‘Inspiring’, ‘uplifting’, ‘heartening’… just some of the adjectives used by attendees to describe the 2018 Independent Pharmacy Awards at the House of Commons. Attended by representatives of all the national professional bodies and executives from the UK pharmaceutical industry, it wasn’t just a day to remember but an occasion that will continue to motivate independents and their teams across the country long after the last bottle of Parliamentary fizz was popped...
The Independent Pharmacy Awards celebrate the critical and perhaps under-recognised role that independent pharmacies play, Andrew Evans, the chief pharmaceutical officer at NHS Wales, told the 150 guests assembled in the Members’ Dining Room at the House of Commons.
He also took the opportunity to explain how community pharmacy is being transformed in Wales.
“It is absolutely true that pharmacies are public health assets, not simply because they provide health services but because they contribute social capital. On every high street in Wales pharmacies are among the key institutions that keep our societies together, build a sense of community, promote longevity and create health,” he said.
The Awards are about celebrating the unique contribution that only independent pharmacies make to the communities in which they are found. It is a genuinely unique contribution, he continued.
“Independent pharmacies understand community - you make a personal investment in communities, investing in bricks and mortar, local people and local businesses. Independent pharmacy understands the needs of communities because it is part of those communities.”
The importance of this intangible asset is understood by Welsh Government, as demonstrated by its national strategy, ‘Prosperity for All’, and its plan for health and social care, ‘A Healthier Wales’. There is recognition that pharmacy is important in achieving the aspirations for a Wales that is more prosperous, more active and healthier, said Evans.
There are very real threats to the future of community pharmacy, he said, but “the threats are not from governments, automation, hub and spoke, changes in supervision, or clinical pharmacists in GP practices. The real threat is a change in consumer behaviour and a failure of pharmacies to adapt to that change. If we believe that in future citizens will continue to access pharmacies in the same way and for the same reasons they do today, I’m afraid we are mistaken.
“There is an urgent need for community pharmacy to adapt and turn what today it considers added value into its core value. In the future community pharmacies must be valued for the clinical services they provide, improving health outcomes and reducing harm; and the contribution they make to communities.
“In future citizens won’t access services from their pharmacy opportunistically when they collect their prescription: they will collect their prescription when they visit the pharmacy to access services. That is a subtle but important shift in emphasis.”
The Welsh Government has committed to transform the contractual framework for community pharmacies, said Evans. That transformation will be built around five key changes – what he called the five Cs:
In the immediate term pharmacies are being promoted as part of the solution to the challenges people face in accessing urgent and unscheduled health services in a timely way.
The national emergency supply and common ailment services – the latter now available in over three quarters of all pharmacies in Wales – was to be enhanced by the roll out of rapid antigen testing for sore throat.
Independent prescribing pathfinder sites will be established in up to 20 community pharmacies from April 2019.
In the medium term, said Evans,community pharmacists must do more to tackle the issue of medicines-related harm. Community pharmacists have for too long seen this as a prescribing problem.
“It is not. This is a shared problem in which prescribers and dispensing pharmacies are complicit and it is one that needs to be addressed,” he said.
“In the longer term community pharmacies must get serious about prevention, by which I don’t mean tokenistic health promotion - displaying posters and leaflets – I mean seriously taking every opportunity to change people’s behaviours in a positive way, making every contact count.”
This is all eminently achievable, and is underpinned by the commitment to roll out the Choose Pharmacy clinical IT system, to provide access to GP records and to allow pharmacies not only to see patients’ hospital and GP records, but also to communicate back to GPs and hospitals about the contribution they make to care.
Evans said there are also plans to increase the number of community pharmacists trained as independent prescribers to 100 over this year and the next, and to create the opportunity for up to 200 pharmacy technicians to train in community pharmacies across Wales by 2021.
Inspiring stories of community pharmacies
Independent Pharmacist of the year
James Tibbs of AR Pharmacy in West Totton was hailed by judges as ‘the future of pharmacy’, having developed over 20 new NHS and private services...
