Evolving medication management from analogue to digital

CW Innovation Fellow: Katey Hewitt

Role: Associate Chief Pharmacist Operations 
Organisation: Chelsea and Westminster Hospital NHS Foundation Trust

Automating the pharmacy top-up process 

Summary: Modernise the medication stock check process by implementing an electronic integrated solution that incorporates barcode technology and aligns with inventory management intelligence 

Story of the project

Wards have a defined ‘stock list’, which is effectively a catalogue of medicines they can order from the hospital’s on-site pharmacy. These are medicines that are commonly used in their area, without a pharmacist having to clinically verify a prescription.  

A member of the pharmacy team, such as a Pharmacy Technician or Pharmacy Assistant, visits each ward once or twice a week to identify medicines that are running low and therefore need to be re-ordered. This requires taking printed stock lists for each ward, manually counting and then writing down how much to order. As part of the top-up process, medicine expiry dates are also checked, and out-of-date packs are removed and disposed of. 

We undertook data collection and determined that the pharmacy spends 44.5 hours a week visiting 51 different storage locations, manually counting and checking expiry dates of nearly 10,000 packs in just one hospital site alone. 

I have worked as a pharmacist for 25 years, and the pharmacy top-up process has not changed in that time. We also know that the majority of hospitals approach the process in the same manual way. The only other alternatives on the market are automated medicines cabinets. These require significant investment as well as adequate space to accommodate the automated units. 

I therefore decided I wanted to modernise the process by implementing an electronic integrated solution that incorporates barcode technology and aligns with inventory management intelligence. This would ensure the correct product is ordered in the right amount at the right time. The solution would also proactively identify medicines that are due to expire well in advance, meaning they could be used elsewhere before expiry and reduce waste. It was also important that the solution could be made commercially available to other organisations.  

As well as monitoring stock levels, we also wanted to enable ward staff to make orders electronically in between their routine top-up visits. It was decided that this step should be completed first, as this would provide the foundation for interfacing and catalogue development to build the top-up solution.  

Outcomes

The project began in December 2024. Work completed so far includes: 

• Approval gained from the Trust commercial assurance board. 

• Identified and engaged with preferred supplier, Promatica, who develop HealthTech for the NHS and other healthcare organisations. This includes preexisting software used in our pharmacy workflows, such as electronic controlled drug ordering. This led to identifying synergies between this software and the solution we wanted to develop. As we also had the relevant IT infrastructure already in place, it appeared to be the most logical and cost-effective way to develop the solution. 

• Secured partnership with Promatica to develop the solution, with a risk share commercial agreement. 

• Submitted a bid to CW+ and successfully secured funding towards the development costs. 

• Engaged with procurement to ensure contracting with the third-party company was aligned to the trust’s standing financial instructions. 

• Developed electronic stock ordering system for ward staff. 

Advancing the project through CW Innovation Fellowship

I decided to apply for the CW Innovation Fellowship (recently rebranded from the Horizon Fellowship) as I thought it was a great way to gain support in developing my idea. It also offered a platform to share ideas with others in the trust that are also passionate about development, innovation and technology.  

I wanted to expand my knowledge and felt there was so much opportunity for learning on the programme. As a pharmacist, you are not trained in technology, yet you must be able to adapt to an ever-evolving environment. Pharmacists, therefore, tend to be self-taught and learn on the job.  

As a non-IT professional, it is very hard to find a suitable technology-based course that doesn’t require a technology background. The Fellowship struck this balance, allowing me to progress my innovative project and gain the support I needed. I was also drawn to the programme as I was intrigued by the ideas and thoughts that could be generated by working with other like-minded people and those working in this field already.  

As a participant in the programme organised for NHS staff, I received thorough support and training customised to the specific context of our operations.

Whilst the scope of the Fellowship was clearly outlined when I applied, I still didn’t fully appreciate the opportunity for learning on the programme. Being part of a programme specifically developed for NHS staff meant that the training and support considered the context and environment in which we are working.  

The programme has really helped me define and articulate my idea, which has enabled me to secure buy-in and commitment from others who are key to its success. Beyond this, it has also enhanced my approach to structuring the project planning and improvement methodology. During learning days, I found the strengths identification invaluable and other sessions relating to change management particularly helpful.  

The programme also provided access to a mentor, whose skills and knowledge were a perfect match to my project. This has proved invaluable, with support and insights into aspects I wouldn’t have otherwise considered. 

Next steps

The first phase of the solution is currently in the testing phase. In the next six weeks, we are aiming to roll out the electronic ordering phase and start work on the next top-up phase. 

We will be using in all wards and departments that store medicines on both hospital sites: Chelsea and Westminster Hospital and West Middlesex University Hospital. As we are working in partnership with Promatica, it will also be a product that is commercially available to other organisations. 

For more information on the CW Innovation Fellowship, which has been rebranded from the Horizon Fellowship, visit the CW+ website. You can also check out our Innovation Directory to browse through the full list of Fellows.