If we want to move from a process focus to a patient focus we will need to re-examine what we do and assess whether the process or the service in our pharmacy meets the needs of the patient.

The dispensing service

Let's think about how the community pharmacy works in terms of dispensing.

Say we simply collected prescriptions for our patients and had them prepared and packed into sealed and labelled bags to be handed out by a counter assistant. While this approach represents an efficient process for the pharmacy and clearly meets the supply need, what needs would we be meeting for our patients? How does this help to improve health outcomes?

To add more value for the patient, we must re-engineer the dispensing process. The only element of the dispensing process that requires the pharmacist's involvement is the clinical check.

It is important for the pharmacist to be involved in handing out the dispensed products and counselling the patient for some, but not all, prescriptions. Having the pharmacist work on the counter, receiving prescriptions, clinically checking them and handing them to the patient and providing counselling when required, will add value.

To achieve this approach, that better meets the needs of patients, we must put a number of things in place:

• Well-trained staff in appropriate roles who manage exceptions and involve pharmacists with appropriate prescriptions
• A PMR system that facilitates access to records from different areas of the pharmacy.

With a clearer understanding of the patient groups that use the pharmacy and their needs, we can also identify the additional patients whom we might wish to target.

NHS services

All pharmacies in England are able to provide the advanced services €“ MURs and NMS. We are now also able to provide flu vaccinations as part of a national clinical service. Ask yourself the following questions:

• How patient-centred is the way in which we deliver these services?
• Are we focused on the targets we need to achieve?
• If we are honest, do we sometimes find we are focused on the process rather than the patient?

We should also reflect on the way in which we deliver the service from the perspective of the patient.

• Does our consulting room provide the right environment to allow for focus on the patient?
• Do we clarify the objectives for the service with the patient to allow them to be central to the process?

If we have identified specific patient issues though our review of the GP practice information, we can start to define services that will meet these specific needs. For example, if hospital admissions from exacerbations of COPD has been identified as an issue, a range of services could be proposed to avoid this, including enhanced MURs or a PGD service for rescue treatment for exacerbations. Basing services on identified needs ensures that the patient is at the centre of them.

Focus on outcomes

In this article we have focused on NHS services, but we should also ensure that the services we provide privately through community pharmacy are focused on patients' needs in order for them to be successful. Focusing on outcomes for patients and understanding our market effectively will help keep the services provided by pharmacy focused on the patient.