In Practice
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Here at TM, we often focus on outstanding individuals and pharmacy teams, but rarely do we highlight the all-important people who work in the medicines supply chain
The team at the Alliance Healthcare service centre in Coatbridge, near Glasgow, are a perfect example of the invaluable work being done to keep the industry going. So, we were delighted when they allowed us to take a behind-the-scenes look at what they do and how they do it.
The Coatbridge site
Coatbridge is one of 16 medical service centres run by Alliance Healthcare UK. It provides up to 11 deliveries a week, twice a day Monday to Friday, and Saturday mornings. This particular centre supplies 1,563 pharmacies with an inventory of approximately 11,600 lines.
Originally based in Livingstone, the team made the move to Coatbridge in 2017. “The Livingstone site didn’t have the room for expansion and the opportunity came up for Coatbridge,” explains Lee Jamison, Coatbridge service centre manager.
“We had numerous people from all over the UK up supporting us during the first few months and it was fantastic. Without them, we wouldn’t have got settled quickly enough – they helped train people, get them up to the standards.
“We went from being – at the time – the worst in the network for damages, stock write-offs and missing parcels to being one of the best sites in the network, which is an absolute credit to the people down there on the floor.
“To turn what was the worst into one of the best is incredible and it’s been well executed to get there. No one person can do that all on their own – you’re only as good as your team.”
How it works
The Coatbridge service centre receives 620 orders every week. The goods come into the warehouse and are checked. “We take the stock in through the back door. Once it comes in, we get it all checked and it gets sent through to be put away,” says goods in checker Lesley Anderson. “Fridge medicines are checked straight away as we have an hour to get them in the fridge, and the controlled drugs (CDs) go straight to the CD room because the girls there check their own stock.”
“This part of the jigsaw is absolutely critical because that’s where it all starts,” adds communications manager Janet Hancock. “If it goes wrong at goods in, then it goes wrong right the way through the chain. The second that anything changes there, that has a knock-on impact on the whole chain, so it has to be right. It’s essential that what you do is done in a timely and accurate fashion.”
Orders then go through an automated process and are separated into tote trays, checked again and then placed into lorries for delivery to pharmacies.
CDs are dealt with slightly differently. “There are the set processes which the staff have got to be trained in before they can work in the CD room,” explains Janet. “There’s a discipline to that work and the training is essential.”
“You have to make sure that you pack; you double check that it’s signed for,” says warehouse operative Julie Leggat. “There’s really expensive stuff there too, so even if it’s just one pack, it has to go in a box so it doesn’t get damaged.”
Delivery drivers are also a hugely important element of the service centre’s operation. Coatbridge has 131 drivers with a combined weekly mileage of 148,000. Vehicles range from vans to HGV lorries. If they want to, drivers can work their way up to driving the biggest vehicles, as Agnes McDonald, Class 1 HGV driver explains: “I didn’t actually start to drive until I was 38 and I found that I had such a passion for it that I joined an agency and that’s how I got my job here. I drove vans forabout 11 years and then I put myself through the Class 2 course and then the company funded my Class 1 course, so I’ve gone through every stage in my driving career with this company.”
The average turnaround from an order coming into the warehouse before going out again in the delivery vans is 45 minutes, and the centre operates on a hub and spoke system with link points across Scotland in Aberdeen, Dundee, Kilmarnock, Dunfermline, Broxburn and Dumfries. The harder-to-reach Highlands areas are serviced on a next-day basis.
As frequent pharmacy visitors, the drivers build up great relationships with the sites they visit. “My perception of this job is – and I always say it – a smile goes a long way,” says Agnes. “You go in with a smile and the amount of people who will smile back at you is unbelievable.”
“It’s all about reputation and building that trust,” says Janet. “Our reputation in being reliable and delivering the service, doing what we do really well, keeps the business healthy and helps it to thrive.”
Covid response
As has been the case for most of the healthcare industry, the past two years have been extremely difficult for both the Coatbridge site and Alliance Healthcare as a whole, but the company has made a priority of being helpful.
Throughout the pandemic, it offered community pharmacy a twice daily delivery service, partnered manufacturers and the NHS to manage the flow of critical medicines, carried out additional deliveries and bespoke stock management and extended its community pharmacy customer base.
