Rachel Carter speaks to Bristol contractor Ade Williams about his pharmacy’s travel service
Name of pharmacy: Bedminster Pharmacy, Bristol.
Name of pharmacy: Ade Williams.
How long have you been offering this service? Since 2018.
Why did you start offering the service? I think it was a realisation that after the NHS funding cuts, we as a pharmacy team needed to diversify some of our workload and increase our private income streams. Also, we had already been offering NHS and private flu vaccinations, and we’d seen how patients were very appreciative of that.
How much did it cost to set up the service? Around £2,000. We purchased the Patient Group Directive (PGD) from PharmaDoctor and we also commissioned a website and had some graphic designs done for our logo and messaging. In terms of ongoing costs, we have to renew the PGD annually and we’ve spent money on advertisements and sponsoring events.
What, if any, training did you or other team members have to undergo? We completed the mandatory training for the PGD. Alongside this, we completed accreditation training for the yellow fever vaccine with the National Travel Health Network and Centre; some online training on safe needle handling, and training on vaccinations for paediatrics as well.
We also updated all of our previous vaccination and resuscitation training. We were conscious that although we had been doing vaccinations already, we were going to be doing a lot more – so we wanted to be sure we had that confidence that everything we were doing would be competent and safe.
Finally, we provided the rest of the team with disease awareness training and helped them to understand more about vaccines, including the messages around them and some of the misinformation. The first person a patient speaks to when they come into the pharmacy is not usually the pharmacist, so it was important for us to educate the team to be confident in the service and be advocates for it, which in turn helps the patients feel confident.
In a nutshell, what does the service involve? We offer a walk-in service or patients can book an appointment. We always encourage them to get hold of any old vaccination records to bring in to us.
One of the first things we do is carry out a risk assessment to better understand the patient’s current health, their previous medical history, and also more about their foreign trip and what the reason for the vaccination is.
During the consultation, we use PharmaDoctor’s e-tool to go through all the up-to-date information on the risks where they are travelling and what vaccinations and other travel health they need to be thinking about. We explain what each of those things means, eg we will talk them through what rabies is. They have to consent to the vaccination, so we want that consent to come from a place of knowledge, not just because it’s being sold to them.
Not every patient who comes in will walk away with us providing a service – we are also able to signpost them to NHS provision, because sometimes a patient may be eligible to receive all the vaccines they need from their GP. We work very well with colleagues in the local surgeries, there is good communication and we are working in an integrated way, which helps us.
If we are providing the service and the patient consents to the vaccine, then we explain the schedules to them and any side effects. After administering the vaccine, the patient will pay and we will schedule any further appointments as necessary. Depending on how many vaccines a patient needs it can be quite complicated, so we offer to send out reminders as well.
Finally, we forward a record of the vaccination to the patient’s GP.
Are there any opportunities to sell over the counter or prescription products during the consultation or after it? We go through a range of products that might be helpful to patients. This could include tablets for altitude sickness, mosquito repellants, water purifiers, first aid kits, anti-histamines, and emergency diarrhoea relief packs.
We might also have some conversations around sexual health, and we also offer period delay medication, which some find beneficial for when they are travelling. We are not up-selling, but we try and take a much more holistic approach to the patient’s health and provide care that considers their general state of health, not solely their travel needs and the vaccinations.
How have patients responded to the service? We’ve had really good feedback. Locally, we were very surprised that one person who has a very positive experience tells lots of other people who need travel health, so that’s been helpful. We’ve built relationships with other organisations too, which has been important for us. We work with quite a few schools who do foreign trips and trust us to help them prepare for those.
We also sponsor local events to try and make people aware of the travel clinic and the pharmacy, and we have partnered with charities including WaterAid and Meningitis Now. We make a donation from the sale of each vaccine to these charities, which helps us to give something back and makes our service stand out. There are also local charities that we offer a discount to – particularly those who take groups of people on trips.
We have also been recognised by Public Health England as a pharmacy vaccination champion, because we are selling the benefits of vaccines, rather than just selling the benefits of our travel health clinic. This means other clinicians are very comfortable referring patients into us and our relationship with general practice has been very good.
Roughly how often each month do you carry out the service? We have seen an average of eight patients per week over the last six months, which is what we were aiming for so we’re very much on track with that.
How much do you charge for the service? The charge to the patient depends on the vaccinations they need. The consultation is free and we try to offer competitive prices. Above all, we try and ensure that we are ethical, person-centred and fair. It may mean that we’re not making as much from each vaccination sale, but we would rather have one person bring two people back to us because they had a positive experience, than one person use us and tell everyone not to come here.
Roughly how much a month do you make from offering the service? The travel health service generates in the region of £1,000 profit each month. Our plan was always that the vaccination service was going to replace our income from the decommissioned MUR service, and I think we are certainly on track for that now. It will soften the impact of that loss of income.
Would you recommend offering this service to other contractors? I think yes – but I think the question contractors should ask is not should they be doing travel, but is there a clinical need in their locality they could be fulfilling. That was the question that led us to providing this service. Travel may be it or it might be a different service – but if you are not asking what does my community need, then you are not seeing yourself as a provider.