Mandeep Sandhu talks about how Dedham Pharmacy's travel health service helps patients with all their travel needs

Name of pharmacy: Dedham Pharmacy, Essex.

Name of pharmacist: Mandeep Sandhu.

How long have you been offering this service? Since 2018.

Why did you start offering the service? It was a mixture of a few different elements.

Firstly, I bought my own pharmacy three years ago this March and it was around the time when the major funding issues were going on with the NHS and the pharmacy contract. So, I started to look at other avenues to bring in revenue and to try and build up a clinical service within our pharmacy.

The previous owner had the pharmacy for around 20 years and it was a dispensing model only, whereas I wanted to take a different angle on what the pharmacy needs to be for our patients and the village we’re based in.

On top of that, I was getting questions from customers about travel vaccinations and a couple of GP practices were reducing what they offer, so that gave me the indication that there was a bit of a gap in the market.

How much did it cost to set up the service? The Patient Group Direction (PGD) from PharmaDoctor costs around £450 per year. I also paid to do an additional training on yellow fever, which was in the region of £200.

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

As the pharmacist, I did PharmaDoctor’s online training as part of the PGD. Because I had already trained in injection technique for our flu vaccination service, I was able to use that training to meet the vaccination element of the training requirement. I also did the yellow fever training separately.

We also did some in-house training for other staff members, but that was more for the promotion side of the service and making people aware of it.

In a nutshell, what does the service involve? For booking patients into the service, we have two options. If the patient has been directed to us by, for example, a local GP surgery, then most of those customers will pop in or ring us up. We’ve also got an online booking tool through our website, which notifies us of an enquiry via email or SMS.

When the patient comes in, we will discuss where they are travelling to and then we’ll run through a risk assessment. This basically takes their personal details, medical history and any allergies, and then we will look a bit more specifically into the country they are travelling to. We use the PharmaDoctor travel health e-tool to do the consultation. I’m all for being paperless as much as I can, so I find this really handy because everything is in one place.

If a patient needs a standard one-off injection, then the consultation will take on average 15 to 20 minutes. If it’s someone coming back for repeated doses, then that probably won’t take me longer than about 10 minutes, because a lot of the risk assessment has already been completed previously.

After administering the vaccines, we advise patients on any potential side effects they may experience and we’ll give them some travel risk advice. This includes discussing what to look out for while they’re abroad and products that might help, so we might offer some inspect repellant, antidiarrheals or anti-malarial tablets, for example. We try to link a few other products into the consultation and then give the patient the option. If they think they need it, then they’ll obviously buy it from the pharmacy at the same time.

We also give patients a record of vaccination at the end of the consultation. This is printed out and patients are also given a user profile for the e-tool. This means they can access their information online at any time, but it depends on the demographic. Older patients usually prefer just to have paper and the younger ones prefer to be paperless. I also normally suggest that patients give the record to their GP so they can have all their information stored in one place. Some prefer to do that, others just keep a copy.

The only thing that’s restrictive [about offering this service] is the quotas for the vaccines set from wholesalers. The issue I’m finding is we’re almost hitting that ceiling now where we have to prove that we need those vaccines, even though we’re a travel clinic. But if we were a GP surgery providing this service, we probably wouldn’t get asked so many questions. It means there are a few more hoops to jump through, so we’re trying to get that sorted.

Are there any opportunities to sell over the counter or prescription products during the consultation or after it? Yes, we link in other things. We’ve got several PGDs, which are ‘add-ons’ to the service, including one for altitude sickness in case people are travelling to mountain areas and trekking, for example, and one for jet-lag. We can also prescribe an antidiarrheal-based antibiotic on a PGD, so we offer that too.

What we tend to do is get an idea of the patient’s travel plans and then link the appropriate options to them. We’re not pushy, we ask whether they’ve thought about any of these options and then let them come to a decision.

How have patients responded to the service? Generally the feedback has been good and patients value the flexibility of the service. What I tend to do is not have a very rigid platform of appointments, I’m very easygoing. So, if a patient is desperate for a particular vaccination that day and I know I’ve got time, I’ll tell them to pop into the pharmacy.

I also have very good stock of all the vaccines here. Initially, I didn’t know whether the service was going to take off or not, so I tended not to hold onto too much stock and just ordered as and when I needed it. But now it’s the case that I’ve decided this is quite a [key] part of my business, so keeping good stock levels is important. If someone walked in in the next 10 minutes and said I need such and such vaccination, then I’ve got it all ready to go. 

Roughly how often each month do you carry out the service? When we first started the service, we were probably looking at two to four consultations per month. Now, for initial or first-time consultations, then it’s 15 or more consultations per month. Or, if you include consultations for repeat customers, then it’s more in the region of 20 to 25 consultations per month.

How much do you charge for the service? At the moment we only charge for the vaccinations, we don’t charge any consultation fee, we just try and keep it all into one cost for the patient.

There are standard prices around for this service and what we charge are in line with those. Most independents use similar pricing.

Roughly how much a month do you make from offering the service? Figures not available.

Would you recommend offering this service to other contractors? Yes, I would recommend any pharmacy looking at their local demographic of what patients need to introduce a clinical service. It doesn’t have to be travel, but I think it’s crucial to start looking outside the dispensing area now.