Farah Ali speaks to Rachel Carter about why her pharmacy chose to expand their service offering and set up a flu vaccination service.
Service type: Flu vaccinations (private and NHS).
Name of pharmacy: Warman-Freed Pharmacy, Golders Green.
Name of pharmacist: Farah Ali.
How long have you been offering this service?
We took over the pharmacy in 2014, and we’re coming into our fifth year now. During the first few years it was about establishing and understanding what the pharmacy was about, and then we really started offering a flu vaccination service in its full capacity in the 2017-18 season.
Why did you start offering the service?
I think it was something at the very forefront of my mind due to needs in terms of business and income. I wanted to be able to expand our service offering and flu vaccination was a service that seemed like the most comfortable route for us to go down, but also one that met community need.
Having spent a couple of years understanding what was missing and what the community needed, we felt that a flu vaccination service was needed and that there was a gap in the offering within our current community base.
How much did it cost to set up the service?
Training is one of the biggest costs, especially for the pharmacists who may not have done face-to-face training previously. The challenge for us was definitely our opening hours, we are open 8.30am until midnight, seven days a week, and I have a team of three pharmacists. So, we’ve taken it gradually because I didn’t want to make a big cost outlay in the beginning and then not be able to fulfil the needs of the service later on.
In the first year, we trained up one pharmacist as a test phase so that we could understand exactly what the service would look like and how we would offer it. Once we established what we wanted to do and felt comfortable that this was something we could drive forward, deliver numbers on, and would generate income for us, I invested in training for two more pharmacists. The training costs were around £180 per pharmacist.
What, if any, training did you or other team members have to undergo?
In terms of the sign-off of competency training, it was a face-to-face session. The pharmacists attended off-site training, which gave them the background, as well as the practical experience of vaccinations. Most of the wholesalers, suppliers and training providers offer this training, but we went with one through AAH because that was the right thing for us at the time.
Once the pharmacists had completed this training, it was about how they then supported and trained the rest of the team. One of the biggest things we learned during the testing phase was that this service wasn’t just about the pharmacist being able to do the vaccination. It was also about how the team were going to engage customers, get the visibility of the service up in store, get people informed that we offered both NHS and private jabs, and understand the criteria: who was eligible and who wasn’t. This was filtered through after the pharmacist training, and into the rest of the team.
In a nutshell, what does the service involve?
I’m hoping that our visibility through posters in the window and our signage is the reason that a patient has come to us, or they’ve heard from other people who have used the service, or seen on the website that we offer it.
Once the customer comes through the door and asks for the flu vaccination, the conversation is led by the pharmacy team. This is because the pharmacist may be busy or already doing a vaccination.
It’s really essential for the team to establish straight away if the vaccination is going to be private or NHS, because the forms are very different for the two services. We have different guidance and criteria for each one and therefore we need the right forms to be filled out. Once we’ve determined that, we can usually offer a ‘there and then’ service. I think that’s been an advantage for us and how we’ve managed to grow the numbers, rather than the patient having to book in. Sometimes people do want to book because they were just passing through the pharmacy and we can do that for them as well.
If the patient is going to have the vaccination straight away, they are given the form to fill out and asked to go to the waiting area to complete it. By that time, the staff have let the pharmacist know that someone is here for their vaccination and is filling out their form. The pharmacist is able to prepare what they need to do and if necessary, hand over any existing workload to staff, so that they are able to take 10 minutes out to do the vaccination.
One of the things we’ve tried to embed is that there is a ‘total service conversation’, rather than we’re going to vaccinate you and say goodbye. So before the vaccination, we have a conversation with the patient around aftercare and what to do for the rest of the cough and cold season. Obviously they can pick up other illnesses, so we explain that we have other things available in the pharmacy that we would be able to support them with - whether that be through vitamin supplements or other healthcare advice.
We also explain that the flu vaccination should prevent them from catching flu, but as with anything, should they experience any other symptoms, we are here for them. I think it’s really important to embed the message that we’re not just here to vaccinate. We’re here for aftercare as well.
Once the patient has had the vaccination, they are asked to wait, because we do need to ensure they are okay afterwards. After a few minutes, the pharmacist will check in to make sure everything is fine, payment is taken, and the patient is free to go. For all NHS patients, we inform their GP that the vaccination has been given, because their records need to be updated. We don’t have to do this for private patients, it’s up to them, but they are given leaflet that gives them that information.
Are there any opportunities to sell over the counter or prescription products during the consultation or after it?
We have a whole range of other products, such as vitamin supplements, that the customer might potentially benefit from over the winter season. We also have other services that they may not be aware of or did not come in for, such as our electronic prescription service. Our opening hours may be something that can enable customers to pick up from us, rather than pharmacies that might be closing at the usual time. From time to time, we offer other in-house services too, so depending on who the customer is and when they’ve come in, we will always give information about those services.
How have patients responded to the service?
It’s been really good. Year-on-year we have developed a regular base of customers and it’s really positive to see that people are returning to us. We get recommendations - I see family and friends coming in of those who have been vaccinated with us in the past and know of the service.
We’ve also got a number of businesses that we’ve vaccinated for the last three years now too, we’ve retained them and built on them. Last year we had three external businesses that we vaccinated and that was really good. Having off-site as well as on-site vaccinations has been a challenge, but it’s been quite fulfilling for the team as well, so that’s been nice.
Roughly how often each month do you carry out the service?
Our split is 90% private patients vs. 10% NHS. We start in September/October and vaccinate up until January/February. The peak months for us are October and November. Of our numbers, I would say 40% are vaccinated in October, 30% in November, and the rest is spread out over the other months. From 2017-18 to the 2019-20 season, we’ve seen a four-fold increase in business, so we’ve done four times what we did first time around.
How much do you charge for the service?
Last year we priced a private flu jab at £11, and the market was around £12 or £13. I believe that we have priced them very competitively, based on local competition and also the cost of the vaccinations. Each year, we’ve been very conscious that we price it in a way that gives patient choice, but also to ensure we are making at least some profit that goes towards the service.
Roughly how much a month do you make from offering the service?
Figures not available.
Would you recommend offering this service to other contractors?
Definitely. I think the first step for any pharmacy, similar to what we did, should always be to identify within your community what other services are available. Flu jabs weren’t easily accessible for most of our customers, either because GP appointments were very hard to obtain or other pharmacies closed earlier, and they therefore weren’t able to get a vaccination out of working hours. So, I think making sure you do that piece of work is important.
It’s also key to consult your team and ask how they feel about it - just because you want to deliver a service doesn’t necessarily mean they want to be engaged. You need to make sure they are on board, include them in conversations, and get their input around marketing and training.
Finally, you need to think about what value it will add. For us this wasn’t just about a flu service, I think it added value across a lot of what we did. The conversations that we had and the training that we did around flu vaccinations has supported us in launching other services as well. This allows you to grow your team and give them confidence in other areas too.
In pharmacy, the more connected we are with the wider NHS offering, then hopefully the more connected we are then seen by both customers and other healthcare professionals. If we support and offer services that are available through GPs and other healthcare providers, then I think we will be seen as part of the same network.