An observational study of pre-registration trainee pharmacy technician activities in ward stock management

Abstract Introduction The pre-registration trainee pharmacy technician (PTPT) apprenticeship is a two-year programme established in 2020 to deliver the NHS pharmacy technician workforce expansion programme. In 2024, an acute London teaching hospital secured funding and innovated to deliver a PTPT-led medicines stock management service. Aim To observe PTPT time spent on different medicines management activities, and to determine the financial impact. Methods Prospective cohort study at an acute London teaching hospital, using direct observations and cost of returned medicines. Observations took place over two months and were co-designed and conducted by two research interested PTPTs using a work sampling tool, iterated through piloting. Seven wards of varying specialties (including care of the elderly, cancer haematology, theatres, acute medicine, and critical care unit), were selected from sixteen wards served by the PTPTs. PTPTs who served these seven wards were observed, with activities recorded every five minutes across observation slots of up to two hours and categorised into three main groups: ward work, dispensary work, and other. Approximate time spent on each activity was calculated as a proportion of the total number of observation hours. PTPTs provided written consent for the observations and self-reported demographics, such as age, sex, and experience (time in months) using an online survey. Financial impact was assessed based on direct cost of returned medicines as well as overall profile of stock holding for the observed areas. Results Twelve PTPTs (10 female, 2 male; mean age 33.4 ± 12.29 years and experience ranging 3 months to 15 months, median 9 months) were observed across 100 hours and 33 minutes. Observations took place in the morning and afternoon. Each observer monitored one PTPT at a time on multiple occasions (ranging 1–10 observations/PTPT observed). A total of 1320 activities were recorded across 56 observations, with a mean observation time of 1 hour 47 minutes. The most time was spent on ward work (59%, 59.5 hours), specifically ordering stock medications (28%, 28.2 hours) and putting stock away (9.5%, 9.5 hours), followed by dispensary work (26%, 26 hours), specifically transmitting ward stock orders to pharmacy stores (5.7%, 5.7 hours) and daily briefings with other PTPTs (5%, 5.1 hours). The remaining time involved other activities (15%, 14.9 hours), which included protected time for professional development activities (1%, 1.1 hours), breaks (3.5%, 3.5 hours) and travelling between work areas (10%, 10.3 hours). Financial returns show a direct cost saving through medicines returned by the PTPTs as well as optimised medicines stock holding by expiry date checking and avoiding overstocking in the clinical area. Conclusion This service evaluation demonstrates the contribution of PTPTs in improved and effective stock medicines management in clinical areas. Limitations include potential observer effect; observations being conducted at fixed times and other factors affecting medicines returns. Further work is in progress to quantify the financial impact, as well as wider assessment of the value of the service to the clinical teams.