Rachel Carter talks to Rachel Potter from Windmill Pharmacy in Manchester about its minor ailments service
Service type: Minor ailments.
Name of pharmacy: Windmill Pharmacy, Manchester.
Name of pharmacist: Rachel Potter.
How long have you been offering this service? Since 2012.
Why did you start offering the service? We started offering this service because the clinical commissioning group (CCG) at that time was introducing a locally commissioned service for minor ailments and asked local contractors if they would like to take it up.
How much did it cost to set up the service? There were no start-up costs apart from training time costs – I paid for two of my counter assistants to attend the training with me.
What, if any, training did you or other team members have to undergo? There was an evening training session organised by the CCG when the service started eight years ago, which was mainly about the service specification. Both myself and two counter staff attended this.
I also have to complete a declaration of competence for minor ailments every two years, which includes the CPPE online training on minor ailments, safeguarding and consultation skills.
In a nutshell, what does the service involve? Most minor ailments we deal with on a daily basis anyway, because that’s part of our advice and role as pharmacies. However, this service is specifically pharmacist-led – we carry out the consultation – as opposed to a patient coming in and getting advice from the counter assistant. The conditions the service covers are as follows:
- Sore Throat
- Blocked Nose
- Temperature (fever)
- Eye infection
- Head lice
- Athlete’s Foot
If we take a patient coming in with a sore throat, for example, I would ask them questions such as: how long have they had the symptoms, have they noticed any redness or white plaques at the back of the throat – I do have a light so I can look down their throat to see if anything is there – do they have any other symptoms such as a fever or cough, are they taking any medication from the GP and have they tried anything already for their throat. We also discuss their expectations and what they’re worried about.
I try and make this consultation like a normal conversation, rather than interrogatory. At the end of that process, I look at the formulary and decide whether there is something on there that would be suitable for the patient. If I feel that they require some antibiotics, I would signpost them to the GP.
I’m not an independent prescriber so I don’t prescribe any medications. Most people tend to come in expecting antibiotics, but most people don’t need them. I always advise patients that antibiotics are not usually required, but I explain how long symptoms are likely to last for and if they last longer then to make an appointment with their GP. It’s all about reassuring them.
A consultation typically takes five to 10 minutes and the information is recorded on PharmOutcomes at the time of consultation.
Are there any opportunities to sell over the counter or prescription products during the consultation or after it? Yes – there is the opportunity for add-on sales, if appropriate. If someone has got a cough or cold and they are feeling rundown then it’s very possible that I might suggest some vitamin C to boost their immune system. In some cases, the patient might not be happy with what I can offer from the formulary. For example, with a sore throat, they might not want the difflam spray and instead want some pastels to suck, so I would sell those to them.
How have patients responded to the service? The response has been very good and we have people who come back fairly regularly if they’ve got anything wrong that they need to talk to us about.
Roughly how often each month do you carry out the service? We do around 30 consultations per month.
How much do you charge for the service? There’s no charge to the patient.
Roughly how much a month do you make from offering the service? We get paid £3 per consultation by the CCG and we are also reimbursed for the cost of any medicines we give out to patients from the formulary. I would say we probably make around £120 a month.
Would you recommend offering this service to other contractors? I think that as we go forward with the Community Pharmacist Consultation Service (CPCS), and we get more minor illnesses directed to us from NHS 111 and from GP receptionists, then the opportunities for us to deliver this service will increase – and therefore we have no choice but to offer it.
I get a lot of job satisfaction from talking to patients and spending time with them as part of this service, as opposed to just checking prescriptions.