“Dispensing practices are often the last remaining public service in a rural community.”

This stark reality, as shared by Matthew Isom, CEO of the Dispensing Doctors’ Association (DDA), during a recent interview with Accord UK, sets the stage for the challenges facing rural healthcare. With banks, post offices, and even local fire stations disappearing, the local GP practice, frequently a dispensing practice, stands as the last bastion of public services within a rural community.

In this interview, Matthew talks about the potential for technology to support dispensing doctors, detailing how digital solutions can address the unique challenges faced by these remaining community lifelines.

The role of technology in dispensing

Technology is often heralded as the new shiny solution to improve efficiency and improve patient care, but many rural practices are struggling to integrate digital solutions due to poor connectivity, high costs, and an outdated funding model.

Despite these challenges, there are ways forward and many dispensing practices have an appetite to find ways to make technology work for them. While not every solution fits every practice, there is growing recognition that with the right infrastructure technology can benefit rural healthcare, rather than complicate it.

Electronic Prescription Service (EPS)

The Electronic Prescription Service (EPS) has been a game-changer for many pharmacies, streamlining workflows and reducing the reliance on paper. In England, over 95% of all prescription items are now dispensed electronically, and Wales is steadily expanding its EPS rollout.[i][ii]

In areas where EPS has been introduced successfully, practices have taken advantage of dedicated prescribing systems that integrate with their existing workflows. In community pharmacy, EPS funding was incorporated into contracts to support the transition.[iii]

However, dispensing practices have not had the same experience. “EPS doesn’t actually work for dispensary patients, because it wasn’t designed with dispensing doctors in mind,”  Matthew explained. Without dedicated funding, practices must purchase and maintain expensive hardware to make EPS functional—a burden that has slowed adoption.

Automation

UK pharmacies have been embracing pharmacy automation for over three decades, although we are still behind the curve compared to US and European counterparts. Whilst the technology is more often deployed in hospital pharmacy settings, community pharmacies are catching up and there have been examples of its use in dispensing practices. [iv]

In some cases, robotic dispensing systems are helping dispensing doctors manage high workloads by streamlining prescription processing and stock ordering. This technology reduces the time needed for routine dispensing tasks, thereby freeing up dispensing doctors to focus on patient care and has the potential to reduce dispensing errors. [v]

Use of automation: “Robots – some practices are using these, but there’s an aspect of the contract called the dispensary services quality scheme (DSQS), which stipulates the numbers of staff that you need in a dispensary. So, any savings from introducing a robot are not necessarily realised. Obviously, the staff would be utilised doing other dispensary related things. So, there is scope in bigger practices to submit use of robots, and then obviously Hub and Spoke is something that has been sold as offering great scope for savings.”

However, not every practice can justify the investment. “The staffing model means the savings from introducing a robot aren’t necessarily realised,”  Matthew pointed out. This is where a flexible approach could make a difference. Some practices have found success by introducing automation in targeted ways using robots for specific high-volume tasks while keeping manual dispensing for more complex prescriptions.

Hub-and-spoke

The hub-and-spoke model, where medicines are prepared centrally and distributed to multiple locations has been shown to improve efficiency and reduced errors in community pharmacies.[vi] Matthew cited that in Warrington, for example, a pioneering hub-and-spoke facility has harnessed automation to centralise the bulk dispensing process.[vii] This approach allows satellite sites to focus on direct patient care, benefiting from the reduced errors and enhanced efficiency achieved at the central hub.[v] Although dispensing practices have only recently been allowed to explore this model,[iv] the Warrington case shows that larger rural practices could also benefit with the right regulatory and financial support.

A digital divide that needs addressing

The challenges of reliable broadband connections in rural areas are well known. As with other sectors such as online banking and shopping, many people in rural areas are unable to access digital pharmacy services. “If you don’t have a mobile phone signal, you can’t do a video consultation. You can’t book anything online if your broadband connection isn’t strong enough,” Matthew said.

