Niki Watts, pharmacist owner and IP at Vale of Neath Pharmacy in Glynneath, Wales, talks to Saša Janković about running an independent prescribing service.
Why did you start offering this service?
We started in September 2019 with a UTI service, as this is a common complaint that community pharmacies are well placed to help customers with. I also work with the NHS111 service as well as running my pharmacy, so my scope of practice is quite wide because of that. When Covid hit I approached the Health Board to ask if could widen what we offered with our IP service, and in March 2020 we broadened the scope.
We can now help customers with prescribing – where necessary – for shingles, otitis media, conjunctivitis, COPD exacerbation, respiratory tract infections, impetigo and rosacea, inflammatory skin disorders and psoriasis, mild to moderate pain, acute gout, dysmenorrhea, rhinitis, pyrexia in children, allergies and urticaria, IBS and GI muscles spasm, nausea, vomiting and vertigo.
How much did it cost to set up the service?
Because we cover so many conditions, we had to buy all the relevant testing kits and equipment, so there’s been some outlay for things like stethoscopes and blood pressure monitors, infrared thermometers, urine sample pots and dipsticks, and so on.
What, if any, training did you or other team members have to undergo?
I qualified as an independent prescriber (IP) in 2009, and my second pharmacist here, Sam Ellis, became an IP this year, and we run the service together in the pharmacy seven days a week. Aside from the IP, I’ve also done training with 111 on minor ailments.
In a nutshell, what does the service involve?
Our pharmacy is next to a health centre and before Covid the GPs would triage and send appropriate patients to us. Since Covid, the service has really taken off because pharmacies haven’t had any restrictions to access, so patients come here first to see what we can do for them and then, where necessary, we can refer them on to the GP if we can’t help.
Are there any opportunities to sell OTC or prescription products during or after the consultation?
Prescriptions are free in Wales, but of course the service does give us the opportunity to sell appropriate OTC products where they are needed. And although we can prescribe, sometimes it’s not a prescription that’s needed either, so we can signpost patients on to the relevant service that can help them.
How have patients responded to the service?
At first, patients were surprised to find that we can prescribe for them, as historically pharmacies were just a supply service, but once they know what we can do the service has gone down really well with them. We are in a small community in a Welsh valley town and as word has got around we see a lot of patients for the service now. We even get other pharmacies sending patients to us as they know we are prescribers.
Roughly how often each month do you carry out the service?
We see someone every day for the service – so at least a hundred patients a month. UTIs are still the most common condition we test and treat for, which is why we started the service in the first place. It’s also useful to be able to do the simple UTI diagnostic test for patients and, where they get a negative result, be able to explain to them why they don’t need antibiotics and talk about antibiotic awareness in general with them.
How much do you charge for the service?
The service is free of charge, funded by NHS Wales, and prescriptions are free in Wales, so patients only pay for any OTC products they decide to buy.
Roughly how much a month do you make from offering the service?
It’s still a pilot service, so at the moment the Health Board funds us for three 3-hour sessions a week, at £150 a session, although we are definitely seeing more patients than that right now.
Would you recommend offering this service to other contractors?
Yes – I’d say definitely train as IPs and get involved. Once you’ve been in community pharmacy for a couple of years the supply element alone is not enough so at least with this you have a new focus. For me, being able to offer services like this keep me engaged in community pharmacy.