Sukhy Somal – superintendent pharmacist, manager and co-owner of PharmaCare Pharmacy in Walsall – talks to Saša Janković about running a care homes and palliative care medicines service.
Service type: Care homes and palliative care medicines service
Name and location of pharmacy: PharmaCare Pharmacy, Walsall, West Midlands
Name of superintendent pharmacist: Sukhy Somal
When did you start offering this service?
My husband and I set up PharmaCare in May 2014, and offered a care homes service almost straight away as I had done it in previous jobs. Initially it was just a basic medicines service, but it has evolved since then. Now it’s not just elderly care we do – we also serve care homes that look after young people with mental health illnesses and rehabilitation.
Why did you start offering this service?
I’d done some volunteer work in care homes many years ago when I worked for Midcounties Cooperative. One of the jobs they asked me to do was recruit care homes for them one day a week, but I had no knowledge of the care home sector so I spent time working in it, reading regulations, and becoming knowledgeable about the sector. After a while I realised I really enjoyed pharmacy’s involvement in looking after the residents, and this is what pushed me to set up on my own in 2014.
What, if any, training did you or other team members have to undergo?
I’ve done all the same training that our care homes do around safe handling of medicines. I have to have the whole picture of how a care home operates as I need to know what the CQC checks them for so they and we are fully compliant on the medicines side.
I also send some of my staff out to the care homes. One helps me do medication audits so is trained on that, and one of my accuracy checking technicians has attended CCG training with me as we do medication audits for other care homes funded by the CCG, so that knowledge also helps us with our homes.
In a nutshell, what does the service involve?
The main element we offer is a pre-emptive palliative care service for all our homes. This means if it’s a Friday or a weekend, or even Christmas day, they know they can call me (if they have got a prescription) and they will get controlled drugs from us – 365 days of the year.
The pre-emptive palliative care pack is four drugs: one to stop nausea and vomiting, one for the respiratory secretions which gives the rattle, Midazolam to help with any agitation and stress, and a painkiller – morphine or diamorphine, whichever the prescriber chooses – which means in their last stages the person is not in significant pain. After personal experience of going through the final moments with some of my relatives where the attending healthcare professionals struggled to get this pack, I know how important it is to be able to do that for someone, and I always said if I had my own pharmacy I would make sure this was available for these patients.
Walsall CCG commissions the pre-emptive palliative care pack service so we are remunerated to provided it within the CCG’s boundaries, but we cover the whole of the West Midlands so if the patient is out of Walsall then we will still do it, free of charge.
I also do the auditing process for the homes we look after, making sure their medicines management is up to regulations, and write policies and procedures – which I don’t get paid to do it – and of course we supply their general daily and monthly medicines.
Are there any opportunities to sell OTC or prescription products during or after the consultation?
We do sell OTC counter products to our care homes and that provides and extra stream of income for us.
How have patients responded to the service?
The care home staff value what we do and the residents like seeing who provides their medication, so we have built relationships with them as well. There are lots of providers that look after care homes but we tend to retain our business because we are not just doing the usual things that everyone else is doing. We’ll go in and do their flu vaccines for them and the staff, at Christmas we go join in their Christmas singalongs, and we take part in their charity events.
How much do you charge for the service?
We are a high-volume dispensing pharmacy and one of the top 10 busiest pharmacies in the West Midlands so although we don’t charge for the care home service itself we have made it work for us. The service has helped us grow our business by word of mouth, and it pays for itself by having such amazing retention levels. We started off with 5,000 prescription items a month but by Christmas we will be heading towards 30,000 items a month.
Would you recommend offering this service to other contractors?
Yes, although if you are a normal community pharmacy and you are the only pharmacist then this service is not for you. You need the team in place with the right training to support you. You have to make sure you are prepared to dedicate the time and expertise to do it properly, and it’s a big commitment to always be on call.
The money will come with any service if you do a good job, but the first motivator has to be that you are making a difference. You get such a sense of joy when you go in to the homes and the residents know your name – and now I’m not just standing behind the counter all day counting medicines.