As awful as the coronavirus pandemic has been, it has highlighted how valuable community pharmacy is to local populations, says Faheem Ahmed. The Independent Pharmacist of the Year talks to Neil Trainis...
Considering the UK’s general public, NHS staff, care home workers, the emergency services, community pharmacy teams, indeed the world, is going through a horrifying time, Faheem Ahmed is remarkably calm.
“We’ve had no issues whatsoever. As a matter of fact, we’ve done extremely well and all the staff are trained and we’ve helped our local communities,” he says over the phone, sounding as if it is just another day in one of his branches of Ahmeys Pharmacy. He has pharmacies in Oxford and Bicester.
“We’ve run private services where patients can walk in and be seen by myself. It’s done really well, we’ve started to highlight what pharmacy can do if it’s up-skilled and it’s trained.”
Community pharmacies all over the country have been working flat out, some of them on their knees, helping to battle Covid-19 to the backdrop of personal protective equipment (PPE) shortages and impatient and angry customers some of whom have been abusive and aggressive towards pharmacy staff.
Yet Faheem, an independent prescriber who recently set up a minor illness and aesthetic walk-in clinic and whose pharmacies offer a wide range of private and NHS services, does not come across as a man consumed by panic and concern. Quite the contrary.
Of course it has been extremely hard work for him and his 16 staff across the two pharmacies over the last few months but, as he puts it with utter conviction, this period is “an opportunity for pharmacists to really showcase their talent..”
One of Faheem’s talents is his ability to pass on his knowledge to inexperienced pharmacists.
“I do a lot of teaching and training at the moment of other pharmacists. We‘re in touch with some LPCs to train pharmacists, to up-skill them,” he says.
“I’m training other pharmacists in the area and also training pharmacists nationally. That’s done through my training company, up-skilling pharmacists to take physical examinations, learning clinical skills.”
His training company, MEDLRN, provides training for healthcare professionals including doctors, pharmacists and nurses.
“So, my training company...it’s going great because pharmacists see the opportunity, they see me as someone who’s a pharmacist, who’s doing it in practice and they feel inspired and they come.”
He insists the pandemic has not meant his training programme has had to take a back seat. Remote working through digital technology, something that has not come naturally to community pharmacy, has allowed him to continue his training unabated.
“It’s taken a front seat. I’m doing it from webinars, we do demonstrations, then we get them to take videos and send them to me so we can critique it. So there’s a lot that happening at the moment.
“Most of my day now is spent on training. Where the pharmacy needs me, I’ve got my staff but normally now I’m spending at least three, four days a week. I’ve (had classes during the pandemic).
“Because it’s on Zoom, we do an hour slot so I`m not sat there for five hours. But I would say I do about seven, eight hours a week easily that I’m teaching. It’s after pharmacy hours, so between half seven, half eight.”
Remote working has also been important for Faheem when it comes to helping people with mental health problems. He started a service for women’s mental health during pregnancy before the epidemic began and has taken that on since the emergence of covid-19 in the UK to help people suffering the psychological impact of isolation.
“We run local workshops, we’re available by Zoom to discuss with patients and the telephone is always an option as well. We’re open to the public.
“We have discussions where we can, so (the pandemic) has not really stopped us as such.”
He says he gets 15 to 20 calls a week from people concerned about their mental health.
“It’s not that everyone is depressed, they just want to be able to have a conversation. They want to have a conversation on Zoom and so forth but I’d like to give them the best service that we can.
“Obviously, there’s a slight fee for it as well. All our consultations, we have a fee. The trouble is, once you start doing things for free, people expect it for free.
“I think anybody’s time is worth more than x, y and z but we reduced our fees on purpose. Normally, where we were charging £30, we’ve run it for £10, I’ve done consultation for £20, I’ve done consultation for £10, I’ve done consultations for free because of where we are right now.
“We just do it so we can keep building this service and people also value it more. And people pay for it. It’s more about giving them someone to speak with, giving someone to share their concerns with.”
Faheem is keen to stress that as a pharmacist, he is not there to make mental illness diagnoses. Pharmacists, he says, must be prepared to refer “if it’s appropriate.”
“It`s more about giving them the opportunity to speak and share so we can refer them. All my consultations are normally between £30 and £35, whether it’s for mental health, prescribing, diagnosing.”
He goes through how he would handle a conversation with someone suffering with depression, anxiety or any other mental problems.
“First, we would want to make sure you`re in a safe environment and you’re not someone who is about to do something that is out of the norm, so we would want to judge your mental state.
“There are really good guidelines on the NHS website. They have these toolkits that you can follow which are fantastic which allow you to gauge that.
“But mainly, it’s just about having a conversation and discussing with people. If you rang up and said you’re struggling, we would just have a chat. (We would say) `it’s not easy, it is difficult, and you just have to find ways around it to stay positive and keep yourself busy.
“If someone is clinically depressed and is unwell, that needs to be seen by the appropriate clinician. This is not a medical mental health service.
“People who are depressed and on a whole concoction of medicines, that needs to be referred to the appropriate clinician because I don`t have access to their notes, I don`t have access to anything.
“(We are) more like a helpline to have a conversation but it`s not anything medical-related. Some people just want to talk. If someone rang up and said ‘I`m clinically depressed, I want to commit suicide,` I am not the best clinician for that. That needs to be seen by an appropriate clinician.
More importantly, it’s not knowing how you can help, it`s knowing more what you shouldn’t be dealing with. That`s more important, knowing your limits, knowing your boundaries.”
Faheem says his dispensing income has increased during the pandemic but insists “dispensing is a dying market because of all the services that we’ve tapped into.”
He provides blood testing, sexually transmitted disease screening and runs a travel clinic and has services for substance abuse and musculoskeletal disorders.
He also completed a master’s degree in cosmetic dermatology and runs an aesthetic service that includes Botox, dermal fillers, laser hair removal, vitamin and anti-ageing injections and microdermabrasion.
“Where we’ve done extremely well is our prescribing service, how we’ve helped patients who need a prescription or need to be seen have been treated,” he says.
“Speaking to pharmacists, it’s a huge opportunity for them to help patients and showcase what they can do. We’ve done quite well, from dermatology, to skin infections. A lot of the basic things people go to the GP, they’re coming here.
“We’ve had good discussions with our local GPs and sending them information on anything that I prescribe. It’s been really good.”
Faheem, who says he has not had to use volunteers to deliver medicines during the pandemic, is asked if he has had many consultations for dermatology and skincare in the last few weeks.
“We were doing about £10,500 on our prescribing and it’s jumped to about £15,000. Sometimes we’ve hit £20,000 on our prescribing because people just can’t see someone.
“If they can be seen, they are happy to pay £30. This is on everything. We do a wide range of conditions that we prescribe for. You could come in with pneumonia and you’d be treated. If you were to walk in with a chest infection, throat infection, ear infection, pretty much the whole whack, a good 50, 60 conditions I treat.
“I have a strong support network with my doctors, so if there`s anything I’m unsure of, they’re just a phone call away.”
Faheem sounds busy on the other end of the phone as he talks. Covid-19, he says, is “not a positive thing but ultimately we have been able to, by educating ourselves, make sure that our patients get the service they need without having to rush to A&E and other places.”
In one part of Oxfordshire, a terrible few months when a rampant disease ruined so many lives will be remembered for a pharmacy team who were there for its local community when it mattered.
“If we’re not the right clinician to see them, they’ll be forwarded appropriately and have a GP appointment,” Faheem says.
“It’s been great, really helping GPs as well with these appointments.”