Why Pharmacies Are Struggling to Provide Dosette Boxes

Many patients rely on dosette boxes (also called monitored dosage systems or MDS) to help them take their medicines safely. These trays organise medicines into daily doses and are particularly helpful for elderly or vulnerable patients who take multiple medicines.

However, what many people don’t realise is that the NHS does not specifically fund pharmacies to provide this service.

A complex service behind the scenes

Preparing dosette trays is not simply a matter of placing tablets into a box. Each tray must be carefully assembled, checked by a pharmacist, sealed and documented to ensure the medicines are correct and safe. Some medicines cannot be placed in trays, prescriptions often change during the month, and every tray must be checked to avoid errors.

This process takes time, trained staff and careful clinical oversight.

Despite this, pharmacies are paid mainly per item dispensed, not for the additional work involved in preparing dosette trays.

Growing financial pressure on pharmacies

For many years community pharmacies have continued to provide dosette trays because we know how important they are for patients. But the financial pressure on pharmacies has increased significantly.

Several factors are contributing to this:

• Pharmacies are often reimbursed very close to the price they paid for medicines, and sometimes even less than the purchase price, particularly during medicine shortages.

• Staff wages increase each year as the National Minimum Wage rises.

• Overall NHS funding for pharmacies has not kept pace with rising costs, even though pharmacies are being asked to deliver more services and clinical care.

Across England, community pharmacies are under enormous pressure and many have already closed in recent years.

An unfunded service

Preparing dosette trays requires a significant amount of staff time. Without specific funding for this work, pharmacies are effectively providing the service at a loss.

We have been working with local GP surgeries to try to find a solution that allows vulnerable patients to continue receiving dosette trays safely. One possible option was for prescriptions to be issued weekly rather than monthly, which better reflects the work involved in preparing trays.

However, some GP surgeries have said that they are not able to issue weekly prescriptions, which makes it very difficult for pharmacies to continue providing this service in its current form.

What this means for patients

We understand that this situation can be confusing and frustrating for patients. Our priority remains ensuring that patients receive their medicines safely and reliably.

However, pharmacies cannot continue providing labour-intensive services indefinitely without proper funding.

Why this matters

Community pharmacies are an essential part of the healthcare system. They provide advice, dispense medicines, and increasingly deliver clinical services that help reduce pressure on GP practices and hospitals.

If pharmacies are expected to continue providing services like dosette trays, the funding needs to reflect the work involved.

If you believe that vulnerable patients should continue to have access to this service, you may wish to raise the issue with:

• Your GP surgery

• Your local Member of Parliament (MP)

• NHS England

Ensuring community pharmacies are properly funded helps protect vital services for the patients who rely on them most.