Ruchna Patel, pharmacist at Sheel Pharmacy in Lewisham, tells Saša Janković why she has launched a microsuction service.

Service type: Ear microsuction service.

Name and location of pharmacy: Sheel Pharmacy, Lewisham.

Name of pharmacist: Ruchna Patel, pharmacist.

Why did you start offering this service?

I started offering this service in March 2021. I’ve worked in this pharmacy for over six years now and you get the odd trickle of people asking about ear irrigation, so there are a couple of reasons why I set up a microsuction service: firstly because ear irrigation is no longer available on the NHS but pharmacists can do it privately, and secondly because I’ve read a bit about irrigation not being as safe for the ear as microsuction.

We are members of the PharmaPlus buying group – which is really innovative in terms of coming up with ideas for new services and sending out emails to members to see who is interested. I’d seen them mention microsuction a few times so I discussed it with my pharmacy (which is a family business) and we agreed that it is important for us to offer as much as we can privately, since our NHS funding is diminishing.

How much did it cost to set up the service?

It is costly but the returns will be there. All in all, if you look at the cost of the equipment (the suction machine, the otoscope and the loops you need to look into the ear) and the training, the cost is almost £1000.

Before the pandemic I had been running a really successful travel vaccine service, and when you compare microsuction with the cost of setting up a travel service (the cost of vaccines plus the training) it’s similar. With travel it was certainly worth every penny and hopefully it will be with microsuction too.

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

I did a day of training that included learning about the anatomy of the ear and nodes in the head, as well as all the different ear examinations you can do and what they can tell you. At the end of this there was an exam to make sure we were confident about doing the procedure and explaining it. We practised on each other during the training because it is run in a GP surgery and normally they ask patients to be our case studies, but because of Covid restrictions we did it on each other. Once you’ve got the certification they say as long as you are competent enough to carry out the service no refresher is required.

In a nutshell, what does the service involve?

Ours is a walk-in microsuction service, so when patients come in I explain what the procedure entails. If it sounds like something they could benefit from, I’ll take them into the consultation room to do an ear examination to check their hearing, check nodes for inflammation around the head, make sure their ear drum is intact and whether they have wax. If microsuction is going to be appropriate I’ll send them home with some olive oil drops and book a follow up five days later for the procedure.

The initial ear exam can take 5-10 minutes, and I’ll repeat it when they come back, and then it takes 10-15 minutes per ear to remove the wax with microsuction.

Are there any opportunities to sell OTC or prescription products during or after the consultation?

Olive oil ear drops are the only thing, but when you do the ear exam you can pick up on infections or inflammation – for example, sinusitis – so as I have access to PharmaDoctor PGDs if the patient has an ear infection I can sell appropriate products.

How have patients responded to the service? They are usually very surprised, and impressed when they see what comes out of their ears. And if ear wax is causing them ear ache they are always relieved when that gets resolved.

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

When you start you might start slow, but once you’ve got your local GP surgeries you could expect to carry out the service at least once a day. Our location and footfall mean I’m hoping to run a whole day clinic in the next few months – and luckily I still have a second pharmacist two days a week from when I used to run my travel vaccinations service, so I’ll run the service on one of those days.

How much do you charge for the service?

We charge £10 for the initial ear exam, and £30 per ear for the microsuction.

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. Our travel vaccine service was really busy up until last year and so it’s nice to be able to do something else. It’s important to look at where your pharmacy is and if you have the potential to have a good client base, and if you do then go ahead. It also helps if you can get local surgeries on board, and make sure reception staff are aware that although ear irrigation and microsuction services are no longer available on the NHS, pharmacists are still doing them privately.

I like running services as it gives me a sense of fulfilment as a pharmacist. In terms of skillset we are really well equipped to do something like this, and the training gives you confidence that you can really make a difference to the customers who have this problem, plus it’s so satisfying to see their reaction.

Read more case studies on minor ailments services.