Three months ago, after several years of consideration, we decided to order a dispensing robot for our large dispensing practice.
Investing in an automated dispensing unit (ADU) should ultimately reduce staff dispensing time, improve accuracy and create a calmer, more efficient working environment. However, preparing for its arrival has caused interim upheaval.
Our dispensary is almost 13 years old and the increase in dispensing workload that necessitated the purchase of an ADU also persuaded us to extend the dispensary.
The extension, along with the need to create extra space for the robot, has caused some slippage in our timetable, partly because our building's curved walls involved modification of our plans.
But the delay has given us time to reflect on our ADU selection and related decisions. For example, we have had time to review working practices throughout the surgery, so we can use the machine to best effect, without introducing many changes for dispensing staff.
For maximum efficiency, it is best for the robot to be working constantly throughout the day, but there are peak times of activity, for example, post-morning surgery. We are looking to even out this workload.
While the majority of dispensing workload involves repeat items, we must ensure that acute items, required following a surgery consultation, can also be dispensed quickly and accurately. The balance between the different demands on the dispensary staff is being studied to ensure the robot gives maximum support.
Liaising with colleagues at a nearby practice that already has an ADU, provided insights: we were able to see their machine, and related accessories, being used in a working dispensary.
This encouraged us to postpone buying a labeller, as theirs proved unreliable, with incidence of error. Increased accuracy in dispensing was a key factor in our initial decision to purchase our robot, so a labeller that did not achieve this did not meet our requirements.
We also changed our minds about the loading mechanism for medicines. Initially, we opted for a system under which the medicine pack's barcode is scanned manually and it is then placed within the machine by the picking arm. However, concerns were raised that, at very busy times, there might be some delay in restocking the machine, particularly in a large dispensing practice.
This is because the machine's 'picking arm' may be so busy selecting medicines for dispensing (a process it prioritises) that it has no time to store the new additional medicines being loaded into the machine.
We therefore decided to buy the pricier 'hopper loading system'. This still relies on bar-codes, but allows medicine packs to be placed in a hopper and sorted by the 'picking arm' when the machine is less busy dispensing items, for example, over night.
Increased tax relief
Though this is a more expensive model, the delay in purchasing the ADU has actually been beneficial, financially speaking. Labour's last budget in April increased tax relief on the purchase of equipment by small to medium businesses.
The previous 100 per cent tax relief for expenditure on plant or machinery was raised from £50,000 to £100,000, so that almost the entire cost of the ADU can be claimed as an expense in the first financial year, along with 20 per cent of costs beyond this £100,000 threshold.
This increased threshold, known as the Annual Investment Allowance, was introduced to encourage capital investment by entrepreneurial businesses, a term which describes many dispensing practices. As we have a non-standard financial year with a 30 June end, this fits perfectly with a July purchase.
We have therefore changed our purchase mechanism from lease purchase to hire purchase, as this better uses new tax rules.
On a less positive note, it looks like VAT will rise in the emergency budget. The current advice is that businesses should bring forward any large purchases to pre-empt this rise.
This is unlikely to affect the purchase of an ADU because GP dispensing qualifies for 100 per cent reimbursement on VAT paid. Only smaller dispensing practices, falling below the £70,000 turnover threshold, are not required to register for VAT, so would be eligible for reimbursement. However, such practices are unlikely to invest in a robot, as their number of dispensed items is too low.
Our next few weeks will be challenging, given the major refurbishment of the dispensary followed by July's fitting of the ADU. We are briefly relocating the dispensary, using temporary shelving, altering the function of some surgery rooms and changing the ordering of our medicines.
However, we are confident these will prove small, short-term sacrifices compared with the long-term benefits that an ADU will bring to the practice and to our patients.
- Dr Phipps is a dispensing GP in Lincolnshire