Bath pharmacist Nick Daines discusses Lifestyle Pharmacy’s flu service, which offers both NHS and private vaccinations.
Service type: Flu.
Name of pharmacy: Lifestyle Pharmacy, Bath.
Name of pharmacist: Nick Daines.
Why did you start offering the service?
I was already flu-trained and had been running flu vaccinations from 2008 as a private service within Sainbury’s, my previous employer, but I began offering this service in Lifestyle Pharmacy in 2013.
We relocated this pharmacy to a new purpose-built site in November 2012. We were part-way through the flu season at that time, so we did a small number of private flu vaccines. We’ve grown the private service gradually and we incorporated the NHS offer within that when it was introduced.
Flu was very easy to introduce to the new pharmacy site. It was straightforward to grow footfall to a new business and to provide a service for which there was a local need in terms of both businesses and individuals wanting to protect themselves. It’s grown year on year – in the beginning we vaccinated colleagues at a local school and a couple of local businesses who are still with us now. We’ve got around 10 business clients now and we offer somewhere in the region of 700 to 800 private vaccines each year.
How much did it cost to set up the service?
The set up costs for flu were quite minimal. It costs around £90 each month for the facility to take away the gloves and sharps disposal and around £100 per year for the PGDs – we buy a PGD for every pharmacist working for us.
What, if any, training did you or other team members have to undergo?
When flu first started and all the PGDs were very strict, the vaccination training used to incorporate general training about flu as well. It doesn’t do that so much now, the training is more about vaccination technique, resuscitation and anaphylaxis. I’ve completed multiple trainings on flu, but every year I also put together a pack for the team. This includes the annual flu letter and a training session and memo for staff about the current flu vaccines, expected efficacy, who we can vaccinate, whether we vaccinate privately or NHS, and whether we give injection or nasal spray products as well – because the PGD also includes the nasal spray for the vaccine. I also ensure our SOPs are up-to-date and that everyone has read them.
Our Local Pharmaceutical Committee often puts some training materials for flu on Virtual Outcomes, the online training portal, as well.
In a nutshell, what does the service involve?
With the NHS flu jabs, the client presents and asks for a flu vaccination. We quickly ascertain whether they are eligible on the NHS or not, and if they are we ask them to fill out the NHS form. Once the form is completed, I’ll bring the patient into the consultation room and give them some advice and guidance about the benefits of the flu jab, how they are likely to feel, any potential risks and what we would do to manage those. I then provide the vaccination, provide the patient with a record of vaccination, and keep an eye on them for a couple of minutes to make sure there is no anaphylaxis or severe reaction. Finally, I follow-up any necessary paperwork back to the patient’s GP.
For private flu jabs the process is similar, except it’s a different form to fill in. The health assessment is basically the same, although the patient might have a different option in terms of products – we can also provide a nasal spray. We would ascertain what service the client is looking for and then complete the documentation with the client, provide all the necessary information and guidance, vaccinate or administer the nasal spray, keep an eye on them for a few minutes, and then process the documentation in accordance with what they’ve asked for. A lot of clients aren’t interested in their GP knowing, but for those who are, we forward it on to the GP for them.
If it’s a corporate service, we will document who has had the vaccination and then provide an invoice to the corporate body at the agreed time. We do an off-site clinic where we vaccinate probably about 60 people in one go. There’s an off-site checklist within the PGD, so we send a pharmacist up there to do that, with a cool bag and all the bits and pieces they need.
Are there any opportunities to sell over the counter or prescription products during the consultation or after it?
No, not really. But one of the good things about the flu service, which I like, is you’re dealing with people who are taking proactive care of their own health. So if you wanted to, there are opportunities to look at other products like supplements, for example – or there’s also lots of things out there that are purported to boost the immune system, such as echinacea.
How have patients responded to the service?
Our flu vaccination service goes from strength to strength every year. I think as patients begin to realise that they can obtain a flu vaccine not just from the GP where they might be in a waiting room with hundreds of other people, but in a tailored, booked 10 minute appointment, they really appreciate that additional time and contact. Overwhelming the response has been positive.
Roughly how often each month do you carry out the service?
We do between 1100 and 1200 flu vaccines per year – 400 NHS and 800 private. The vast majority of provision is throughout October and early November, but this year we did have a significant trickle in December.
How much do you charge for the service?
£10 for the injectable flu jab, £30 for the nasal spray.
Roughly how much a month do you make from offering the service?
I can tell you that the services we offer do now make up quite a significant proportion of the overall income for the pharmacy, so it’s somewhere in the region of 15% of our total turnover and a significant amount of our net profit.
Would you recommend offering this service to other contractors?
Generally, I don’t think you can offer too few services privately. If you’ve got the consultation space and you are willing to work outside of your comfort zone while you gain experience in providing these services, then I think there is a really huge benefit. For me personally, I love providing services because it’s another string to the bow, it’s something unique and ahead of the curve in terms of pharmacy. If we prove that we can do these things privately then hopefully we should be able to get them commissioned by the NHS as well. I think that’s why the flu vaccination service was commissioned – without any prodding from anywhere else, pharmacy created itself a private flu service and it’s been recognised as a cost-effective and viable alternative to GPs.