The following tables’ present collated data for pharmacies within the LCS compared to pharmacies not participating in the LCS to compare promptness of supply for:
all urgent prescriptions (Table 4.9), this includes drugs on the LCS stock list and drugs not on the stock list;
subcutaneous medicines (Table 4.10), of which 90% were on LCS stock list;
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controlled drugs (Table 4.11), which includes enteral and topical formulations which are not on the LCS stock list.
In each case the time taken has been calculated from when the prescription is dropped off to the pharmacy dispensary by the pharmacy user or the GP surgery to the time when the prescription was completed and ready for collection or delivery. Median, minimum and maximum times have been calculated as well as upper and lower quartiles. The time taken in each scenario is predicated by stock availability in the pharmacy at the time the prescription is presented.
Table 4.9 Urgent prescriptions
LCS pharmacies (%)
Non-LCS pharmacies (%)
Total no. urgent prescriptions (Px)
105 (56.8) 80 (43.2)
No. Px for which time data missing
67 (63.8) 6 (7.5)
No. valid Px for analysis 33* (31.4) 74 (92.5) Minimum time taken
(hr.min)
0.03* 0.10
Median time taken (hr.min)
0.10* 5.00
Maximum time taken (hr.min)
3.39 47.15
Lower quartile time taken (hr.min)
0.08* 1.00
Upper quartile time taken (hr.min)
0.11* 26.30
*Five urgent prescriptions excluded from analysis where minimum time was 0 minutes where user sent to another pharmacy to obtain urgent supplies to prevent skewing results
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Urgent prescriptions were analysed and compared across pharmacies. There were 112 cases, however, five prescriptions were recorded at 0 minutes where one of the requested items was not available and the pharmacy user had to obtain the prescription elsewhere. Removing these five prescriptions left 107 valid cases for analysis across the five pharmacies. The median time taken for all urgent prescriptions across all participating pharmacies was 2 hours with the range between 3 min and 47.15hr.min. The median time taken within LCS pharmacies was 10 min and non-LCS pharmacies was 5 hr; an independent samples median test was calculated (p=0.002). At a significance level of 95% the medians of total time between LCS and non-LCS
pharmacies are not the same with the time taken within non-LCS pharmacies being significantly longer than LCS pharmacies. Due to low numbers of prescriptions and missing data no reliable comparison could be made between individual participating pharmacies.
The analysis does not account for confounding variables including time of day, prescription numbers, number and type of staff working in the pharmacy at the time the prescription was presented. The missing data and presence of confounding factors therefore limit interpretation of the results.
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Table 4.10 Subcutaneous medicines (via syringe driver or anticipatory) LCS pharmacies
(%)
Non-LCS pharmacies (%)
Total no. s/c prescriptions (Px)
100 (74.1) 35(25.9)
No. Px for which time data missing
65 (65.0) 6 (17.1)
No. valid Px for analysis 30* (30.0) 29 (82.9) Minimum time taken
(hr.min)
0.03* 0.27
Median time taken (hr.min)
0.10* 21.18
Maximum time taken (hr.min)
0.30 146.00
Lower quartile time taken (hr.min)
0.08* 1.00
Upper quartile time taken (hr.min)
0.10* 26.30
*Five urgent prescriptions excluded from analysis where minimum time was 0 minutes where user sent to another pharmacy to obtain urgent supplies to prevent skewing results
Prescriptions for subcutaneous medicines were analysed and compared across pharmacies but there were only 59 valid cases for analysis after removal of five cases where minimum time was recorded as 0 minutes due to prescription items not being available at the pharmacy. The median time taken for all subcutaneously administered medicine prescriptions was 27 mins with a range from 3 min and 146 hours. The median time taken within LCS pharmacies was 10 min and non-LCS pharmacies was 21.18 hr.min; an
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independent samples median test was calculated (p=0.801). At a significance level of 95% there is no difference between the medians of total time
between LCS and non-LCS pharmacies in dispensing subcutaneous
medicines. Due to low numbers of prescriptions and missing data no reliable comparison could be made between individual participating pharmacies. Again the analysis does not account for confounding variables at the time the prescription was presented limiting the interpretation of the results.
Table 4.11 Controlled drug prescriptions
LCS pharmacies (%) Non-LCS pharmacies (%) Total no. CD Prescriptions (Px) 68 (59.6) 46 (40.4)
No. Px for which time data missing
48 (70.6) 3 (6.5)
No. valid Px for analysis 18* (26.5) 43 (93.5) Minimum time taken
(hr.min)
0.03* 0.10
Median time taken (hr.min)
0.10 23.00
Maximum time taken (hr.min)
5.45 171.30
Lower quartile time taken (hr.min)
0.08* 2.30
Upper quartile time taken (hr.min)
0.10* 26.40
*Five urgent prescriptions excluded from analysis where minimum time was 0 minutes where user sent to another pharmacy to obtain urgent supplies to prevent skewing results
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Prescriptions for controlled drugs were analysed and compared across
pharmacies, which resulted in 61 valid cases for analysis after removal of two cases where minimum time was recorded as 0 minutes for controlled drugs when prescription items not available at the pharmacy. The median time taken for all controlled drug dispensed palliative prescriptions was 4.47 hr.min with a range from 3 min to 171.3 hr.min. The median time taken within LCS pharmacies was 10 min and non-LCS pharmacies was 23 hr; an
independent samples median test was calculated (p=0.0450). At a
significance level of 95% there is a likely to be a difference in the medians of total time between LCS and non-LCS pharmacies in dispensing controlled drug items.
4.4.1 Effect of errors on promptness of supply
The effect of legal errors on prescriptions for subcutaneous medicines was minimal within the sample as these errors were resolved within 10-30 minutes.