Bath pharmacist Nick Daines explains how his sexual health service works.
Service type: Sexual health.
Name of pharmacy: Lifestyle Pharmacy, Bath.
Name of pharmacist: Nick Daines.
Why did you start offering the service?
I’ve been offering this service since 2014. When we partnered with CityDoc (the UK network of healthcare clinics) to deliver a travel health service, it came as part of the package.
How much did it cost to set up the service?
In terms of time [for setting up all the services that we offer], it was probably a couple of weeks’ worth of training for me. In terms of financial costs, the consultation room was already in place, but we did quickly realise that we needed an additional PC point in that room, so we had to renegotiate the contract with our systems provider. For the sexual health service specifically, I also completed a Phlebotomy course, which cost £350 and a one-day training with CityDoc, which would have cost another £200 or so.
What, if any, training did you or other team members have to undergo?
I completed a one day training at CityDoc and some personal self-directed training, and the Phlebotomy course, which involved a two day face-to-face training with additional study time at home and some essays to complete.
In a nutshell, what does the service involve?
We take the client into the consultation room and explain what the service offers and what the limitations are. We are set up for screening, but not for physical examinations. We then run through the consultation, ask the patient what the risks are and what the exposure was. We perform any necessary tests, such as taking bloods, a urine sample and throat swabs, and provide them with the toilet or private clinic space to do any self-administered swabs. Depending on the circumstances at the time, we will then give the patient a results leaflet and advise them of the turnaround time.
We send the information and tests off to the laboratory in central London, the laboratory then communicates the information back to CityDoc centrally, and the client rings CityDoc to the results line. If there are any further discussions to be had about results, a clinician from CityDoc would call the client back and explain any follow-up action. We can provide some medication and treatment for chlamydia, but if it’s something that requires antibiotic injections for example, then the patient would be referred back into the NHS.
Are there any opportunities to sell over the counter or prescription products during the consultation or after it?
Very limited opportunities. Sometimes clients present with thrush, in which case we can provide Canesten, for example.
How have patients responded to the service?
People are more reticent to talk about sexual health or admit they’ve had this service, but I’ve not had any negative feedback or a single complaint about the services we’ve provided here over the last six years. I think patients are just generally happy that they can obtain a service privately, confidentially, quickly and efficiently.
Roughly how often each month do you carry out the service?
We normally do one per week, so four per month. We do a get a lot of bookings for this service, but there are some no shows unfortunately.
How much do you charge for the service?
There is a £50 consultation fee. The full list of charges can be found on the CityDoc website.
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 the challenges are that you need pharmacists to think a bit differently in terms of what they can do and how they can provide the services. You also need to empower the rest of the team to run the pharmacy while you run services, or engage a second pharmacist. So, you’ve got to think carefully about the skill mix and whether you need any additional support, which can of course bring cost challenges with it as well.