“In the summer, dexamethasone was acknowledged as helping to treat anyone who had Covid-19, so as Almus dexamethasone is one of our brands, we donated 500,000 tablets to the NHS to support them because we felt we should and we had the medicines to do it,” says Sam Unsworth, acting head of marketing and communications. “I think it set a good standard to show colleagues that we’re not just moving medicines; we do care as a business. We stood shoulder to shoulder with community pharmacy. They didn’t close their doors and neither did we throughout the pandemic.”
The company also played a key role in the logistics of the Government’s Nightingale hospitals. “We supported stocking the nightingale hospitals as soon as we heard about them,” says Janet. “We worked with the team there to make sure they were fully stocked and ready to open their doors whenever needed. We worked really closely with the NHS with a really fast turn around and we were just really proud to be part of it.”
“What was really good after that was when some of the Nightingales started to be used as vaccine centres, we supported getting the vaccines there as well so they could maintain the doses that they had to get every single day,” adds Lynn McWhinnie, regional operations manager – North. “Especially as the Pfizer vaccine comes frozen and after delivery you can’t refreeze, so the stock could potentially go to waste. It was super important that we were trying to support them as much as we could, getting the stock to them just in time.”
“We stood shoulder to shoulder with community pharmacy. They didn't close their doors and neither did we”
In fact, since December 2020, Alliance Healthcare has delivered vaccines to approximately 1,490 sites of care, with deliveries taking place up to seven days a week.
Like many community pharmacies and hospitals, the Coatbridge site had to deal with its own set of Covid worries, and was particularly affected by absences across its departments. “There was one day when somebody in the CD staff tested positive and then the other three girls had to go and get tested so they had to pull from other areas to cover that and it’s a specialised skill,” recalls Lesley.
During this time, people like Lesley, who are multi-skilled, kept the operation going because wherever the gap was, they were able to step in. This applied not only at the Coatbridge site, but at Alliance Healthcare service centres across the UK.
“Wherever Covid cases peaked, if we had a core of people that could help and agreed to travel, we would move them to make sure we had that continuity of supply,” explains Janet. “The roles are essentially similar – it’s just a different setting, so we were able to move people around to make sure we kept that service going. We’re really lucky that we had people that were flexible enough to do that for us.”
“They’re superhumans,” agrees Lee. “Sometimes, my team were getting asked on a Friday to go to Leeds [217 miles south] on a Saturday. The Coatbridge team probably went and supported more sites than any other site in the network, but that’s because of how good that team are at reacting to situations and how good they are at turning it around.”
Award-winning performance
All of their hard work paid off when Alliance Healthcare UK and its logistics partner Alloga UK won the Special Recognition Award for Outstanding Response to Covid-19 at the 2021 Logistics UK Awards.
To enter, the company had to demonstrate how it led a class-leading response to Covid-19, how it achieved this, and the outcome that followed. In an internal letter to colleagues, Julian Mount, Alliance Healthcare UK managing director at the time, wrote: “We particularly want to say thank you to all the service centre and cross stock centre operations. Without you on the frontline, we couldn’t have succeeded over these past months. We could not have continued with twice daily delivery; we could not have coped with an extra 1.6 million parcels moving through the network, practically overnight; we could not have assisted in setting up the nine Nightingale hospitals; we would not have been the sole distributor of lateral flow test kits within the UK... none of this would have been possible without all of you.”
The Alliance Healthcare team were thrilled with the award. “Even to just be shortlisted and have that recognition was amazing, but then when we actually won, that was just incredible,” says Janet. “Because it comes in stages and you’ve been through it like a whirlwind, to have it repeated back really does hit home that it is quite phenomenal.”
Teamwork
Walking around the Coatbridge warehouse, it is easy to see a real sense of teamwork and family. On one of the centre’s walls is an extensive list of employees celebrating 10, 15, 20 – even 30 – years of service. It seems to be the kind of place that you join and don’t ever want to leave. As Janet says: “You’re drawn in... if the bug bites you then that’s it!”
The collaboration between employees and the wider healthcare industry, and the importance of their work for the NHS and pharmacies is something Julie really feels. “You get satisfaction that you’re helping other people,” she says. “My dad is diabetic, so I know that we have to make sure to get all that medicine packed and check that it is all correct. We feel really good doing our job, day to day.”
This kind of atmosphere has been exactly what the business has needed during the pandemic. "It's been the hardest two years, but it's also been really rewarding," says Lee. "The things that people have done for me when I've asked them to go the extra mile...
"I wouldn't ask anyone to do something that I wouldn't be willing to do myself, but when you're asking constantly during different situations, it is personal. People are doing it for you, and it's fantastic. I will truly appreciate it constantly because my team are incredible individuals."