Part of The Pharmacist’s series of case studies on how cuts to community pharmacy funding are affecting ordinary pharmacists, a Kent contractor explains the impact on their pharmacy
Sunil Kochhar – consultant pharmacist at Regent Pharmacy in Gravesend, Kent and founder of online forum pharmacyTALK.
‘The cuts have massively affected our whole business model.
‘We’ve always relied on customer service and the standards that we give. Before, there would be enough buffer and margin in the system to allow us to focus on that quality and service. But now we’re having to change.
‘The man power that goes behind the dispensing, regardless of whether you’re doing three to four thousand items or ten to fifteen thousand items, is pretty similar. And that’s what’s taken the biggest hit. We’ve not been able to invest in staff. We’ve had two staff members leave and we’ve not recruited again.
‘We now have a team that covers the equivalent of three and a half staff members plus a pre-reg pharmacist. That includes one dispenser, a dispensing assistant and the others are healthcare champions.
‘But the pre-registration student takes extra energy because we have to take time out and guide them as their tutor. If it wasn’t for that we’d be two staff members down, but because of the effort of a pre-registration pharmacist, it’s probably more. People say that it’s extra hands but to be honest it’s extra work.
‘You have to dedicate time as their tutor to make sure you’re guiding the new pharmacist in the right way and giving them experience. So, we’re now considering whether we should be taking on a pre-registration pharmacist or not because it actually takes away another staff member.
‘Now we’re having to change our habits to make up for being two staff members down. Goodwill gestures like outreach work and helping charities in the local community have stopped.’
‘We’re also having to look at how we’re buying things. Whereas before we would just replace things we’ve used, now we’re trying to find bargains and hunt for better prices. And that’s not my role. My role as a pharmacist is to take care of my community. But now we’re taking care of drug prices, which is not the reason I got into pharmacy, not the reason I bought a pharmacy and not the reason why I invest my time in the community.
‘We’ve also been spending money for years building up our private services. We offer services like health screening from the basics like checking cholesterol and HbA1c for diabetes, all the way through to having the rooms booked out for an acupuncturist, a chiropodist and other practitioners who come in and use the rooms.
‘You need a well-established private service as a separate business to break even right now. A pharmacy on its own with the cuts is not viable because there’s certain medication that we’re making losses on because we’re not being paid the amount that we’re being charged by the wholesalers. But again, you need manpower to maintain a reception and appointments system. So, it’s a balancing act we need to get right.
‘We have five consultation rooms and there are some days they’re all fully booked. But we’ve spent a lot of time on this, it’s not something we’ve done since the cuts. It’s been building over the past 15 years and it’s not something a pharmacy could just start. It takes a lot of time, effort and energy. But it’s the only way to break even in pharmacy.
‘We’re still struggling and we’ve had these services established for quite some time.’
‘The decision we have to make now is do we grow the dispensary side or do we tailor it down so we don’t have as much work and focus on the private clinic? The only thing that we use the dispensary side for is getting the footfall in and working to convert them to private clinic.
‘We did a scope on the business and if we didn’t have the dispensary then we’d be quite a profitable business. But because of the dispensary aspect, the manpower that goes into it and with the losses we’re making on medication, it’s the opposite. No business can survive if you’re actually paying out more than you’re earning. And that’s what’s happening with the current drug market.
‘But the only way to get better prices is to buy larger quantities and without the cash flow, we can’t even do that. So, we’re stuck in a rut.’