Controlled Drug Dispensing 2 to 3 hours Earlier Each Day for UH Bristol

Controlled Drug Dispensing 2 to 3 hours Earlier Each Day for UH Bristol


University Hospitals Bristol and Weston Foundation Trust had previously adopted the prescription tracking and ordering system Web Tracker. Following a General Pharmaceutical Council (GPhC) inspection in 2017 the trust concluded a solution for their controlled drug ordering was required. Recommendations from the GPhC included stepping away from a paper-based system to a system that allowed for reporting and offered the ability of authorisation for controlled drugs.

The comments from the GPhC prompted the trust to initiate research into a suitable alternative. Following contact with Promatica Digital, it was concluded that the Promatica Digital CD ordering system could be implemented within Web Tracker and allowed for a fitting change from a paper-based to a digital system.

The Challenge

Previously the trust used a ‘carbon copy book’. This book would record which controlled drugs needed ordering. Orders would be written down by hand and the book was handed over physically to the pharmacy department.

Using the carbon copy book proved to have a number of disadvantages:

  • The carbon copy book was a liability, as it could easily get lost.
  • The carbon copy book did not allow for tracking an order and meant nurses and pharmacists were required to call the right department/ward in order to discover whether deliveries had been successful.
  • The carbon copy book did not allow for easy reporting where data could be pulled from a system and analysed to further improve Patient Safety.

Additionally, the proper authorisation method needed to be set up for booking in controlled medicine. This needed to be a viable solution that would not provide unnecessary additional work.

The Goal

To have an efficient, digital system that allowed for a safe, authorised process that would save the pharmacy staff time.

The Implementation Process

The implementation process consisted of different steps with four hospitals and three dispensing sites seeing the transition to the new system.

When the implementation process kicked off, the trust saw an immediate need for the solution across its COVID-19 wards. In April 2020 the trust rolled out the solution in these wards as well as the Bristol Royal Infirmary as a whole.

Late April 2020 the Cardiology department of the Bristol Heart Institute implemented CD Ordering. This was quickly followed up by the Institute’s Medicine Wards. Mid May 2020 the solution was rolled out at Bristol Children’s Hospital and St Mike’s Hospital, and June 2020 saw its adoption at Bristol Eye Hospital.

“In terms of the implementation process, it was pretty organic how things grew. We at first targeted wards for COVID-19, because that had immediate priority.”

– Finbarr Canney, Clinical Informatics Pharmacist

The final leg of implementation happened in August 2020, when the system was rolled out for high-risk medicine. This part of the implementation process proceeded smoothly as the pharmacy staff was using the system daily.

The Results for UH Bristol and Weston

CD tracking and ordering went from paper-based to digital. UH Bristol saw great improvements in time spent on ordering and dispensing controlled drugs. In comparison to the old paper-based system, Controlled Drugs are dispensed approximately 2 to 3 hours earlier each day.

“At UH Bristol we do Controlled Drug stock checks for each ward. This is done at night. Previously any shortages for medicines would be written in our carbon copy book. There usually would be towers of books waiting in dispensaries to be processed. The implementation of these shortages would usually happen late morning, early afternoon. With the implementation of Web Tracker we have seen a massive productivity change where those medicines are dispensed by 11am rather than being ordered by 11am. It is a big revelation.”

– Finbarr Canney, Clinical Informatics Pharmacist

Furthermore, to meet the brief of offering a security measure for controlled drugs, the solution requires authorisation for booked-in prescriptions by a registered health professional. The system automatically cross checks whether the person giving authorisation is registered via their professional registration number. This safety check meant the trust had installed the necessary GPhC requirements.