Geeta Sharma, pharmacist, IP and owner of Waterbeach Pharmacy in Cambridgeshire, talks to Saša Janković about expanding her private minor ailments services.
Service type: Private minor ailments clinic (ear syringing).
Name and location of pharmacy: Waterbeach Pharmacy, Cambridgeshire.
Name of pharmacist: Geeta Sharma.
Why did you start offering this service?
I started offering this service at the beginning of autumn 2020. I completed my IP training last year (in 2019) because I wanted to do so much more clinically but I knew I’d have to go out and make it happen myself. Once I qualified I decided to add to my skills by doing walk-in clinic training, from MHRx, and that is really where my clinical journey began.
As pharmacists I believe we are very good at gauging what to say to each patient, how to talk to them appropriately, and we are used to having to make time for them. We don’t have the 10-minute countdown that GPs have, but that means our patients know they will get exactly what they need from us, when they need it. From the perspective of the minor ailments walk-in clinic, this meant I had to get really switched on in terms of my documentation, as we don’t have the systems the GPs have but we still need to meticulously document every single thing that goes on in the consultation process.
By doing ENT consultations in the walk-in clinic, I noticed that lots of patients were complaining of ear problems – especially in the winter – such as minor ear infections, being slightly deaf, and ringing in the ears. I also knew that fewer and fewer GPs offer ear syringing on the NHS, so I went for ear syringing training.
How much did it cost to set up the service?
The cost of the ear syringing equipment was £300, plus there was the training which wasn’t too expensive. Then you have to create an SOP, and train your staff so they know when to refer and when not, but that’s just time more than money.
What, if any, training did you or other team members have to undergo?
So far it’s just me who has done the training, but I’m planning on upskilling my staff in this area in future. Community pharmacy is changing and with technicians getting even more skilled there is so much we can do. I have one technician already and another going for ACT training now, and they are helping more than ever, which frees me up in the clinic.
I’m also interested in microsuction, so I’m booked on to a course to see whether this might be something to add in. It would mean investing in a really expensive piece of kit but we have had such good demand for our syringing service that this might be a consideration. I know some patients prefer it, and there is a train of thought that it carries less risk of eardrum perforation.
In a nutshell, what does the service involve?
The minor ailments clinic service is still relatively new to us, but we advertise it on our website and Facebook pages, and people have been finding out about it that way.
When customers come in complaining of ear pain I’ve developed a preliminary screening form that my staff can go through with them to assess if they need to see me or if they can get OTC care then and there. We offer them a bookable appointment if it’s something I need to look at, but more often than not if I’m free I’ll happily see them straight away.
If I take them in for a consultation it takes about 15 minutes, plus about 30-40 minutes if they need both ears syringed. If we are going to syringe then they need to have been using olive oil in the ears for at least a week beforehand, but most people know to do this already because they’ve had it done previously by the GP. And of course if there are any red flags such as tinnitus, cleft palate or a perforated ear drum then I won’t syringe.
Are there any opportunities to sell over the counter or prescription products during the consultation or after it?
Although we don’t sell any products on the back of the service we have seen new customers coming back to the pharmacy after we have syringed their ears.
I’m looking at how I can branch this out from being only a private service, maybe getting some funding for it in the future, and making community pharmacy more integrated in the whole GP pathway.
How have patients responded to the service?
You only need one person to come in for ear syringing and notice the difference instantaneously, and they go tell their friends. It’s a lovely circle of returns.
Roughly how often each month do you carry out the service?
At the moment we see about 2-3 people a week. You can syringe anyone over 12 years old but we mainly see people aged 45 and above, and of course in the winter season you get more ear problems. We get enquiries all the time, but some people prefer the microsuction option, which is why I’m exploring that route too.
How much do you charge for the service?
£30 for one ear, £50 for two.
Would you recommend offering this service to other contractors?
Yes, I’d absolutely recommend offering ear syringing. It’s such a good way to show what pharmacists can do, plus it doesn’t need much space or take much money to set it up. And your HCAs could definitely do it too. Pharmacists still need to be involved at some part of the process, but it’s really empowering for staff to know that we can all make a difference to our customers.