Ali Harb speaks to Rachel Carter about setting up a minor illness clinic.
Service type: Minor illness clinic.
Name of pharmacy: Harbs Pharmacy, Ealing, London.
Name of pharmacist: Ali Harb.
How long have you been offering this service?
Since 2015. My cousin and I own the pharmacy together and we started off by hiring a prescriber to run the clinic. In 2016 we completed our independent prescribing training and have run it ourselves since then, although we do use the help of others, if we are away for example.
Why did you start offering the service?
First, it is very important as a pharmacy to look at innovative services, especially with the NHS cuts that have been going on for the last few years.
Second, we found that there was a need for a service like this because of the waiting times in A&E, or the length of time people were waiting to see a doctor. We felt this was something that needed to happen, and it worked out. It definitely was a positive with our patients – not just the people signed up with us, but others who heard about the clinic and wanted to use it.
How much did it cost to set up the service?
It wasn’t too costly. The independent prescribing course was roughly £1,300 at that time, although it might have gone up since then. We also needed to buy the diagnostic tools for the clinic, which cost around £300.
What, if any, training did you or other team members have to undergo?
In addition to the prescribing course, we completed a minor illness training with Belmatt. This was face-to-face and goes through all the minor illnesses that you might see in a GP or urgent care setting. As part of our prescribing course, we also sat in with doctors at the GP surgery to go through the clinics they normally do, and at urgent care centres in hospitals. This meant we got exposed to the kind of conditions we might see in the pharmacy.
In a nutshell, what does the service involve?
We are a late-night pharmacy and there is generally a demand out of hours for this service, but we can see people during normal working hours too. Sometimes a patient might call in the morning and say they haven’t been able to get in at their GP surgery for e.g. symptoms of a urine infection and ask to come in to us that day. We usually have someone on site daily, so often the patient can come in straight away. It is quite instant and rapid.
When the patient comes in, we take them through to the consultation room so that we can talk privately and go through what needs to be done. We’ll be looking at whether they have a certain condition, is it safe to prescribe, or if they need to be referred to another service. So, we will go through their history, presenting complaint and any symptoms they are experiencing, and any examinations such as taking their temperature, pulse and oxygen levels.
Depending on what condition it is, there is a wide range of examinations we can do. For example, if it is a urine condition we will take a urine test, or for a suspected chest infection we will listen to their chest. We also go through the patient’s drug history and then we decide if they need treatment or not.
We will write a prescription up if needed and the patient can get it from our pharmacy or take it elsewhere. Generally, they do get it straight from us.
The service covers a number of conditions, but the ones we regularly see are urine infections, chest infections, ear infections, tonsillitis, allergy treatment, skin infections, pain management, and anti-malaria prophylaxis.
Are there any opportunities to sell over the counter or prescription products during the consultation or after it?
Yes, there is some link-selling with OTC too. Sometimes patients don’t need a prescription and can just buy things off the counter. Or, for something like tonsillitis we might prescribe an antibiotic but because of the pain swallowing the patient might take some painkillers or throat spray as well.
How have patients responded to the service?
The response has been fantastic. One thing we’ve done – that I think is beneficial for anyone who wants to run a clinic like this – is to advertise on social media pages for the local area. So here we have things like ‘Ealing Friends’ and we advertise on there, or people will recommend us. That’s been very positive, and we’re quite known in the area for the service now.
Roughly how often each month do you carry out the service?
It varies, but I would say at least five to 10 patients on average each day.
How much do you charge for the service?
We currently charge £20 for the consultation. If you compare that to seeing a private doctor for similar conditions, they charge around £70 to £100.
There is also a charge for the cost of medicines. The service is completely private, so even if the patient is normally exempt they will have to pay it. Prices depend on the drug, but generally it is around the prescription charge.
Roughly how much a month do you make from offering the service?
Without sharing the exact figures, what I would say is that, because medicine use reviews are now being phased out, running this service is definitely something that might cover that lost revenue, and maybe more than that too.
Would you recommend offering this service to other contractors?
In these difficult times for pharmacy with all the cuts, I would definitely recommend providing this service. Or, finding a service that would cover the loss of NHS payments, so it doesn’t have to be this service – it could be any kind of private service that you might find to be a benefit to your patients.
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