The community pharmacy environment is really the public face of pharmacy and has been privileged by being protected by legislation.
There is an obligation to do the job properly and utilise the space to accommodate highly trained staff to deliver a complete service.
There is also an expectation that skilled staff will be paid appropriately and it is currently disappointing to see that the PGA is opposing the payment of penalty rates for pharmacists.
This will influence a future supply of pharmacists as students, or proposing students, find pharmacy less attractive.
Owning a pharmacy is much more than dispensing and retailing products.
It is a major training ground for future pharmacists; it is a major source of advice for the community at large and is the launching pad for specialist medical type products that require patient elaboration and information.
It is an environment that must engender mutual respect and collegiality between pharmacist professionals.
It is an environment that should be a sharing environment held together through lifelong learning and mentoring personalities.
Respect is the key overriding factor between pharmacists, staff, patients and customers.
Owning a pharmacy is a privilege and should be treated as such.
The core business of any pharmacy has always been dispensing + clinical services + retailing. The balance of each of these “core” segments has always decided the design and presentation for each business model of pharmacy.
The distinctiveness of each pharmacy model relates to the percentage of attention captured.
For example, a compounding pharmacy will have a large dispensary fitted out with equipment that a warehouse pharmacy, for example, would never envisage.
It will focus on patient engagement and will have a receptionist and patient engagement station close to the pharmacy entrance and will have a private interview room. Retail space will be minimal and stock held will be specialist stock.
Location for this type of pharmacy can be away from the middle of a main street shopping centre or mall environment.
This type of pharmacy would be the closest to the type of pharmacy I started my career in (minus the private interview room) and at the commencement of the PBS dispensing system.
It is the type of pharmacy where a patient would insist on “their pharmacist” dispensing their prescription and where the patient could ask for advice and be confronted by multiple internal pharmacists competing with each other to provide a free advisory service.
It was also the type of pharmacy where apprenticed pharmacists (like me) would be taught sales skills with the “bible” here being Dale Carnegie’s “How to win friends and influence people” – a book still available today and just as relevant.
UK pharmacists are experiencing image difficulties after a period of relative government support to introduce new clinical services.
To achieve this they had to run the gauntlet of “commissioning” – usually a doctor controlled service.
Whenever a service was considered one that could be performed by GP’s, the commissioning bodies inevitably ruled against pharmacists providing the service – even though they were just as proficient, and cheaper.
This has left UK pharmacists frustrated and wondering how they can communicate pharmacist skill levels to patients given the lack of government support.
The General Pharmaceutical Council commissioned a poll on the 14th January 2015 to determine how UK pharmacy fared with other health providers.
Some 87% of the 1,160 people questioned for the poll revealed that they trust pharmacist advice — this was similar to the proportion that trusts opticians, dentists and nurses but less than the 95% who trust their GP.
Some 12% said they do not trust advice from a pharmacist and 39% said that they trusted the advice a ‘great deal’ — which was lower than the proportion with this degree of trust in other health professionals (62%, 50% and 49% for GPs, dentists and opticians, respectively).
The survey found that trust improved if the member of the public was white, had visited a pharmacy in the past year or was aged over 65 years.
The age of a person related to their memory of a pharmacy service pre-government intervention.
i2P has found that the above poll also compares with research it has compiled and confirms that there is an area of pharmacy activity that lacks public trust.
In the public mind, services that rate high in terms of trust relate to the service level the public are used to receiving.
Anything new or different flags hesitation in a prospective patient that translates as a “danger” to that patient and generally leads to a patient choosing to see a GP, irrespective of the training or high specialisation of the pharmacist.
However, i2P has also found that if a prospective patient has an adequate explanation, delivered over time, they will absorb new information and the trust rating for a pharmacist will increase towards the level of a GP.
In the pharmacy of my apprenticeship there was a high degree of patient engagement and we were often recipients of the statement:
“You are as good as any doctor I know”
The patient meant it as a compliment, but most pharmacists were frustrated by these comments because they believed they were delivering a pharmacist service to a high standard.
We were often asked what our fee was after delivering a cognitive service, but we always declined.
This we were able to do because margins on dispensing and OTC products covered the time spent with patients.
Not so today so cognitive services must be valued and paid for.
i2P has recently publicised two elements that need to be included in pharmacy designs that are required to support the concept of clinical pharmacy delivered from a community pharmacy environment.
One is the “connected” shop window that is a display case for illustrating pharmacy services through photography, display posters and high quality pamphlets and publications.
The “connected” component is an iPad type device set into the glass where a prospective patient can order packaged information or specialist products without having to enter the pharmacy.
The patient information required for this to happen forms up into a patient database that enables an interaction with other types of communication, particularly electronic newsletters.
The same information packages are delivered to targeted customers entering the pharmacy for other reasons. The objective is to have a continuous strategy to convert a customer to a patient.
The second element for pharmacy design is what we call a “Health Station Central (HSC)”, which is a specially designed bench holding a range of iPads (for staff use) and one or two laptop computers (to Wi-Fi connect with pharmacy dispense systems and other systems such as accounts etc.).
It will also sell S3 products, nutritional supplements and specialised medicated toiletry and cosmetic items.
The HSC is a concept borrowed from LloydsPharmacy in the UK, which they call a “Health Bar”.
Only qualified people can populate the HSC and the team is headed up by a pharmacist, with a range of others such as clinical assistants and specialty sales personnel who may be trained in medical cosmetics, nutrition or some other specialty.
The pharmacist must meet as many people as possible who present as patients.
The HSC is not a private location so other private spaces must be utilised.
i2P believes that to launch a new paradigm pharmacy it will require goodwill from all areas of pharmacy until a new business model is established, and beyond.
It is not helpful if industrial action takes place at the moment because employed pharmacists need to be nurtured into new services.
Opportunity abounds for all pharmacists willing to come together and harmonise.
The forward pharmacist based at an HSC is an essential part of revitalising your pharmacy.
At the HSC there is complete divorce from the dispensary flow processes.
So this pharmacist has to engage with patients and reconnect to them in such a way as to build trust.
At the correct trust level a patient will unhesitatingly accept an advanced service offered by a pharmacist.
Without sufficient preparatory work, the trust level will be too low and aspirations will languish.
i2P looks forward to seeing some pharmacists prosper by taling advantage of the natural business upswing that will occur over 2015 and continue into the future.
As they say, the “early bird catches the worm”.