Diyana Spahovic works as a locum pharmacist in London. She talks to Saša Janković about helping patients with minor ailments across the capital.

Service type: Minor ailments

Name and location of pharmacy: Locum pharmacist in Westbourne Grove and Southwark, and at D.R. Harris in St James’

Name of pharmacist: Diyana Spahovic

When did you start offering this service? I’ve been a locum since 2002

Why did you start offering this service?

I’m from the former Yugoslavia, and qualified as a pharmacist in Belgrade. When the war started in Sarajevo I left with my baby, moving first to work in the Czech Republic and then to Sunderland in the UK. I started my pre-reg in Sunderland in 2000, got my conversion in 2002, and began locuming as it fit around having a child.

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

After my conversion I trained in all the usual services such as MURs, minor ailments, consultations for all advanced and basic services, and then flu vaccinations.

In a nutshell, what does the service involve?

I work in pharmacies in deprived as well as affluent areas, so it depends on pharmacy I’m booked in as to what services I do.

As a second pharmacist I’m free to go out and meet more people in the pharmacy, not just give out bags of medicines, and I’m much more satisfied when I can go and talk to them a little bit – especially those who are embarrassed or hesitant to bore their GP with certain things.

Being able to take the time to talk to patients and ascertain their problems can make a big difference to them, and helps us pick up on signs that something more serious might be going on with them.

For example, if someone is complaining of irritation in the eye, when you go through the questions with them you often realise it’s not conjunctivitis so there’s no point selling chloramphenicol when in fact maybe you need to refer them on to the eye hospital. First they are disappointed that you can’t help them on the spot, but if your referral helps something more serious get diagnosed then they always come later and thank you.

I often realise that a patient has low iron levels and although it’s a delicate conversation I try to find out if they are bleeding from the rectum and what colour the blood is, which can help us spot an ulcer or something worse. One of our customers kept coming in for Gaviscon for IBS and was delaying seeing their GP, but I noticed this and persuaded them to go and it turned out to be bowel cancer.

We recently had a gentleman with what he thought was an insect bite on his leg but I could see infection was starting to creep up his leg and referred him on to his GP – so it was professionally very rewarding when he came back and told me it wasn’t a bite after all, it was cellulitis.

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

I know not everyone has got time for this as it can be very chaotic in the pharmacy, but sometimes people just need a couple of extra minutes to finish their story. This builds relationships with your patients, so the next time you are selling something to them they trust you and are happy to spend money on something which will do good for them, and is good for the business.

How have patients responded to the service?

When people come back with a prescription from the doctor they admit they didn’t want to go, but I was right to encourage them.

Would you recommend offering this service to other contractors?

The fact that doctors are stretched means it's so important to spend time to talk to patients and listen to them. If we can give them another two minutes to finish their stories we can help even more.

I love the way people here respect pharmacy but I don’t like the way the business side of things mean we have less time for patients, more admin, and spend the bulk of our time on dispensing. Are we going to lose that opportunity to talk to people and let them talk? We have to stay as the caring profession as much as possible and we have to protect our time in future for those things. That way the public would trust us even more and that could be our advantage, like it used to be long ago.

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