so the way you use the skill mix within your pharmacy should be reviewed.