Pharmacist manager and independent prescriber James Martin won the Independent Pharmacy Awards Innovation Award for his work at Chapel Pharmacy in Farnborough. Saša Janković caught up with him…

Chapel Pharmacy in Farnborough, managed by pharmacist and independent prescriber James Martin, has a highly skilled and forward-thinking team offering a wide range of NHS services.

Bought by owner Makand Johal over thirty years ago, the pharmacy has blossomed from a small store with three staff members to a prominent double unit premises which now employs 17 people, alongside a dispensing robot. Serving a mixed age, nationality and economic demographic, Chapel Pharmacy is also an IP Pathfinder site.

James moved from a large chain to join the business in 2019 and gained his IP annotation in 2021, with a specialism in skin conditions. “Moving here reignited my passion for community pharmacy because the ethos of the business is really forward-thinking, and it’s a lovely place to work”, he says.

In recent months the new Pharmacy First service has enabled James and the team to help their community even further.

“We've done around 140 Pharmacy First consultations so far and have certainly had a few examples where the patient fell outside the inclusion criteria for the pathways but we were able to help them instead via our PGD or the Pathfinder bracket, or with private prescribing when it was within my area,” says James.

“For example, we were confident one patient we saw the other week had flu as his wife had been diagnosed with it and prescribed Tamiflu. He has a new baby so he was willing to do whatever was needed, and as we had access to the PGD we could supply him with that, and he was really pleased.

“We also offer earwax removal and we have full clinic every week, with a dozen or so patients, so that’s really popular as well.”

Valve disease pilot

One service in particular stands out. Before Covid, Chapel Pharmacy caught the attention of Dr John de Verteuil, a GP with special interests in heart valve disease – which can affect blood flow and put extra strain on the heart – who recognised the pharmacy’s innovative approach and successful track record with previous pilots.

With this in mind, Dr de Verteuil asked the pharmacy to take part in a pioneering pilot aimed at early detection and diagnosis of valve disease within the local community.

Targeting patients over 75 years old or those suffering from atrial fibrillation, type two diabetes mellitus, ischaemic heart disease, hypertension, or symptomatic for valve disease, the pharmacy identified eligible individuals during the clinical check stage.

Patients were informed of the service through prescription highlighting, confirmation by the dispenser, and a leaflet for distribution.

For those who took up the offer, James and his team of pharmacists performed auscultations in the pharmacy using a digital stethoscope coupled with AI technology called eMurmur, with the goal of identifying pathological murmurs and referring patients for further evaluation, aiding timely diagnosis and intervention.

“It was a simple service to do and is something that could be done as domiciliary service for people who can’t come into the pharmacy”, explains James. “The digital stethoscope has a microphone in the diaphragm which pairs to a phone or tablet using bluetooth.

“We auscultate the patient and press record on the tablet or phone and it takes 15 seconds to get the data. The application analyses the data using AI and tells you if there's a murmur or not.

“The patient’s GP is notified of the result, regardless of the outcome, and if there was a murmur the person was also referred on to Dr de Verteuil for an echocardiogram within two to four weeks, which meant we weren’t adding to the GP’s workload.

“We used Jelly software, which we use for our private prescriptions and has a functionality where you can make notes, capture patient signatures and will automatically generate letters for you, which we sent to the patient’s GP and a copy to Dr de Verteuil along with printout from the eMurmur and link for him to listen to it.”

Nonetheless, without access to shared care records, James admits the paperwork side of it was “pretty onerous.”

“This is where community pharmacy is disadvantaged,” he says. “With shared care records we could have plugged in our parameters to find eligible patients, but we had to highlight them manually and then try to engage them in the pharmacy.”

Life-saving impact

The pilot began pre Covid, then Covid stopped it, then it started up again in summer 2022 and ended in February 2023, with some life-saving results.

“We saw one severely unwell patient who came into the pharmacy with his concerned wife, after already seeing his GP and A&E without successful diagnosis and treatment”, says James.

“We conducted an auscultation and immediately sensed a problem, so contacted Dr de Verteuil for remote listening to the recording. This led to the patient being rushed to Frimley Park Hospital, where he received an echocardiogram and was diagnosed with aortic stenosis and underwent a successful transcatheter aortic valve implantation, effectively saving his life.”

Community connections

It’s care such as this that has helped Chapel Pharmacy forge strong bonds with its local community.

“We get hundreds of cards at Christmas and presents for the team, so there’s a lot of love in Farnborough for the pharmacy,” says James. “Mak has been here for 30 years and they all adore him and you can see that, and when I was doing my IP training I spent time in three GPs surgeries and they all spoke so highly of him. He’s given me the tools to succeed and that has helped me keep my passion for the sector.

“I feel very positive working here with exposure to these new services, and because we have such a good support network in this area so we can speak to other pharmacies and GP practice staff really easily.

“It’s a really good example of how well things can work when community pharmacy is recognised as offering such a good opportunity to help people rather than being seen as an opposing force to general practice.”

Pictured: James Martin with Sam Unsworth (right), head of communications at Alliance Healthcare, the sponsors of the Pharmacy Innovation Award.