Dylan Jones, superintendent and owner of Llanidloes Pharmacy in Wales, tells Saša Janković how being an independent prescriber has transformed his business

Service type: Independent prescribing services

Name and location of pharmacy: Llanidloes Pharmacy, Wales

Name of superintendent pharmacist: Dylan Jones

Why did you start offering this service?

The GP surgery here was losing two partners who were retiring, and the other GP surgery 20 miles way was down from 10 doctors to six, so I approached the Health Board to say: ‘I can help you out’. I pitched them the idea of an acute illness service, partly because I was fed up with sending people to the surgery only to see them back 20 minutes later with a prescription for antibiotics. But I wasn’t an independent prescriber then, so I also gave them the costing for the training for that, and they paid for all the set up costs for the service. We launched the service in 2015.

How much did it cost to set up the service?

I told the Health Board that to offer this service I needed, I think, £15k by the time I added everything in including my time. We agreed a share scheme where I got so much upfront and then worked to clear the remainder of the debt. I thought after six months I might be seeing 50-70 patients a month, but I saw 75 the first month and it has grown from there. Last month I did 260 consultations.

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

I did my IP training.

In a nutshell, what does the service involve?

I try to concentrate the service on treating acute illness, so everything from skin infections, ENT infections, chest infections, UTIs, rashes and sore throat. I’ve always been of the opinion that pharmacy should be open access, so I never run appointments. If people want to see me, they just queue up and wait.

Even though I prescribe, my referral rate has been 10%, where I’ve had to send a patient to someone else – an optician, GP, A&E. The relationship I have with the surgery here is excellent, so I can refer directly to them, and they don't mind because they know the volume of patients that I’m seeing.

How have patients responded to the service?

People love it as they want to be seen, especially since Covid when the surgery was harder to access. Over the years, I've called an ambulance direct to the pharmacy a dozen times for immediate admission for things like PEs, numerous pneumonias, pneumothorax, and diabetics with toes infected.

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

It will vary, but generally I rarely see fewer than 10 people a day, but I have seen 30 in a day, especially when a GP rings up sick. I can prescribe for anything under the Common Ailments Scheme as well and I do 50 to 80 consultations each month for that too.

How much do you charge for the service?

Since the first of April 2022, this service is all done free on the NHS in Wales.

Would you recommend offering this service to other contractors?

It’s the best thing I’ve ever done, and I’d say to pharmacists: definitely train up as IPs. I think you will be left behind if you don’t, and it’s actually probably one of the most rewarding things in my job now as I’m mainly seeing patients all the time.