Table 3

Detailed ethnographic description, (known as ‘thick description’) of the four community pharmacies47

Woodland independent pharmacy group
Willow pharmacy, housed in purpose-built premises, has a small footprint given the volume of medicines it dispenses. Much of their work comes from the GP surgery over the road. Every bit of space is taken up with stores of medicines: small boxes of pills in blister packs on shelves from counter to ceiling; large canisters of barrier creams, syrups and fortified milkshakes on lower shelves below the counters; robot-prepared dosette boxes stacked in floor-to-ceiling shelves. Delivery men visit twice daily, trolleys laden with large cardboard boxes full of medicines that are unpacked, cross-checked off the order sheet and stacked on the shelves as quickly as they are removed. At regular intervals, the low hubbub of dispensing and dosette box production work is punctuated by a woman at the front counter calling out ‘Prescription waiting!’ as she clips the prescription on a tiny metal hanger at the front of the dispensary. The low whooshing noise from the dispensing robot signals drugs ready for a technician and pharmacist to check, bag up and pass to a customer. All 10–15 staff move quickly around the space as they gather up medicines, stack the shelves, deblister tablets to replenish the hungry robots, add a reminder to the whiteboard or post-it note, respond to customers—switching seamlessly between languages as needed. They skillfully navigate the tight space, shifting boxes, climbing steps, passing medicines from one to the other and always listening out for each other.Foxglove, sister pharmacy of Willow, has an even smaller footprint than Willow. It’s housed in a converted Victorian building, within a row of shops with flats above. Entering the pharmacy through an automatic sliding door signals the shop has recently been modernised. A padded bench along one wall allows customers to sit while they wait. A selection of over-the-counter medicines is on display. The front counter is staffed by two people, handling patients who hand over their paper prescriptions or ask to pick up medicines. Counter staff flick through a card file to find a customer’s prescription which cross-checks to a numbered shelf where medicines have been bagged up, waiting for patients to collect them. The dispensary is at the back with an eye-level counter, giving staff cover as well as a view of what’s happening on the shop floor. The dosette area is hidden from customer view, even further back in this Tardis-like building and is particularly narrow. Here, a counter runs the length of one wall, which the ‘dosette team’ use to check the robot-produced dosettes (sent over from Willow) for errors before they are given to patients. Pharmacists tip and flick the dosette box from underneath to check and count the capsules and tablets in each cell. Floor to ceiling shelving runs around the room, storing each patient’s four- weekly supply of dosettes, stored alphabetically by patient’s surname and according to their collection or delivery day. As with Willow, there are on average ten staff diligently working away, but always with an ear out to help one another.
Meadow independent pharmacy group
A steep slope marks the entrance to Poppy pharmacy, located opposite a GP practice, in a quiet, residential part of a suburban town. I wonder how some older customers navigate this entrance, but a sign on the door tells people to ask for help if needed. Each time the door opens a tune bleeps out, signalling the arrival or departure of a customer or delivery man. This immediately prompts someone to leave the dispensary which is in a raised area at the back of the shop, to leave their tasks, come forward and ask ‘how can I help?’ The shop floor houses an array of over-the-counter medicines and beauty items. It has a welcoming feel, with a row of chairs opposite the counter for customers waiting for prescriptions or just needing a seat. There are usually two or three people working in the shop at a time, in quiet dedication to their tasks. When there are no customers, staff focus on dispensing prescriptions, preparing baskets for filling dosettes, checking dispensed medicines, answering the phone, ordering medicines and receiving deliveries. Every available wall space is full of shelving to house medicines. Sticky, fluorescent yellow labels stuck to the shelves remind staff to ‘select with care’.Lilac pharmacy is in a parade of shops: a builder’s trade shop, fish and chip shop, Co-op mini supermarket and a café in a suburban residential area. I am struck by a large sign plastered along the length of the front window ‘FREE DELIVERY’, similar to a sign on the glass shop front at Poppy. Inside it’s very calm and quiet—the door opens onto a spacious, airy and light shop with shelves displaying all manner of over-the-counter medicines and beauty products, even children’s toys. People frequently come in for a chat with the counter staff—often without even the excuse of a prescription to pick up. Despite the large shop floor, space behind the counter in the dispensary and dosette areas is tight—when I’m there, as with all the other pharmacies, I feel I am in the way although nobody seems to mind. I notice all the worktops are black, and Leena, the pharmacy manager, explains that all the pharmacies in the group are replacing their worktops with black ones. I am told that black worktops make the white tablets easier to see: when checking and counting tablets staff can simply lay the clear plastic dosette box on the worktop and easily see the number of pills in each cell. Compared with the Woodland group pharmacies, pace of work at the Meadow group pharmacies is less frenetic.
  • GP, general practitioner.