Setting up an aesthetics clinic has been an empowering experience for contractor Rahul Patel and his pharmacy.

Name of pharmacy: Brothers Pharmacy, Leicester.

Name of pharmacist: Rahul Patel. 

Why did you start offering the service?

I wanted to widen my horizons and try and offer a unique service. Aesthetics was something that appealed to me at the time and it gave me a chance to use my prescribing skills in a different sort of platform. I’ve now been offering the service for four years. I started out while working as a manager at an independent pharmacy, a role which allowed me the time to focus on setting up the clinic. I’ve since bought a pharmacy and we’ve recently undergone a £120,000 refit, where I’ve been able to put in two dedicated aesthetics rooms. One has disabled access and the other is upstairs.

How much did it cost you to set up the service?

The biggest cost was the training. I wanted to make sure I was fully qualified first, so that involved at least £3,000 to £4,000. The setting up of the clinic itself wasn’t a huge investment, you need a therapeutic bed and chair really. I also wanted to make sure I had a proper insurance policy for the service, so that it didn’t affect my day to day pharmacy business or me as a professional, so I had a separate indemnity covered as well. The equipment and the insurance was around £2,000.

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

I completed my independent prescribing course in 2015.

In terms of specific training for the aesthetics service, I have done the majority of it with the Medical and Aesthetics Training Academy (MATA). The initial training was on Botox and fillers, I focused on three areas for Botox and for the derma fillers it was mainly lips. I then developed that further by undertaking more training on tear troughs, jawlines, marionette lines and nasolabial lines with fillers, and for Botox I focused on more medical treatments, such as hyperhidrosis and fixing gummy smiles. I am currently in the process of completing my level 7 accreditation.

I have also done some training with Church Pharmacy.

I did some ad hoc training for my staff too, which included what to do in emergencies. Normally the consultation and treatment process it’s only me as the practitioner involved, but I needed to make sure that I had a staff member on call if I called out for assistance with an emergency, for example, a patient fainting.

In a nutshell, what does the service involve?

First, the patient will have a consultation with one of the practitioners, so either myself or whoever is carrying out the treatments if I am on duty at the time. We normally have two or three practitioners who work in the clinic, it just varies on who is flexible and available at the time. We are all pharmacists by background. If no one is available we will make an appointment for the patient to come back.

At the first appointment, no treatment is carried out. We are very strict on that policy. We like the patient to go away with an understanding of what they want to do, so the initial consultation will always involve going through the risks and benefits of the procedure. We take a full medical history to make sure it’s suitable, but also to try and gauge the reasoning behind getting cosmetic treatment. We always try to look out for body dysmorphia and see if there’s any signs of that. We want to make sure the patients are fully competent in making the decision.

Once we’ve gone over all of those aspects, we tell the patient to go away and come back to us in a week or two weeks’ time if they still want to have the treatment. We always say go away and come back to us, and if you decide you want to go ahead then we will happily make an appointment for you. It’s just because nowadays a lot of people get caught up with the adrenaline, say they want treatment and then regret it later. We heavily believe that this is not something that should be taken lightly, especially because we look at it as a medical procedure. We need to make sure the utmost care is taken and the consent is robust.

If a patient choses to proceed, then they come back, complete a form and we go over their consent once more. Then, normally we will treat them.

After the treatment has been carried out, the process then goes to aftercare. We talk about aftercare with the patient, what the most ideal ways of looking after themselves over the next 24 to 48 hours would be, and then going forward. We also give them an emergency number for the practitioner. If something does go wrong or there is something they are worried about or unhappy with, we want them to have full confidence that they can call that number at any time and speak to us. All the practitioners are independent prescribers and have done training to know the signs and symptoms of infection. If there are any concerns or something does go wrong, we will book the patient in for another consultation as soon as we can and either write a prescription up for them, or treat them accordingly.

We like to see everyone for a follow-up after two weeks, but it is optional. Some people prefer to give us a call to say everything is fine, but others want to come back. Normally at that consultation we can give them a top-up, or they might want to talk about what they liked or didn’t like and then they go on their way. But we do encourage people to come back because, if they have any niggling questions they want to ask, it gives them a professional and safe environment to do so.

Are there any opportunities to sell over the counter or prescription products during the consultation or after it?

Yes, there are some opportunities. It can be something as simple as a face cream to make sure the patient stays clean, helps keep the hyaluronic acid in their lips or face, or helps to increase the longevity of the treatment. There are drinks that do that too. We tend to focus the link-selling around what they can do to take more care of themselves, so we promote things like collagen creams and face washes,

How have patients responded to the service?

The feedback has absolutely been positive, it’s been great. I went on Groupon when I first started to try and get a bit more exposure and patients under my belt, but the response has been very good. I was initially sceptical about whether people would want to get treated by a pharmacist, but once they have come in and had a consultation, they are happy and want to carry on with the service.

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

When the service was up and running properly, I could have anything between two and five or six patients in a day, which would include consultations. Normally I would only do up to three actual treatments in a day. The consultations are usually around 20 minutes, so you can fit them in throughout the day.

Sometimes I spend a day in the aesthetics clinic and hand over my normal pharmacy workload, but a lot of the time people like to have treatment in the evenings or at weekends because they are working or don’t want people to see them. So, that means it doesn’t always interfere with my day to day work anyway.

How much do you charge for the service?

The consultation is free because we believe that if you charge for it then you are incentivising the treatment. If a person puts even £10 or £20 into something then they are more likely to want to pay to get something treated, rather than just being told ‘no you don’t need anything’. So, we offer the free consultation service and after that they can decide if it’s something they want to proceed with.

The full list of treatment prices is on the clinic’s website.

Roughly how much a month do you make from offering the service?

We’ve not been doing aesthetics treatments due to Covid-19, but normally gross profit would be, on average, around £1,000 to £2,000 a week. That means you can carry on a day to day pharmacy business as well.

Would you recommend offering this service to other contractors?

Definitely. With the current climate and the NHS reducing contractor fees and trying to save money with Category M clawbacks, it’s definitely an avenue that should be looked at. It also empowers the pharmacy and the pharmacy contractor, because it is a service we can have full control over and be able to see the progress. In a normal pharmacy, we don’t tend to see patients after they’ve been in for their medication and so we don’t see the benefit. But with aesthetics you are able to see the benefits there and then, and I think the job satisfaction that comes with that is a little bit more than what you get from just the day to day work.