Dispending prescriptions and giving advice to patients is community pharmacy's 'foundation'
The covid pandemic was a gruelling and testing time for community pharmacies across the land but what it did do was shine a light on the valuable 'routine pharmacy services' that the sector provides.
The Prince of Wales made this point during his speech at the special reception he hosted for the sector at St James’s Palace in May.
He told NPA members: “As well as your great achievements during that extraordinary (pandemic) time, I really am deeply conscious of your efforts in ordinary times too…the marvellous work you do in your communities day in and day out.”
InPharmacy spoke with four community pharmacists who were present during the royal reception about the importance of the ‘day job’…
Afua Thompson, H.E. Matthews Pharmacy
Afua Thompson a pharmacist from Sutton who runs H.E. Matthews Pharmacy said: “Sometimes we only look at the negatives covid brought, but to pharmacy, it's really shown what we do. Generally, people don't see what we do in the background.
“I've seen patients from when they were babies and then you see them all grown up. These are families that have been supported right through their lifetimes by our pharmacy and it’s nice they can come to us for minor ailments or anything else we can help with.
“We’d deal with their queries straight away and where we can't, we’d signpost them to someone who can. We work in a network; we don't work on our own.
“In terms of supply of medicines, you'd be amazed how many medicines are out of stock. You’re phoning the wholesaler and ordering, and if it’s not in stock, you have to contact the GP and ask for an alternative and then go back to the patient and let them know that ‘this item is not available and we'll have to substitute it with something else, are you okay with that?’ We're going backwards and forwards with the patient, the GP and the wholesaler. Most people aren’t aware of how much goes on behind the scenes but this happens daily.”
Jay Patel, Anna Pharmacy
Jay Patel, pharmacist and owner of Anna Pharmacy in Carshalton has been serving the needs of his community for 10 years.
“My parents started this pharmacy and I expanded the business acquiring another four in the last five years.”
He told InPharmacy that even though the sector is seeing many different types of services being introduced, community pharmacy’s anchor will always be dispensing prescriptions.
“There's been talk about services since when I qualified ten years ago and they are good and you can see how introducing services can help, especially from a business perspective. But 90 per cent of my income is still my dispensing - that’s my foundation. Pharmacy should always be part of the dispensing model because it's about supplying that medication safely, giving that advice alongside it and then seeing that patient regularly – this is so important.”
He revealed that many patients come to the pharmacy to just get out of their house.
“I’ve lost count the amount of times I’ve seen a patient who come in to the pharmacy just to get out of the house and come out. We tell them we can deliver but they still come. You see them twice a month and when you see them 24 times a year you're going to notice if something is odd or off. I’ve seen patients lose weight drastically and they'll say 'Oh have I?' because no one else tells them. And it’s sad but sometimes these changes turn out to be something serious like cancer.
He added that because community pharmacies have a close relationship with patients they are able to check on their emotional state too.
"Those with mental health problems for example that come in everyday - they have nobody else to talk to or nobody to show them guidance on basic things, not just medication related. Who's going to fill that void? These people will come into the pharmacy and say ‘I’m feeling like this today’ and we'll talk to them and give them what advice we can. I’ll say ‘Come back in a few days and make sure you say hello to me’. That kind of thing is so important for the community.”
Bola Sotubo, A-Z Pharmacy
Bola Sotubo, a pharmacist and co-contractor at A-Z Pharmacy in West Croydon said before the pandemic the sector had been missed from primary care conversations but it has improved after the country saw the value of pharmacy through the Covid vaccination programme.
“Community pharmacies still remain the most accessible healthcare professional, we are highly qualified and we provide that face-to-face support to the patient.
“We know the patient, and the discussions that take place with the community pharmacist enable patients to understand their medicines better so they can make an informed decision.
“Our recognition is still a work in progress. It’s not just about announcing new services for the sector but all the support that goes along with it.”
Bola explained that she often gives informal advice to patients on a daily basis, which is outside the scope of commissioned services.
“We are providing a service here that is not remunerated and it takes time doing that,” she said.
Getting the basics right is especially important and Bola believes community pharmacy does very well on customer service.
“It’s why more services are being thought about and being delivered through community pharmacy,” she said.
“Whatever we do, we know customer service is key for those services because that is the basis of our customers and patients trusting us.”
Shushma Patel, PSM Pharmacy
Shushma Patel, has been with the independent family owned PSM Pharmacy in Surrey since 2009. She says during that time the pharmacy has become “a pillar of the community.”
“It is a place where the elderly come for a chat, the lonely come for company and the confused seek advice.
“Sometimes we joke that PSM Pharmacy is more a wellness centre than a pharmacy with our daily conversations stretching much further than just medicines. As medical professionals, we realise that medicines can only solve part of the problem and with the mountain of ‘routine work’ that we need to get through, we also need to be available to our patients."
She explained that in recent times, “routine” pharmacy work has become increasingly difficult.
“The prices of medication have skyrocketed and the amount we are paid covers less than 40 per cent in most cases,” said Shushma.
“This doesn’t cover the cost of staffing, the pharmacy, the stock or just our time. All pharmacists will tell you that the reason they have survived in a community pharmacy is because they genuinely care.”
At the core of everything is “patient care” as PSM Pharmacy has a long-standing and established relationship with patients.
“They are able to walk in and spend more time with us than the GP appointments that they can’t book.
“We try and ensure they have sufficient amount of time to receive their medical support whether that would be minor health concerns or questions regarding their daily medication.
She added that the services provided by the pharmacy from smoking cessation, needle exchange, hypertension initiatives, vaccinations and emergency contraception help support the community.
“Alongside this we do daily delivery to care homes as well as deliveries to our patients. Our weekly MDS blister packs have transformed the way our patients take medication and alongside this we are a vital tool to our community nurses.
Reaction to meeting the Prince of Wales
Afua Thompson from H.E. Matthews Pharmacy said the whole experience was surreal and brought memories flooding back of her childhood in Ghana.
“We watched the Prince of Wales marrying Princess Diana, it was a massive thing where everybody in the city where I lived stopped to watch this wedding. Then to be standing there next to HRH was beyond my wildest dreams.”
Afua said the Prince of Wales “paid attention to everybody.”
“When he was shaking my hands, he was looking in my eyes and had a genuine interest in what I had to say,” she explained.
The experience will stay in my mind for a very long time.”
Shushma Patel from PSM Pharmacy said it was “an honour to be invited” and be among her “brilliant pharmacist” colleagues.
“As a local independent pharmacy, we never would have thought we would be called and it was a genuine surprise that we were recognised. Community pharmacies have stayed open right through the pandemic and there was such a sense of pride but also comradery in that room. We had all suffered through the pandemic together; rising costs, worried patients and immense pressure on the NHS. However we saw the same values across our different communities and it has banded us together.
Shushma said on meeting Prince Charles, she shook his hand and said “hello” and then in the traditional Hindu manner of the BAPS Shri Swaminarayan Sanstha greeting by saying ‘Jai Swaminarayan’
“Our pharmacy is called PSM Pharmacy and it stands for Pramukh Swami Maharaj who is our guru and inspiration. His life motto was ‘In the joy of others lies our own’ and this encapsulates the meaning and service of community pharmacy.”