Rachel Carter speaks to Shaftesbury Pharmacy’s Lila Thakerar about the OTC sales and advice she offers to patients with hay fever
Name of pharmacy: Shaftesbury Pharmacy, Harrow.
Name of pharmacist: Lila Thakerar.
How long have you been offering this service? Since 2015.
We’ve offered over the counter advice on hay fever for the last 27 years, but over the last five years, it has become more and more popular.
Why do you offer this service? Patients are now being advised to go and see their pharmacist first. There is a lot of encouragement from GP surgeries, more so in the last two years, for patients to be directed to the pharmacy and purchase their antihistamines or nasal sprays from us. Often the doctor will make the same recommendation that a pharmacist will make anyway, and patients have to pay a £9 prescription charge, whereas some of these products are cheaper than that.
More and more hay fever products are coming onto the market to be sold without a prescription, so it is a much quicker and wiser option for patients to see their pharmacist. You can walk in, no appointments necessary, have the privacy of a consultation room and purchase the same products.
How much did it cost to set up the service? The only cost to us is in training – sometimes we have evenings held by companies that bring out a new product. I always encourage my staff to go to these training sessions and they get paid for the time. So, for me, those are resources – investing in staff and ensuring they are adequately trained.
There is also a cost involved in the time giving advice and not being able to generate an income from that advice. But as pharmacy contractors we have a duty of care to the patient and an obligation to NHS England to provide a service to patients… so a lot of the time it’s not about generating income, it’s about providing patient care, which is really what we have a duty to do.
What, if any, training did you or other team members have to undergo? Hay fever is a category that has brought a lot of products out over the counter in the last few years. If there’s a new product that’s being put on a P-med line, from a prescription-only medicine, then the representatives come in and spend some time training little groups of our staff, usually two team members at a time. So, in the last five years, we’ve probably done three or four of those sessions each year, plus one or two sessions at other venues.
In a nutshell, what does the service involve? Firstly, we would go through the patient’s history. I will ask how long they’ve had the symptoms, what medication they are on, and check the patient’s prescription record to see if there is anything they are taking, or what they’ve already had, and to see whether the recommendations I may want to make would clash with their history of medications from the GP. Some patients like to do this in confidence, so we would take them into the consultation room.
After we’ve gone through these background questions, I will make a recommendation for treatment. If it’s an unusual recommendation, we always try and log that onto the patient record – if the patient is my patient and I can access it. Depending on what I’ve recommended, the advice is always that if they don’t feel any better, they should come back and see us, or see their doctor.
Are there any opportunities to sell over the counter or prescription products during the consultation or after it? We offer a range of over the counter products. Some nasal sprays and antihistamines used to only be available as branded products, but there are now generics for Clarityn and Loratadine, for example, and they are almost half the price.
So my recommendation to a patient is that these products are exactly the same – I always explain that if they want a branded product that they know, then this is how much it’s going to cost, but the generic is the same thing, so to give them the option. Patients are very cost conscious, so if you give the right advice and assure them that it’s exactly the same product, then they will accept it. It goes back to the faith in the profession and the faith in the advice that we give them.
How have patients responded to the service? The proof is in the pudding – they keep coming back every year and stocking up on the same antihistamines or other products we’ve recommended.
I think more and more people are having faith in the profession and are coming to see pharmacists – partly because of cost implications, but also because of the time involved getting a GP appointment, and due to GPs referring patients to us – that’s been quite a change in the last few years.
Roughly how often each month do you carry out the service? It’s very seasonal. As soon as the pollen season starts, which is normally about the third week of March, the service picks up like wildfire and is busy until the weather gets cooler, so sometimes as late as the end of September. It’s incredible – sometimes we just cannot get enough nasal sprays in. I would say (very approximately) we see 300 patients each month at this time.
How much do you charge for the service? No charge. I don’t think it would be fair for patients to have to pay for advice that pharmacists are expected to give anyway, nor would it be accepted very well by patients if we were to charge. As a profession, patient care is very crucial, we have to make sure we look after them – it’s not all about money ultimately.
Roughly how much a month do you make from offering the service? Figures not available – but it’s certainly lucrative. Hay fever season is a very, very busy time of year for us and it generates a lot of income.
With the new community pharmacy consultation service (CPCS), there will also be an opportunity for us to get paid for hay fever consultations, if a patient is referred to us from NHS 111. This year will be the first hay fever season since the CPCS has been implemented, so we are yet to see how effective it’s going to be and how the popular the hay fever referrals will be.
Would you recommend offering this service to other contractors? Yes – hay fever is a very opportunistic category. I think you’ve got to grab what’s available out there. It’s also possibly one category where you’re not competing with supermarkets and petrol stations. There are certain products that are a P-med line, which supermarkets are selling and we can’t compete. However, hay fever is a category where advice from a professional is needed, and pharmacists are professionals giving that advice, supermarkets won’t be doing that. People will come to us because they know they won’t get that advice, or even the product in some cases, from a supermarket or a petrol station – so we’ve got to make the most of that opportunity.