They say a leader is someone who knows the way, goes the way and shows the way. This year’s Independent Pharmacist of the Year, James Tibbs, works in a progressive, family-run pharmacy in Hampshire. Among his many accomplishments, he has implemented over 20 new NHS and private services.
Under his guidance the pharmacy delivered the second most NHS flu vaccinations in the country (over 2,000 including private vaccinations) and consistently delivers in the top 5 in the country the most NMS (average of 100 per month).
It provides a full travel clinic in close association with the local GPs, whereby the pharmacy acts as a triage service for the surgeries. It does on average five travel consultations per day. It has just started to provide a full aesthetics clinic where an independent pharmacist prescriber administers Botox and other aesthetic treatments.
Since James joined the pharmacy, items have increased by 15% due to his efforts in increasing the profile in the local area – by delivering services and identifying and assisting in rectifying health inequalities. For example he has implemented a Gypsy and Traveller drop in clinic for health checks and flu jabs, which is now being commissioned by Hampshire County Council.
The pharmacy has just been granted planning permission to extend into a ‘Pharmacy Health Hub’. The plan is to create a multidisciplinary team of health professionals who work closely together, and an inter-referral relationship so that the patient is treated holistically.
Speaking to Independent Community Pharmacist, James was very modest about his win.
“I felt really embarrassed at first because this win is all down to great teamwork. In particular Liam O’Sullivan is my right-hand man. It’s a real team effort.”
A former pharmacy manager at Boots – “I have very fond memories of working there” – he admits it was frustrating and enjoys the flexibility and freedom of working in an independent.
“A multiple is just another pharmacy,” he says. “But here it’s like a family and we really become a part of the community.”
He’s a big believer that services are the way forward and urges independents to learn from each other. “We need to start being more cohesive as independents,” he says. “We need to start sharing our knowledge. If you hear of someone doing something interesting, get on the phone and ask them if you can come and visit.
A recent conversation we had with other local contractors saw us band together on flu vaccines and share stock. Maybe we could have a big WhatsApp group to share ideas?”
The Highly Commended award was presented to Michelle Claridge of Aqua Pharmacy in Ipswich, whose work with the less fortunate in her community impressed the judges – as well as Dr Keith Ridge, who recently visited the pharmacy!
Among her community achievements, the pharmacy’s close links with a local hostel have allowed it to develop constructive working relationships to support and improve the health of this group of patients. Its open rapport has allowed pharmacy staff to challenge behaviours and raise issues in a vulnerable group who are usually very difficult to reach.
Health Champion of the Year
Judges agreed that Leama Cheall from PharmacyExpress in Eaglescliffe “embodies the culture of a healthy living pharmacy champion..."
In a busy pharmacy, Leama Cheall from PharmacyExpress in Eaglescliffe, Stocktonon-Tees, stands out for her imaginative and creative approach to local health campaigns.
She plans and budgets for them, sets objectives, and uses national organisations for support to maximise their impact. The judges were especially impressed by her use of social media and her ability to get both customers and the rest of the pharmacy team involved and engaged.
Leama’s motivational skills have seen the pharmacy team embrace health campaigns as part of what it means to be a pharmacy team in the 21st century. She has developed and delivered out-of-the-ordinary campaigns around hydration, stroke awareness, ‘walk after work’ and bowel cancer and her campaigns have had a huge impact on the local community, patients and even further afield, with pharmacies as far north as Newcastle enquiring about “how she does it” following posts on the pharmacy’s Facebook page.
Leama is noted for her organisational skills too, which allow the rest of the team to build, with creativity, campaigns that engage the public. She has also started training other dispensers and HCAs in running health campaigns.
She is always looking for ways for her campaigns to be more effective, carrying out prior surveys with patients in the pharmacy to find out what matters to the local community. And she looks outside the pharmacy for inspiration too: she is currently looking to work with the local pub, the local exercise group and MIND to organise more public engagement.
“Winning this award has inspired me to do even more,” Leama told Independent Community Pharmacist, also admitting that she was still on cloud nine!
