Objectives This article describes key changes made within one hospital pharmacy department in the UK during on-going work to improve services and meet the aims of the National Health Service (NHS) Quality, Innovation, Productivity and Prevention (QIPP) agenda. A series of projects designed to significantly increase the value of the service; reduce waste, increase efficiency and improve clinical services, without employing more staff, were undertaken.

Methods The department used various change management techniques and lean methodologies to bring about change. This has been reinforced by robust and continual data collection and interpretation via run charts, to objectively demonstrate improvement.

Results Average prescription turn-around times are approximately 25 minutes each day or less. Delays in provision of chemotherapy have fallen from around 60% to less than 5% of patients each day. Clinical pharmacists see approximately 98% of available inpatients each day and on average 92% of patients have their medicines reconciled within 24 h of admission. The Trust Medicines Management Improvement Group has also run a number of successful improvement projects to improve medicines safety.

Conclusions The use of common change management techniques are applicable to hospital pharmacy and can result in measurable improvement in service delivery. It also indicates that the small size of a department is not necessarily a handicap to achieving better quality and efficiency in dispensary and chemotherapy production units, or in measurably addressing local and national patient safety concerns, without the need for additional staffing resources.