Rachel Carter speaks to Jack Lewis, pharmacy manager at Mayberry Pharmacy Blackwood in Wales about his approach to supporting patients to quit smoking
Jack Lewis, a pharmacist at Mayberry Pharmacy Blackwood, in South East Wales, says the best part of running a smoking cessation service is hearing the individual stories of patients whose lives have been changed by quitting.
He remembers how after giving up smoking for six weeks, his first patient for the service could finally walk up the steep hill on Blackwood high street without gasping for breath, a couple who quit together and could afford to run a second car, and a man who managed to save enough money to take his grandson on holiday.
‘These are the little things in life that non-smokers would take for granted,’ Mr Lewis says, ‘but those are the kind of things I love to hear about.’
Mr Lewis has been running the smoking cessation service at Mayberry Pharmacy Blackwood since August last year. In the first quarter of 2018-19 (April to June), nine out of the 10 patients supported by the service quit smoking after four weeks.
The enhanced service is funded by NHS Wales and is divided into two separate programmes, both of which run over a period of 12 weeks. For level two, the pharmacist’s role is to supply products to patients referred to them by the national stop smoking service, and ensure there is no interaction with existing medications.
In the level three programme, the pharmacist takes charge of providing behavioural support to the patient, as well as products, and guiding them through the smoking cessation process. This involves meeting with the patient for a consultation on a weekly basis for five weeks, and once a fortnight for the remaining seven weeks.
As well as being reimbursed for any products supplied to patients, the pharmacy receives payments from NHS Wales for each consultation. The longer the patient stays in the programme, the higher the payments will be, Mr Lewis says.
‘The only thing you need to offset the cost against is the products, and the time the pharmacist spends with the patient, which you’re paying for anyway,’ he adds.
‘As pharmacists we love to spend time with patients to better their health, so it’s beneficial for the pharmacy and the financial benefits are there as well.’
Mr Lewis was required to undertake a training programme provided by the Wales Centre for Pharmacy Professional Education, before delivering the service. This involved an online course and a face-to-face interactive session, which included information on the products available to patients, how to use them and different consultation techniques for supporting patients, as well as an online assessment.
‘Once you’ve learned all that, it’s a case of developing your own way of speaking with patients – I’m sure every pharmacist would do it slightly differently,’ he says.
‘What I like to do first of all is to get to know the patient and get them to take me through a typical day, specifically focusing on when they have a cigarette.’
Before enrolling on the level three programme, a patient will have to demonstrate that they are motivated to quit. They are provided with a quit book, information on what’s expected of them and what support they can expect from the pharmacist.
If they decide to come on board, the first consultation usually takes about 20 minutes, Mr Lewis says. This involves completing paperwork about the patient’s smoking habits and reasons for quitting, measuring their baseline carbon monoxide level and discussing what products might be most suitable for them and why.
‘I also like to fill the patient with confidence before the leave, tell them I have faith in them, and start building up that positive spin on it,’ Mr Lewis adds.
‘The following consultations are usually pretty straightforward – and can take as little as two to three minutes, depending on whether they are struggling or not.’
Mr Lewis sees all the smoking cessation patients at Mayberry Pharmacy Blackwood, which has enabled him to ‘build a bond’ with them, but he says the service can also be run by an accuracy checking technician, where appropriate.
The pharmacy didn’t run a specific marketing campaign to draw patients in, he adds, but there are two large posters on display in the pharmacy’s windows and he also attended a meeting with ‘smoking champions’ from local GP surgeries.
‘This was so I could put my name forward as a pharmacy that is really happy to take on new people to try and absorb some of the pressures off the doctors, asking them to send patients to me rather than writing prescriptions,’ Mr Lewis says.
‘That was one of the things I did right at the beginning, but apart from that it’s mostly been word of mouth and people have just turned up.’
‘Passion and enthusiasm’
Mr Lewis says his main piece of advice for other independent contractors who might be interested in setting up a smoking cessation service is to ‘be prepared to invest in people, spend time with them and really get to know them.’
‘People smoke at certain times and because they do certain things. By taking an interest in what they get up to outside of just coming into the pharmacy, you can have a direct impact and really tailor the support,’ he adds.
‘Tailoring your advice and being enthusiastic and passionate about what you are doing – that’s how you get people in, and how you keep them.’