1. Your Dispensary Profitability Journey
Dr Wayne Turner

2. We are going to present to you today our tried and tested 4 point process which will not only maximize but also future proof your dispensary profitability and operational efficiency.
This process was developed because we have realized that many practice did not implement our audit findings because of time restrictions or lack of inhouse expertise.
But before we do this I just want to show you our clients say about us …..

3. What Our Clients Say
“DDS conducted an in depth audit of the dispensary operations, we are so glad that we did”
We are so Glad we did

4. What Our Clients Say
“The four point journey plan to increase profit margins was clear and easy to follow”
It was clear and easy to follow

5. What Our Clients Say
“Furthermore the changes implemented are in line with the CCG formulary”
Changes are in line with CCG formulary

6. What Our Clients Say
“We wouldn’t have gained such a positive CQC outcome without the Controlled Drugs Training”
We would not have achieved a positive CQC outcome

7. What Our Clients Say
“Our new policies and procedures have given us confidence for the future”
We now have confidence for the future

8. Benefits of the DDS Journey
Increase NET profit Margin
Dispensary team training & upskilling
Strengthen governance arrangements
Improve dispensary efficiencies
Future proof profitability
So what are the benefits of going on the DDS Journey
Increase NET profit Margin – As we will see later in the presentation there are may pressures on our dispensaries driving profits down & yet a profitable dispensary is often key to cross subsidizing clinical services and making our practices viable.
Dispensary team training & upskilling – essential to make sure your dispensary team have the skill set necessary run a profitable dispensary.
Strengthen governance arrangements - Important to note this is not just about profitability but all aspect of your dispensary operation. For examples we will review and advise on your standard operating procedures ensuring that all staff are conversant with these.
Improve dispensary efficiencies - Important to look at how we can maximise efficiency in the dispensary. Not just to save money but to improve the quality of the dispensary staffs working environment. Ensuring that the dispensary runs smoothly.
Future proof profitability – Now having invested in staff training and a detailed review of dispensary operations you are in a strong position to maintain those profits into the future.
All sounds very nice but what have we been able to achieve in reality – well lets have a look. Here are some typical examples ….

9. Benefits of Profitability Journey

10. Benefits of Profitability Journey
Kent – 21% increase in NET profit

11. Benefits of Profitability Journey
Worcestershire – 18% in NET profit

12. Benefits of Profitability Journey
Lincolnshire – 23% increase in NET profit

13. Benefits of Profitability Journey
For many of our practice this has meant an increase in NET profit of over £100,000
Real quantifiable, evidence based results achieved and sustained through our 4 point Journey.
So what are the commercial challenges we need to address ….

14. What are your challenges ?
National
Category M
Fluctuations in dispensing fees
Clawback on all lines
PPRS - Pharmaceutical Price Regulation Scheme
PPRS - Voluntary agreement between the government and the pharmaceutical industry ensures that the NHS has access to good quality brands at reasonable prices.

15. What are your challenges ?
Industry
Fewer traditional direct discount schemes
Increasingly bewildering array of schemes
Reduced MDS and WS discounts
Disbanded pharmaceutical company sales force
Needless surcharges
Voluntary agreement between the government and the pharmaceutical industry ensures that the NHS has access to good quality brands at reasonable prices.

16. What are your challenges ?
Local
Medicine management formulary restrictions
Increased competition from pharmacy
Increased patient expectation
More work & less time

17. Your Dispensary Profitability Journey
So here it is then. The DDS Dispensary Profitability Journey. A 4 phased approach consisting of Audit, Implementation, Ongoing Support and Annual Review.
Let start by looking at the audit phase.

18. Phase 1 – Audit Commercial Benchmarking Operations Procurement
Prescribing
The Audit will start by commercial bench marking your dispensary against our large database. Very important to initially know how well you are preforming compared to other practices Nationally.
Operations – We will observe the operation in detail and advise on any changes required to strengthen governance and operational efficiency.
Procurement – Key to dispensary profitability is your ability to procure stock as cheaply as possible below drug tariff reimbursement. Try to do this in the most transparent way so that you can clearly see how your profit will be realised - there are lots of smoke and mirrors in this market. We will analyse your procurement on all dispensary lines (Generics, Brands, Surgical lines, Specials etc) and ensure that profit from procurement is maximized.
Prescribing – Not only what you prescribe but how you prescribe are also key, not just to profitability but to wider NHS efficiencies. Our audit will highlight this to you.