While this issue won’t be resolved overnight, there is hope. Satellite broadband has the potential to provide a more stable connection where traditional broadband services fall short. Thanks to a government-backed initiative, providing up to £3.5 million in funding, pilot projects are set to test hybrid connectivity solutions that integrate satellite technology with mobile networks, promising to pave the way for improved digital infrastructure in the future. [viii]

New ways to support patients via tele-pharmacy

The dispensing practice is often more than just a place to collect medication, it’s a point of contact for ongoing care and advice. Tele-pharmacy provides remote consultations with a dispenser via video or phone. Although the technology behind tele-pharmacy has existed for some time, it’s recent adoption in the pharmacy community, which was accelerated during the pandemic, has extended pharmacy care to remote or underserved areas.

In some cases, this approach has helped rural patients receive medication reviews and support without needing to travel long distances. While still in its early stages, tele-pharmacy could complement existing dispensing services, ensuring that patients continue to receive personalised care even when face-to-face appointments aren’t possible.

A collaborative approach

Technology alone won’t solve the pressures facing dispensing doctors, but collaboration between healthcare providers, industry, and policymakers can make a difference.

Matthew pointed out that pharmaceutical companies like Accord have played a role in understanding and supporting dispensing doctors, noting, “Accord’s team are excellent.”

Beyond industry partnerships, cross-sector collaboration including engagement with NHS policymakers could help ensure that funding models reflect the realities of rural dispensing. The DDA’s Ramp Up campaign is one initiative aimed at highlighting the unique pressures facing rural practices, encouraging MPs to visit and see first-hand why a one-size fits all approach doesn’t work and why a more tailored approach to the needs of dispensing doctors is needed.

Ramp Up campaign: “We want to alert Members of Parliament, just exactly what dispensing practices are, that they exist, that rural communities are different. They have different needs to the rest of the community… It’s about showing the politicians what these practices represent and what will happen if they, for whatever reason, disappear.”

The future of technology in dispensing

It is clear there is potential for technology to improve efficiency and patient care in rural dispensing practices, but it needs to be applied in a way that works for these settings. Dispensing practices that have been able to integrate digital prescribing, automation, or remote services have shown what’s possible, but wider adoption will depend on addressing funding gaps, regulatory barriers, and connectivity issues.

Matthew reflects that “Once all the staff and the doctors have gone, you know, it’s almost impossible to sort of start it up again, so we need to preserve and protect these organisations.” However, with the right support, dispensing practices can continue to evolve and protect patient care without adding unnecessary strain on already stretched resources.

By learning from what’s already working, ensuring that financial and logistical barriers are addressed, and by taking a pragmatic approach to technology adoption, rural dispensing doctors can continue to provide a vital service to their communities and one that remains as essential as ever.

To learn more about the DDA please click here

[i] NHS Digital. ‘Electronic Prescription Service’. Last accessed: May 2025

[ii] The Pharmaceutical Journal (October 2024). ‘Electronic prescription service used to dispense 100,000 items’. Last accessed: May 2025

[iii] GOV.UK Department of Health and Social Care. Community Pharmacy Contractual Framework: 2024 to 2025 and 2025 to 2026. Published April 2024. Last accessed: May 2025.

[iv] Med Management. The future of pharmacy automation and pharmacy robotics. May 14, 2024. Last accessed: May 2025.

[v] Granta Medical Practices. New dispensing robot Toby. Last accessed: May 2025.

[vi] Gov.uk. Government response to the consultation on hub and spoke dispensing. 13 May 2024. Last accessed: May 2025.

[vii] Pharmaceutical Journal (April 2016). Automated hub-and-spoke dispensing technology set to transform the business model of community pharmacy. Last accessed: May 2025

[viii] Gov.uk. Satellite communications to improve connectivity in remote areas. 27 November 2024. Last accessed: May 2025.

Date of prep: May 2025  Job bag number: UK-Gen-NP-01532