In most surgeries, the dispensing team runs like a well-oiled machine and could not dispense large numbers of prescription items if it were not. However, complacency must not be allowed to creep in.
The best way of maintaining efficiency is to carry out regular appraisals of all staff who have input into the dispensing function. These appraisals are usually carried out yearly by the lead dispensing GP and the practice manager, but this will vary from practice to practice.
The Dispensing Services Quality Scheme (DSQS) was introduced in November 2006 and has provided an excellent framework with which to assess a dispenser's work.
Under this scheme, practices had to put into place effective governance arrangements to allow GPs to assess competencies for dispensing staff, even those who held the minimum qualification. Standard operating procedures (SOPs), also had to be produced and every dispenser had to sign that they agreed to the way of working described with them.
The scheme acknowledged that the best way of checking competencies was during the yearly appraisal, competence being defined as a dispenser 'having the necessary skill, knowledge and attitudes to undertake a job properly and consistently'.
There are seven sections within the DSQS document, outlining various skills which any dispenser must demonstrate during the course of the working day: customer service; health and safety; teams and teamwork; the supply of prescribed items (including prescription receipt and collection); the assembly of prescribed items; ordering, receiving and storing of stock; and supplying pharmaceutical items.
Using the contents of these sections as markers of knowledge, GPs can assess whether the dispenser is meeting the terms of the DSQS document and their own contract of employment.
If there has been any breach of an SOP, this can be raised at the time of the appraisal, as could concerns over an individual's attitude or standard of work.
The appraisal meeting should be a positive forum, enabling a two-way dialogue. It should give the dispenser the opportunity to raise any issues that concern them, ranging from requests for continuing professional development to new uniforms; every point should be discussed and documented.
Ideally, an appraisal should be separate from a pay review, though requests for salary increases are often brought up.
If necessary, a timeframe should be agreed during the meeting, for any changes to be made or decisions taken and a further meeting can be requested if this is not met.
Many practices will have a designated dispensary manager under whose jurisdiction the day-to-day running of the dispensary will fall. Their contract of employment will outline the scope of their position.
In some practices, this will include responsibility for dispensing staff; in others they will manage the processes of dispensing, including the buying of stock, but will have no direct authority over staff.
Where the latter is the case, any staffing concerns, as well as appraisals, will be undertaken by the practice manager or lead dispensing GP.
This involves ensuring that each dispenser knows exactly what their role involves, including how they will be expected to cover colleague's absences for reasons of sickness or holiday. Such responsibilities might include ordering stock, taking in prescription repeats and dispensing itself, tasks with which trainees or junior dispensers may not be comfortable.
It is the manager's job to ensure efficiency is not compromised by delegating these tasks, but it is important, particularly in small units, that every member of the team has a working knowledge of every function.
Dispensary meetings should be held regularly so that any concerns can be raised and dealt with by the management team. Good lines of communication, combined with ongoing appraisals and positive, proactive management from GP employers will guarantee that dispensaries function happily and efficiently.
- Annette Arthur is a consultant for dispensing practices.