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How to design pharmacy premises to support pharmacy services delivery

Community pharmacy is changing. With pharmacists’ clinical advisory role coming to the fore, pharmacy premises in the community are having to change, too. This is demonstrated by the proliferation of consultation areas in pharmacies throughout the UK.

Now community pharmacists in Scotland are being asked if their premises are up to scratch. This week, the Scottish Executive published (in an NHS circular) a checklist for pharmacists to use to assess their premises. If premises meet the requirements, or if a development plan for improvement is agreed with the NHS board, then pharmacists will receive a payment.

Bill Scott, chief pharmaceutical officer, Scottish Executive, explains: “The overall objective is to ensure that community pharmacy premises are fit for purpose and support the delivery of the new community pharmacy NHS contract.”

The premises assessment is one part of the work covered by the “contract preparation payments” (PJ, 9 June, p663). These are tasks that have to be undertaken before the introduction of the acute medication service and chronic medication service. They include clinical training and IT improvements, as well as the premises work.

Both Mr Scott and Community Pharmacy Scotland point out that investment has already been made in premises development. Alex MacKinnon, CPS head of corporate affairs, says: “Within the strategic intent of ‘The right medicine’ and the development of the pharmacy contract, it was recognised that support should be provided to ensure that pharmacy premises are fit for purpose. Funding has previously been made available for provision of private advice areas, compliance with the Disability Discrimination Act legislation and security aspects.” He adds that if this premises assessment reveals particular problems, CPS will seek to negotiate additional funding.

In addition to the checklist, detailed standards for premises are also being published this week: although currently aspirational, they add context to the checklist and provide a blueprint for developing a new pharmacy. This document (“Scottish health planning note 36 — part 3, community pharmacy premises in Scotland”) may be obtained from the Health Facilities Scotland website (www.hfs.scot.nhs.uk).

Mr Scott comments: “It outlines guidance, drawing from best practice, on the design of pharmacy premises. It is aspirational and is intended to help community pharmacists when upgrading existing or planning new premises. The document is dynamic and will evolve and change as the clinical aspects of the contract develop over the next few years.”

Checklist

The checklist gives seven core requirements for pharmacy premises.
They are:

• Ensure equality of access for all patients — the premises, and the pharmacy’s services, must meet the requirements of the Disability Discrimination Act 1995

• Have a waiting area with seating — it must be big enough for a wheelchair user, or someone with a guide dog or pushchair to sit without causing an obstruction

• Have a consultation area which is private and fit for purpose — it must be large enough to accommodate two people (standing or seated) and be accessible for wheelchairs (if supervised consumption of methadone is provided, then the area should be safe for clients and staff, and be reasonably separated from other pharmacy users)

• Have a specific health promotion area to display health promotion and education materials

• Have a professional image and be uncluttered, particularly in areas where clinical activities are provided

• Have facilities to collect and store returned medicines

• Display a sign stating the services the pharmacy offers, and further signs around the pharmacy pointing out particular facilities

To be eligible for the premises contract preparation payment, the pharmacy must meet at least four of the requirements and, for any deficient area, have a development plan in place.

How Toll Pharmacy in Prestwick, Ayrshire, rose to the challenge

A consultation room

A consultation room

Pharmacist Cathy Burns has transformed Toll Pharmacy in Prestwick, Ayrshire, so it delivers much more than the core requirements of the new premises standards.

The pharmacy now has two consultation rooms, a treatment room, two semi-private areas (one for quiet words at the medicines counter and the other for supervision of methadone consumption) and a seated waiting area. It is bright and airy with a modern, clinical feel.

“The pharmacy used to be long, dark and narrow, and customers in wheelchairs had difficulty coming in. This clearly was not good enough so,in February last year (2006), I approached the people who owned the flat next door to find out if they would sell to me,” she explains.

“We had some problems buying the flat and getting planning permission, but eventually we were able to expand the pharmacy so it covers a much wider area.”

The refurbishment was completed last month and the new space allows Mrs Burns to offer supplementary prescribing, emergency hormonal contraception and smoking cessation services from a consultation room. She rents the other consultation room to a reflexologist (at a rate of £25 for half a day), and is currently in discussion with the local harm reduction team about using the treatment room to treat things like injection site wounds.

Mrs Burns used Mark Forbes, of Retail Design Consultants, to plan the new pharmacy based on a draft version of this week’s premises standards. She also made use of her environmental engineer brother’s skills to advise her on air conditioning, lighting and space.

Buying the flat cost £140,000, and the refit and building work another £160,000, but Mrs Burns says the decision was not just about a business investment: “I did it because it feels right. I think pharmacy has a bright future in Scotland. Six years ago, my oldest son was deciding which course to study at university and I encouraged him to do medicine rather than pharmacy. Now my youngest son is making his choice and I am encouraging him to study pharmacy. That underlines the difference the new contract in Scotland is making to community pharmacy.”

Citation: The Pharmaceutical Journal URI: 10004833

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