We present the findings of a discrete event simulation study of the hospital pharmacy outpatient dispensing systems at two London hospitals. Having created a model and established its face validity, we tested scenarios to estimate the likely impact of changes in prescription workload, staffing levels and skill-mix, and utilisation of the dispensaries' automatic dispensing robots. The scenarios were compared in terms of mean prescription turnaround times and percentage of prescriptions completed within 45 min. The findings are being used to support business cases for changes in staffing levels and skill-mix in response to changes in workload.

A questionnaire was sent to all nursing sisters in Hammersmith and Queen Charlotte's special health authority, a provider of specialist hospital services in London. They were asked for their overall impression of the pharmacy service and staff, for their opinions of specific services and for suggestions for improving the service. Eighty‐six per cent of respondents thought the service was good, very good or excellent and 92 per cent thought the service was either the same or better than that of other hospitals in which they had worked. Just under half the suggestions received were for service improvements related to supply of drugs stocked on the ward. The other main areas commented on were drug delivery, discharge medication and the pharmacy on‐call service. The survey provided useful information about the pharmacy service and has enabled the department to implement some of the changes suggested as well as look at the feasibility of other improvements. It is intended to repeat this survey annually.

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