Ajay Berry explains how he set up a service to support patients with UTIs.
Service type: Urinary tract infection.
Name of pharmacy: Severn Pharmacy, Oadby, Leicestershire.
Name of contractor: Ajay Berry.
Why did you start offering the service?
We started offering the service in 2018. A lot of ladies seemed to have urinary tract infections (UTIs) on a Friday afternoon, when all the GP surgeries were going to be shut. They were desperate to have a check, or they had tried over the counter products and drinking a lot of water to flush it out and this hadn’t worked, so they needed somewhere to go for treatment.
How much did it cost to set up the service?
It cost around £39 to purchase the PGD.
What, if any, training did you or other team members have to undergo?
There was no specific training other than going through the PGD, but for your own safety and to be competent in delivering the service, you do need to do some self-study. I used materials provided by Pharmadoctor and the CPPE, as well as doing my own research online into the symptoms, the side effects of the drugs we use, and examples of other people’s experiences.
In a nutshell, what does the service involve?
The service involves a consultation with the patient where we discuss their symptoms. We will ask a series of questions about the smell of their urine, if it is cloudy, whether it contains blood, and also if it is painful to urinate, if they are experiencing a lower abdominal ache, or if its impacting on sleep.
If it’s appropriate to proceed, we ask the patient to do a urine sample. If they’ve called in advance we ask them to bring this with them, and we advise that it should be a sample taken mid-stream from the first urination of the day. We test the urine using one of our urine testing sticks, which shows nitrites, blood and lymphocytes, to indicate whether there is an infection.
If there is an infection, then we need to check for any contraindications, such as whether the patient has any allergies to antibiotics or is pregnant. If they have catheters, for example, or if they’ve been treated for a urinary infection within the last three months, then we are not able to provide treatment.
The normal route for treatment would be a three day course of nitrofurantoin slow release 100mg capsules. Based on our clinical judgement, we may prescribe a longer course – it depends how long the patient has suffered for.
Finally, we contact the patient’s GP if it’s appropriate to do so, and if the patient has consented, to ensure their medical records are updated.
Are there any opportunities to sell over the counter or prescription products during the consultation or after it?
There are not many products we can offer as an add-on, but we might recommend a herbal product containing cranberry, parsley and juniper. This can be taken on a regular basis to help prevent the return of a UTI. We sometimes also offer probiotics with cranberry juice.
How have patients responded to the service?
We advertise this service regularly on the screens in the pharmacy and the feedback has been good. Sometimes it hasn’t worked so a patient has gone back to their GP, but most of the time it has and patients have been quite happy with it.
Roughly how often each month do you carry out the service?
On average probably three times per month, but sometimes you can do six in a week and then nothing for the next four weeks, so it fluctuates.
How much do you charge for the service?
The consultation is free – the patient would be charged for the antibiotics if they need them. We charge a mark-up on the cost of the drugs.
Roughly how much a month do you make from offering the service?
Figures not available.
Would you recommend offering this service to other contractors?
Yes I think so. When the patients come to us for this service they always seem to be quite desperate – they’ve tried all the OTC products and they haven’t been able to get an appointment from the doctor, so offering a service that involves antibiotics means we can help the patient.