Trays on the bench, a change on the phone
Your compliance pack patients are on four-week or weekly cycles, each with its own collection or delivery day. The trays for next week are part-made when the phone rings: a GP practice has changed a dose, or stopped something, or started something new. Someone writes it on a note and puts it in the patient's folder.
The next day a discharge letter arrives by email for another patient. A carer rings to say a tablet has been dropped. By Friday, the folder for that first patient has two notes in it and it is not obvious which is the latest.
Why changes are the risky moment
Making up trays is repeatable work. Changes are not. They arrive through the phone, email, fax, NHS mail, discharge letters, and new prescriptions, at any point in the cycle, and they may affect trays already made.
Each patient has their own cycle and their own paper folder or file. There is no single place showing which patients have a change pending and whether it has been actioned. The process relies on the person who took the call also being the person who makes up the trays, or on a note being read.
What missed or late changes cost
| Problem | Consequence |
|---|---|
| Change noted but not seen | A tray is made up to the old instructions |
| Trays already made | Rework when a change arrives late in the cycle |
| No sign-off record | You cannot show when a change was actioned |
| Prep dates in heads | Trays made in a rush on the day they are due |
| Staff absence | Only one person knows the state of each patient |
What any change means clinically, and whether a tray needs remaking, is the pharmacist's decision. We make sure the change is in front of the right person at the right time.
A change log and prep schedule
- A patient list for everyone on compliance packs, with their cycle, prep day, collection or delivery day and any notes you keep.
- One change log. Every change, whatever channel it came from, is entered once with the date, source and a copy of the document if there is one. Emails can be forwarded straight into it.
- Status on every change: received, reviewed by pharmacist, actioned on the PMR, trays updated. Nothing drops off until all steps are ticked.
- A prep schedule showing which trays are due to be made each day, with a warning mark on any patient who has an open change.
- A cycle view for each patient so anyone covering can see what was done and what is pending.
- A weekly summary of changes by source, which helps when you talk to surgeries or care homes about how they send updates.
The PMR remains the record of the patient's medication. The change log is the tracking layer around it, so nothing arrives and gets forgotten.
Tray prep with nothing hiding in a folder
When the team starts on the day's trays, the prep schedule shows which patients have open changes, before anyone opens a blister. Changes taken on the phone by one person are visible to everyone. When the pharmacist signs off a change, there is a record of when and by whom.
Cover during holidays becomes easier too. Someone who does not normally run the trays can open the schedule and see exactly where things are.
Signs your tray process needs a change log
- Changes are written on notes in patient folders
- Trays have been made up before a change was seen
- Only one or two people know the state of each patient's cycle
- Discharge letters and emails arrive in different inboxes
- You could not quickly show when a particular change was actioned