19. Your Dispensary Profitability Journey
Amanda Chell
I’d like to introduce Amanda to take you through the rest of the journey

20. Your Dispensary Profitability Journey
Stage 2 is the implementation

21. Phase 2 – Implementation
Operations
Procurement
Prescribing
Training
What we do in the implementation phase
Operation – are you operating effectively? 48 hr turn around-Typically throwing hours into rota, historical staff, slow turn over of staff, things done historically, ask why?
Better working conditions, minimising errors
Owings and how to reduce them
CD processes, are you adhering to legislation, locked receptacle, record keeping, destruction
Ensuring your SOP are up to standard and giving help if required.
Getting the operation right will result in happier patients, which will result in happier staff.
Procurement are you procuring effectively? Do you have purchase profit, do you staff know how to identify purchase profit? Cover in training
How do you manage your generics above d/t price?
PI – do you purchase PI? Do you staff know how to net price uk stock to know when to buy a PI
MDS deals – get to know your deals , pack sizes, thresholds, capitations.
Not just the dispensary- mention nursing team
DAC- are you getting the most from you DAC – do you have a DAC
Getting the procurement right will result ina better cash flow
Prescribing – detailed analysis of prescribing done off site.
We would help you put together a easy to follow formulary for all of your prescribers
How are you prescribing? generically or by brand do you know which is the most profitable way
Identifying your loss making lines – key to know your loss making lines- DDS will suggest more profitable alternatives
Ensuring you are maximising all profits between prescribing and dispensing. We also look at other areas where money is seeping out of the dispensary. WGM – train accordingly
Training – dispensers, managers, nurses and gp partners
Its your team who will take this forward.
Compliance and concordance
Power-point training with lots of practical exercises.
Training in the dispensary one to one with each member of the team to help them understand the financial process.
analysis work doesn’t just stop with the dispensary, its looking at all areas, including the nursing team.
Ensuring team are purchasing from the correct place to maximise discounts

22. Your Dispensary Profitability Journey
The next stage is the ongoing support

23. Phase 3 - Ongoing Support
Monthly horizon scanning
Advise on Medicines Management
Website
Bespoke in-house training
DDS will inform you of any changes in the market place or areas that you need to observe such as generics above drug tariff price, new or stopped MDS, s starting with ‘its sounds like a silly question but’
Meds management - annually you will receive actions from meds management, we can help you make an informed decision.
Website – fantastic – general disp news, generics above drug tariff price,DT news such as ezetamide cat C to M , morphine liquid has gone from cat c based or oramorph to cat M
In-house training – we can come to you, make the most of your PLT days
Monitored Dose Systems – mention GP and pharmacist advisory
DTE with lots of practical exercises
CD - + a look at your register and your operations
Procurement training – titled income streams, profits and losses – very popular – removes the smoke and mirrors
The dispensary lead – a general overviews of all areas of the dispensary- popular with new disp leads or new disp managers.
Risk management – looking at errors and how to minimise and also training on standard operating procedures. Writing a good SOP will reduce errors.

24. Your Dispensary Profitability Journey
Phase 4 is the annual health check

25. Phase 4 - Annual Review Re-audit Outstanding issues Training
The annual review is to ensure that the dispensary is staying on track, that all the systems are being adhered to
Outstanding issues – changes in the market place that may not have been spotted by the team mention Hawkhurst 15% - 31% but found another 4% on the review
From that any re-training which may be required.

26. Your Dispensary Profitability Journey
So this is our 4 phase approach.
An approach that can deliver results like this…

27. Benefits of Profitability Journey

28. Come and talk to us… …We are on the DDA stand
Dr Wayne Turner – Senior Partner Leicestershire Dispensing Surgery & DDS Director.
Prad Savania – Consultant Clinical Pharmacist & DDS Director
Amanda Chell – Experienced dispensary manager and trainer for dispensing doctors & DDS Director.
Thank you to DS for sponsoring lunch. They had no involvement in the content of the talk.
We will not be taking questions as past experience has shown they tend to be very practice specific and of little relevance to the wider audience but we would love to meet you and answer your questions so Myself, Amanda and Prad will be available at the DDA stand after the presentation.

29. Dispensing Doctor Solutions Ltd
Contact Details
Dr Wayne Turner
Director
Dispensing Doctor Solutions Ltd
Prad Savania
Amanda Chell