Leama has worked in pharmacy for 11 years, the past four at PharmacyExpress, and says she enjoys the ability to make a difference.
“Popping into the pharmacy isn’t just about picking up pills any more, there’s lots more on offer and through HLP we can help people to change their lifestyles.”
Her advice to any pharmacy team member looking to kick off health champion campaigns for the first time is to focus on an activity-led initiative.
“Getting active with, say, a brisk walk a day has benefits both mentally and physically and you can reach a lot of people.”
Working collaboratively with charities and health organisations is also time well spent, she says. “And speak to the rest of the team about ideas. Then everyone can get onboard.”
Highly Commended in this category went to Jeanette Smith of Kepple Lane Pharmacy in Garstang, who has successfully facilitated numerous outreach events, health check sessions and promotions within the community.
Trying to be accessible for all members of the public, she even orchestrated a day of health checks at a local home for the blind. Judges were also impressed that she had inspired other members of the pharmacy team to make important lifestyle changes.
Some have quit smoking with her assistance, taken up regular exercise and some of the team have started to change their diet and understand which foods are healthy.
Customer Care Award
Judges praised Priory Community Pharmacy in Dudley for its “outstanding service in all areas...”
Priory Community Pharmacy in Dudley is a pharmacy that truly focuses on community engagement. This is shown by its bi-monthly stakeholders’ meeting, its five consultation rooms, and the health promotion events it runs outside the pharmacy.
The stakeholders’ meeting brings together the community association, the local vicar, local councillors, public health representatives and pharmacy users, helping to shape the services it provides. Since dispensed items are relatively low in number, customer care is key to the success of this pharmacy (which is run as a social enterprise).
“At Priory, it’s all about the patients, not the money,” says Superintendent Pharmacist, Olutayo Arikawe. All staff members are dementia friends, antibiotic champions and NCSCT-accredited smoking cessation practitioners and everyone is trained on every aspect of the business.
The pharmacy was used as a case study by the National Pharmacy Association campaign, ‘You are the answer’, telling the story of its driver who was able to save a woman who had been lying helpless on the floor for some days in her home. The driver was also able to support another woman who almost fell from the stairs while coming downstairs for her delivery.
It also boasts a suggestion box for the community, ideas from which are regularly reviewed and actioned. Indeed, the opening hours of the pharmacy were changed following customer suggestions.
Olutayo told Independent Community Pharmacist that it was important to think outside the box when it came to services, public health and customer care. “Believe that you can deliver,” she says. “You have to have a can-do attitude. You have to have a passion for your patients.”
She said it was important for pharmacies to enter award programmes. “We need to show Government what community pharmacy can do,” she said. “And we need to show the public! People are still not fully aware of what we do. They still think of us as, first and foremost, dispensers. We need to change that narrative.”
In order to do this, she is a firm believer in taking pharmacy to the people too. “We started going into community centres and giving services such as distributing EHC cards,” she explains. “We showcase what is available in the pharmacy and try and create awareness around it.”
Highly Commended went to Milton Kent Nuako Owusu of Fieldway Pharmacy in New Addington. Judges praised her for her enthusiasm and her active promotion of the pharmacy on social media. The pharmacy’s sexual health clinic, for example, has attracted over 20 teenagers since she trained as a c-card agent, with most young people coming in and asking to speak directly to her, as the person they were most comfortable with.
Pharmacy Innovation of the Year
With the well-documented ongoing pressures on community pharmacy, there’s never been a greater need for innovative thinking. Judges praised Badham Pharmacy in Cheltenham for its highly successful – and replicable – county council staff flu vaccination programme...
The Gloucestershire County Council Staff Flu Vaccination Programme was designed to help keep council staff healthy and to stop flu spreading among council teams. The main focus was to protect staff working in social care and those working in the community.
More than 20 specialist vaccination clinics were held at a number of council offices during winter 2017. The programme was particularly innovative in the way that each clinic was planned. Working with the council the aim was to make it as easy as possible for staff to access a clinic, removing any barriers that stopped them from getting vaccinated in previous years.
