Many GP dispensaries are forced to function in inadequate spaces due to the physical limitations of the building in which they are located.
However, should extra funding or space allow you to redesign your dispensary area, or plan it from scratch, ensure there is as much discussion as possible between contractors, GPs and dispensing staff so that the end result meets everyone's needs.
Floorplans, electrical plans, lighting plans and overall construction plans, including heating and ventilation that comply with health, safety and welfare regulations, all need to all be amalgamated into the finished design.
If you are already a dispensing practice, your dispensing staff will have clear ideas of what is required in a new space, but if you are developing a brand new dispensary, ascertaining the requirements can be daunting.
Planning should be done one step at a time. The first essential is to ensure the dispensary's physical security, since it may be a target for thieves.
Ideally, three security firms should be asked to provide quotes and all three should be interviewed before a decision is made. Advice and information on security can be obtained from the your local district police crime prevention officer.
Pay attention to the dispensary's doors, windows and ceilings: every internal door to the dispensary must be of solid construction and lockable. Access to the dispensary should only be from inside the surgery.
Windows must be lockable, alarmed and, ideally, barred or shuttered. Louvered windows (which have several strips of glass that are tilted open to allow ventilation) are not suitable for dispensaries. Not only are they energy inefficient, but they present a security problem because it is easy to break one glass strip and then remove the rest, one piece at a time, to gain entry through the window.
The outer walls of the dispensary should be solid, although partition walls can be used within the dispensing area itself. Protect access to flat roofs or other vulnerable areas by, for example, using 'anti-climb' paints or roller barriers.
However, bear in mind the Occupiers Liability Act: a risk assessment should be conducted to identify the risks to property and equipment and the control measures identified as the most appropriate in the situation.
Inside the dispensary, panic alert buttons for staff should be installed in strategic positions, to comply with health and safety at work regulations. Storage of controlled drugs, poisons and cash must also be considered from a security perspective.
It is a legal requirement that all Schedule 2 controlled drugs be kept in a locked steel cabinet bolted to the floor or wall and this requirement is often the cornerstone of the dispensary's design. An electronic, lockable cash register is strongly recommended.
Numerous power points will be needed in a dispensary, so establish where these will be sited before putting in cupboards or shelving. Allow for double the number of plug sockets you think you may need.
Lighting should be as shadow-free as possible and should penetrate all the corners.
A hot and cold water supply is essential, as is a stainless steel sink. A paper towel holder should be sited above the sink along with a pump style soap dispenser. Glass measures and bottle brushes should have a proper storage area near this.
Decide where to locate the patient collection hatch and site the main computer reasonably near it, if possible, to optimise the dispenser's efficiency.
The storage area for completed prescriptions awaiting collection should be near the hatch but, for confidentiality, the patient should not be able to read anything from outside of the dispensary.
Space must be left for a pharmacy refrigerator which must have a temperature range of +2 degs to +8 degsC and a built-in thermometer that can be read from the outside.
Decisions regarding the type of storage for the drugs can be the most difficult. Do you go for drawers, open shelves, carousels, cupboards, pull-out storage or a mixture? There are dozens of designs incorporating some or all of these options, so browsing dispensary supplier sites on the internet can be a source of ideas, as can kitchen suppliers.
Sufficient workstations should be factored in, with storage of dispensing sundries like bags, white card boxes and bottles in easy reach. There should also be at least one drawer allocated to stationery and another lockable drawer to store claim forms needed by patients, spare prescription forms and the controlled drugs register.
Time spent at the planning stage should ensure a modern, bright, efficient unit in which staff are proud to work.
- Annette Arthur is a consultant to dispensing practices
- Health and safety in health and social care services www.hse.gov.uk/healthservices/index.htm
- Misuse of Drugs Act http://drugs.homeoffice.gov.uk/drugs-laws/misuse-of-drugs-act/