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Pathology service: ‘Offering such a full range of tests leads to lots of opportunities’

Consultation with patient

By Saša Janković

19 Jul 2021

Patricia Ojo, owner and independent prescribing pharmacist at Stevens Pharmacy in New Eltham, talks to Saša Janković about running a pathology service.

Service type: Pathology service

Name and location of pharmacy: Stevens Pharmacy, New Eltham, Kent

Name of pharmacist: Patricia Ojo

When did you start offering this service?

June 2021

Why did you start offering this service?

We wanted to offer services for specific tests that patients are unable to obtain from the GP surgery, or tests they have been asked to carry out but want done quickly. Being able to offer our patients Well person, Senior person, sexual health, cardiovascular risk evaluation profile, and drug/alcohol tests if needed means we can give them the peace of mind of a basic assessment with results that can then be passed on to their GP.

How much did it cost to set up the service?

There were costs associated with getting the relevant training done, but in terms of equipment it’s all pretty standard and not expensive. The testing lab we use gives me the supplies I need but I have to pay for them to carry out the tests.

What, if any, training did you or other team members have to undergo?

I did a one-day course to learn how to take blood, and to understand the requirements for doing it in-house in the pharmacy, which involved doing several draws to be able to qualify, but due to my previous experience as a nurse this part came back to me quite quickly. 

In a nutshell, what does the service involve?

Customers for this service are either looking for specific help, or people we identify through conversations in the pharmacy.

For example, I had a patient for our Saxenda service who had a history of anaemia and wanted to have a blood test to see what their nutritional status was before they began the weightloss program, so they could repeat the test a few months later and see what had changed. Another example with Saxenda customers is that I can do a glucose test for them in the pharmacy to make sure they are not prediabetic, rather than having to refer them to their GP for that.

The service very much complements and in fact enhances the Community Pharmacy Contract as it lends itself to signposting into other services such as drug/alcohol services, and sexual and reproductive health clinics. 

I wouldn’t recommend anything that involves venepuncture for just anyone, but for the right kind of patient it is really helpful to be able to link this in to the appropriate tests for them. I use the results to manage patients in the pharmacy where I can, and then only send them to the GP if there is something we can’t help with.

Are there any opportunities to sell OTC or prescription products during or after the consultation?

Being able to offer such a full range of tests leads to lots of associated opportunities. For example, with women who want a blood test to check their fertility you may find that they have not considered taking folic acid or quitting smoking, and this is something pharmacy can help them with.

With hayfever sufferers you can check their allergy status as it can feed into how you manage them. If they have a high count this makes a referral a lot easier, because they wouldn’t normally get referred on for hayfever, and they may even have asthma, which further explorations could show up.

We can also help people coming in for weight management to understand that it should involve diet and lifestyle. Now NICE recommends obesity is treated as a disease, we can talk to patients about other products they can buy in pharmacy to make sure they are nutritionally balanced, as well as making sure they are not cutting things out of their diet that could be good for them, so they don’t get to the stage where they are deficient. As well as supporting weightloss and protecting nutrition, we are also helping people preventing diabetes with these kinds of tests.

Roughly how often each month do you carry out the service?

It’s in its infancy but I am hoping it will develop and help patients who haven’t been able to access these services easily on the NHS.

How much do you charge for the service?

​Tests range from as little as £35 to more than £300 depending on what is required. 

Would you recommend offering this service to other contractors?

As with any service that people have to pay for, you have to think about your customer base so it depends on where you are.

What spurred me on was that so many people were telling us they wanted a blood test but couldn’t get one, and this was even more noticeable during Covid. There are also people who, for a variety of reasons, prefer to have some tests done in the pharmacy environment.

You have to be able to justify whatever screening test you are doing, and be confident that when you have the result you know how to manage that with the patient and not cause more work for the GP unnecessarily.

My vision is to bring comprehensive and accessible care to patients which is akin to what they may have been able to get free on the NHS but are not always able to now. It is a way of giving peace of mind to those who want to know and take charge of their health, which fits in well with the Self Care Model that the NHS wants for the future. At the moment, it is for those who can afford to do so independently, freeing up resources for the NHS to hopefully put into those who are unable to do so for whatever reason. 

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