Staff groups were micro-targeted for highest uptake, ie, the choice of clinic setting, and timing in relation to work activities or alongside other events whether business or social. This included how the clinics were advertised and delivered.
Council staff were also attracted to the clinic as personal case studies were used in the poster campaign, demonstrating the social norming of getting vaccinated. All council staff were also given the option to walk into any high street branch of this particular pharmacy to get vaccinated.
Almost 1,500 council staff were vaccinated as a result. Judges felt that Badham helped to break the stereotype of what a pharmacy is and can do, and that it was a highly replicable model.
The council put the service out to competitive tender in 2018 and Badham won it again. Programmes like this herald a ‘new world of pharmacy’, Peter Badham told Independent Community Pharmacist.
The flexibility of being an independent means there’s no big corporate ladder when it comes to making decisions about creating such a service, which is a huge advantage, he said. He advises that working outside the pharmacy is very different.
“It’s a fresh environment and you can end up running a clinic in the chairman’s office,” he said. But he believes that the only way for community pharmacy to survive the various onslaughts – including the threat of online pharmacies – is to offer something special.
“This is our strength,” he said. “The ability to offer that one-to-one service that you can’t get everywhere.
Highly Commended in this category went to Ken Agravat of Pharmaco Chemists in Manchester for pioneering a homeless-friendly service that really impressed the judges.
Ken attends charity drop-ins every two weeks, dealing with 10-30 cases per drop-in. There have been been extremely positive impacts for patients who are in a demographic that often gets forgotten. The service has further developed through working with other health professionals, getting a local optician and dentist to help these vulnerable patients.
Pharmacy Team of the Year
The judges stated that the team at Walkers Pharmacy in Great Barr demonstrated a clear focus on patient care and empowering patients to improve compliance and adherence...
The winning team of 10 at Walkers Pharmacy in Great Barr, Birmingham, includes long-serving members boasting 21 and 19 years of service respectively. It has recently relocated to new premises which has given it the opportunity to implement numerous services including smoking cessation, a full travel clinic, flu vaccinations and umbrella sexual health including emergency/ongoing contraception, STI testing, alongside 10 PGDs including Test and Treat Sore Throat.
It has introduced atrial fibrillation screening alongside its Medication Use Reviews and New Medicines Services. During the first three months of introducing this service, the team identified two patients with abnormal heartbeats who were referred to their GP.
The judges were particularly struck by the team being largely responsible for the new location’s redesign, which has contributed to turnover increasing by 25% (since relocation). The team is very active in promoting health campaigns in fun and engaging ways. For example, during the last flu season, they provided oranges with the pharmacy logo to promote flu vaccinations, which increased uptake.
It is currently introducing a ‘Know Your Meds’ service, which so far covers three categories: blood pressure, cholesterol and blood-thinning medications. With mental health issues being prevalent in the community, it is also in the process of introducing a questionnaire for all patients receiving anti-depressant medication to screen for those that require a review or further help with their symptoms.
Malkit Singh, pharmacist at Walkers Pharmacy, told Independent Community Pharmacist that one of the secrets to good teamwork was the upskilling of staff.
“Each member of staff should be able to multi-task,” he said. “Every team member here has a role in each service, which helps services work efficiently across the team.
“Upskilling may be expensive but it pays off in the long run. It’s more rewarding too, and the workload is shared. We’re very lucky that we’ve got enthusiastic staff!”
To keep teams motivated, he believes that you need to keep staff involved and set targets. “We hold a general overview once every three months and often hold a social event.
“Winning this award is a nice slap on the back.”
The Highly Commended winner in this category went to The Priory Community Pharmacy in Dudley, a pharmacy that operates as a social enterprise, established to serve one of the most deprived areas in the West Midlands.
It employs nine multilingual and multiracial staff who are all dementia friends, antibiotic guardians and NCSCT accredited smoking cessation practitioners.
Judges praised the team’s commitment to public outreach and noted its significant impact on patients (an example of which was used as a case study by the NPA campaign, ‘You are the answer’).