First draft

Author: joejulier-nhs

app/manage-your-appointments/2025/10/pharmacy-visits-what-we-learnt-part-1/index.md

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-title: Pharmacy visits what we learnt part 1
+title: What we learnt from visiting pharmacies: part 1
 date: 2025-10-02
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-The service will enable healthcare providers to create and manage availability and appointments
+We recently visited 10 pharmacies in London to see how they were using MYA just as appointment booking for this year’s seasonal vaccinations opened. 
 
-The service is set up to initially support vaccinations, but over a longer term, could be used to support appointments for other services if needed.
+We did this research for two main reasons: 
 
-## The background
+##1. To help us better understand the feedback we were receiving 
+We’ve been getting lots of feedback through our feedback survey, in the Q&A during training webinars and via the service desk. This feedback is great for learning what users want and where they’re running into problems, but it’s usually it’s missing the detail required to fully understanding the underlying need. 
 
-A 3rd party appointments management solution was procured by the NHS in response to the Covid-19 pandemic.
+##2. To hear from users unlikely to take part in remote research 
+Up to this point, most of the research on MYA has been remote. This means the sample has skewed towards the kind of users who can easily join a pre-scheduled Teams call. As a result, we’ve heard from lots of back office staff for large pharmacy chains, and people in admin roles for Trusts and PCNs. But, we haven’t heard from as many pharmacists or dispensers as we should have, especially given pharmacies account for roughly 95% of MYA’s users.  
 
-The Manage your appointments service was designed to replace the existing 3rd party software, and provide more flexibility for expansion of appointment management services.
+#What we learnt 
 
-## Where we are
+##Different approaches to running seasonal vaccinations
+This research helped us get a clearer picture of how pharmacies run their seasonal vaccination services and how, in turn, they set up appointment availability in MYA. Broadly, the pharmacies I visited took one of two approaches. 
 
-We’ve built an minimum viable product (MVP), and are testing our service with users delivering the RSV vaccination service in the east of England.
+##A flexible approach 
+The most common approach pharmacies took was to allow bookings at any time and set up their appointment availability to mirror their opening hours. That meant going into MYA, creating a weekly repeating session for Monday – Friday, adding all the vaccination services they offer, and then setting the start and finish times to match opening hours. More often than not the start and ed dates for this covered the whole campaign.  
 
-The service will expand in line with the community pharmacy expansion initiative, and we plan to continue testing and improving the service, to support further expansion, including COVID-19 and flu vaccines.
+[image of typical availability] 
+
+Pharmacies taking this approach typically had lower demand for both seasonal vaccination appointments and other pharmacy services. They also had more capacity, with 2 pharmacists on site at any time, or at the very least trained vaccinators. This gave them the breathing room to offer seasonal vaccinations all day, while still being able to take breaks and stay on top of everything else. 
+
+This also meant they had a relaxed attitude to walk-ins and patients ringing to book an appointment, which they would often just note down in a paper diary. As one pharmacist put it “it’s not go manage your appointments, it’s go with the flow”. 
+
+##Less room for manoeuvre 
+At the other end of the spectrum there was a smaller group of pharmacies who found it more difficult to juggle seasonal vaccinations alongside everything else.  These pharmacies typically had a single pharmacist on site, coupled with high demand for other services, like dispensing. This meant they were more worried about falling behind, or becoming overwhelmed, and they were trying to set up MYA in a way that kept things manageable.  
+
+Across these sites I saw 3 approaches to this: 
+1. Limiting appointments to a smaller portion of the day, for example from 11 – 3 instead of 9.30 - 6.  
+2. Increasing the appointment length until they got to what felt like a manageable volume of appointments throughout the day, for example setting 15 minute appointments so they had a maximum of 4 an hour
+3. Blocking out time for seasonal vaccinations in the calendar they use for all other bookable services, and then creating specific appointment availability in MYA to fit with that. This meant they avoided the consultation space being double booked. 
+
+These approaches worked okay, but still felt like ‘workarounds’ with trade-offs in either appointment availability (approaches 1 and 2) or maintenance overheads (approach 3). One approach some of these pharmacies asked about was setting a maximum number of vaccination appointments per day. That way, the appointment slots could match their real opening hours and the time each appointment actually took. It would also mean the day couldn’t be swallowed entirely by vaccinations, giving them time to keep on top of dispensing and other essential services. 
+
+##Assumptions challenged
+In addition to helping us understand how pharmacies run their services, this research challenged a few unspoken assumptions I think we’d been making.  
+
+###Assumption 1: Professionals are more confident with technology 
+We assumed that because our users are professionals, with higher level qualifications, they’ll be “tech savvy” and comfortable with more technical language than we might include in a public facing service. In reality, that wasn’t the case. In general, as long as the task was straightforward they were okay, but when things got a little more tricky it caused problems. For example, many pharmacies really struggled to track down the service welcome email using by searching their inbox. 
+
+###Assumption 2: They'll read guidance or attend training first 
+We’d assumed staff would attend training or read guidance before using the service. We also thought they’d approach creating availability carefully and methodically, with a mindset more like doing a tax return, than doing online shopping. 
+
+In reality pharmacy staff simply don’t have the time for guidance or training beforehand, or to carefully double check everything. Plus, finding time without distractions to do an admin task like this is hard. That means when they get to it, the mindset is to get their appointment availability set up quickly before they get interrupted. 
+
+###Assumption 3: Pharmacies run services to the minute 
+We assumed pharmacies deliver most vaccinations at pre-booked time slots, sticking closely to scheduled appointments. At the pharmacies we visited in this research, we found walk-ins were equally, if not more common. My impression was that pharmacies are less concerned with strict timings and more focused on providing a good service overall. If someone turns up early, they may be seen early; if they’re late, it’s usually not a problem. 
+
+When you take a step back, none of this is especially surprising. But, without regular research with end users, it’s easy to slip back into self-referential design. 
+
+##Opportunities for improvement
+During these visits we also observed pharmacy staff using MYA for the first time. This highlighted several usability issues, which are outlined in What we learnt from visiting pharmacies: part 2.