Christmas and New Year is often a time for reflection. Amid the usual festivities, I found myself reflecting on a recent “Major Incident” involving our dispensary IT systems.
The outage lasted five days. During that time, we had an unprecedented loss of access to systems that are fundamental to our day-to-day dispensing and that we often take for granted. We lost all access to the NHS spine.
While the disruption was significant, it reinforced the value of robust Business Continuity arrangements. Thanks to clear processes and a well-prepared team, we were able to continue supplying essential medication safely and in a timely manner.
The experience served as a reminder that Business Continuity planning is not just a dull paperwork exercise, but is in fact a core component of patient safety. When systems fail, patients still need their medication, and staff need clear, supported ways of working.
What Is Business Continuity?
In a GP dispensary, Business Continuity is the ability to maintain the safe, legal, and timely supply of medication despite operational disruption. It is not about preventing every incident, as many are beyond our control, but it is about being prepared and able to adapt and recover when incidents do occur.
Effective continuity planning ensures that staff understand what to do, who to contact, and how to adapt workflows while maintaining appropriate checks, governance, and standards.
What might operational disruptions look like?
Thankfully, serious disruptions are relatively rare, but when they occur their impact can be immediate. Common challenges include:
- Medicine supply chain interruptions.
- IT system outages.
- Staff absences
- Power failures
- Cold chain failures
- Premises issues such as fire or flooding.
Any one of these can significantly hamper dispensing activity. Prescriptions may be difficult to process, items impossible to label or check, or medication could be rendered unsafe to use.
Without a clear fallback plan, the risks to patient care, and the wellbeing of our team, begin to escalate.
Identifying and assessing risk
To understand which risks are relevant to your dispensary, you should complete a thorough, yet realistic risk assessment. For each identified risk, you should consider the likelihood, impact, and recovery time, considering local circumstances such as practice size, staffing model, and any reliance on particular systems or suppliers.
Reviewing previous incidents and near misses can help ensure the assessment reflects real-world challenges rather than hypothetical risks.
Here is a simple risk assessment layout that might help:
| Risk | Likelihood | Impact | Risk Score ( Lx I) | Recovery Time | Mitigation |
| Risk 1 | |||||
| Risk 2 | |||||
| Etc … |
Where significant risks are identified, these should be added to the practice Risk Register, with clear owners, actions and review dates.
The Business Continuity Plan
All GP practices should have a Business Continuity Plan; we cannot simply close our doors when things go wrong. For dispensing practices, this should include a clear extension covering dispensary operations, recognising the additional regulatory and patient safety responsibilities involved.
A well-constructed plan sets out likely disruptions, as identified in the risk assessment and the actions required to maintain safe dispensing services.
Another simple template you could use is:
| Disruption | Action 1 | Owner | Action 2 | Owner | Communication plan |
| Event 1 | |||||
| Event 2 | |||||
| Etc … |
Consider where the Business Continuity Plan is going to be kept - if it is only on the GP IT computer network, how will you get a copy when the network goes down? Often the best place is Cloud Storage (and dare I say it, even a paper copy can come in handy!).
Testing, review, and continuous improvement
A plan is only effective if it works in practice. Business Continuity arrangements should be tested regularly and reviewed after any real incidents occurring.
Scenario exercises help identify weaknesses in your Business Continuity Plan and build staff confidence should an incident occur. Based on this exercise, you should make required improvements and retest. Continue the cycle.
Here are some scenario ideas you can discuss as a team, and even role-play your actions:
Scenario 1 - The fridge temperature has risen to 10 degrees Celsius for more than 30 minutes.
Scenario 2 - The suppliers ordering portal website has crashed.
Scenario 3 - Your power goes off.
Scenario 4 - Your card payment machine breaks. (Hardly anyone has cash).
Scenario 5 - You can’t connect to the NHS spine.
A great way to engage your team is to have them create their own scenarios, which can be played out during a half-day closure, or when you shut your dispensary over lunch (if you do shut that is).
Conclusion
Business Continuity is about more than policies and paperwork. With clear planning, trained staff, and a culture of preparedness, dispensaries can continue to deliver their essential service care even when systems fail.