Chandani Raghwani from SMS Pharmacy started an erectile dysfunction service after noticing an increase in requests for prescription medicines - especially sildenafil.

Name of pharmacy: SMS Pharmacy.

Name of pharmacist: Chandani Raghwani.

Why did you start offering the service?

We've offered this service since 2019. We are a 100-hour pharmacy and we were getting a lot of requests for prescription medicines, especially sildenafil - people wanted to buy viagra but it was a bit too expensive for them over the counter, so they were always asking if they could get it cheaper. The pharmacy had previously provided a Patient Group Direction (PGD) for this service, so we looked into it and decided to do it again.

How much did it cost you to set up the service?

Around £800 - we purchased a package of clinical services from Pharmadoctor, which included the PGD for an erectile dysfunction clinic.

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

Only the pharmacists completed training. We just had to read the online materials provided to ensure we were compliant with the PGD requirements.

In a nutshell, what does the service involve?

A consultation takes place with the patient in the consultation room. Firstly, we would check whether a patient has had any medication for erectile dysfunction previously and if so, which one and whether it was bought over the counter or given on prescription.

We take their medical history and complete a risk assessment form that guides us through the questions we need to ask. We will also check whether there are any exclusion criteria that apply to the patient. If there are, then we explain what they need to do next.

If treatment is appropriate, there are three medication options available - sildenafil, tadalafil, and vardenafil. We go through with the patient what these are, how much they cost and then they can choose the option they want.

There’s also an option on the risk assessment form where the patient can choose whether or not they want us to inform their GP. If they want us to, then we will let their GP know that they have been given some medication.

We do a follow-up at 12 months to see how the patient is getting on with the medication, if they’ve had any problems and whether they need any further assistance. If they need to see a GP, we will send a referral for them.

Are there any opportunities to sell over the counter or prescription products during the consultation or after it?

Yes - sildenafil, tadalafil, and vardenafil are all provided as prescription-only.

How have patients responded to the service?

Patients like the service. They don’t have to wait for a GP appointment, they can walk in anytime when they’re free, we’re open on the weekends as well. They like the privacy - they can go into the consultation room, they don’t have to worry about anyone seeing them. We also have a male pharmacist available at the weekends, so if they prefer to speak to him they can do that.

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

We see a minimum of two patients per month.

How much do you charge for the service?

The consultation is free, we just charge for the products themselves - the minimum price is around £12.50 for a box of tablets.

Roughly how much a month do you make from offering the service?

Approximately £20 per month.

Would you recommend offering this service to other contractors?

Yes - it’s a great opportunity for the pharmacist to develop their clinical skills and for continuing professional development. We learn a lot of clinical skills at university but we don’t necessarily use them all the time, unless we have to do PGDs.

So, offering this service means you have to read up on something new and you go through more detail than you would when you’re just giving out prescriptions, so it helps us to develop more.