Terry Maguire has been exploring business opportunities that the Covid pandemic might offer but cannot report much success so far...
My purchase of Covid-19 antigen tests in November proved disappointing: I sold not one. No insurance cover, which I found out too late, and a trenchant objection by government to their clinical usefulness meant I was left with them. I resorted to handing them to colleagues at cost, mainly to test family members returning home for Christmas dinner.
Legal controls mean there can, at present, be no commercial opportunities from the UK emergency-licensed Covid-19 vaccines. The only opportunities therefore are in delivering vaccinations as part of the health service vaccination campaign.
I have always argued that a commercial flu vaccination service is counterproductive. Offering a private flu-jab for £15 to the worried-well might increase till receipts for a few weeks but adds nothing to our clinical reputation or the nation’s collective protection against seasonal flu. The Joint Committee on Vaccination and Immunisation identifies the groups who should receive a flu vaccine which the science tells us is the most efficient population approach. This is public health, and this is what we should be doing.
I chastised one of our senior negotiators on this point some years back at a time when Scottish pharmacists were commissioned for flu vaccine services. He was not interested in negotiating a local annual flu vaccine service, he told me, because one of the pharmacists at the Health and Social Care Board told him “she was not interested.” I did question this approach to policy and strategy development!
Thankfully things have moved on and following a successful pilot in the North West in 1999 community pharmacies across N. Ireland were commissioned in Autumn 2020 to provide flu vaccines for health and social care workers. This proved very successful. For my business, having avoided a commercial flu offering for the reasons given above, this allowed me to gain experience.
The service was extended in January 2021 to include individuals between 50 and 64 years of age who were, for the first time, included in the JCVI flu categories. This was less successful: it was late in the flu season and, at that point, the incidence of flu was down by 95 per cent on the previous year, something unheard of, so people weren’t so worried.
No doubt we will eventually find out why flu disappeared in 2021: social distancing, more handwashing, the two viruses competing, or all three and more?
Another reason I got a flu vaccine contract was in anticipation of Covid-19 vaccination. There is sufficient need here and community pharmacy must be involved and not just talking about it. In early December pharmacies were asked for interest in providing a service if HSCB needed it. I was delighted.
When forwarding the request to contractors our negotiating body, CPNI, was, to put it mildly, unenthusiastic. The Pfizer vaccine would never be part of a pharmacy commissioned service, they reasoned, so we should think twice about signing up. We can’t afford to have valuable pharmacy staff out of the pharmacy working in large vaccination centres, was the logic.
It’s an important point but it was taking a narrow perspective. We needed to be in from the start so that when the Oxford AZ vaccine, which does not require storage at temperatures colder than the south pole in winter, was licensed and rolled out (as it was on January 4), we would be in a position to become part of a commissioned service.
Then, more or less out of the blue at the end of January, the HSCB asked for contractor interest in delivering a mass Covid-19 vaccination service similar to the one provided in England from December, where about 60 contractors are already up and jabbing. A minimum of 1,000 jabs a week is a big ask, and we were told during a Zoom meeting that HSCB did not feel that “many, if any” contractors would be eligible for this scale of service. Here we go again - HSCB doesn’t really want the service…
So I filled in the forms more in hope and defiance than in expectation. The beautician next door to my pharmacy is also my tenant and has been locked out by Covid-19 regulations. The prospect of getting her rent paid and a short-term admin job was exactly what brought her on board.
I will store vaccine in the pharmacy, and I have premises with a flow through layout that ensures social distancing, with entry to an admin area, then movement to the vaccination suite, then transfer to an observation room and out through a different door back on to the street.
I am doing this not because it is easy but because community pharmacy needs to be working within the Health Service, expanding our services along professional lines and fully aligned with public health needs, not outside with doubtful health benefits. If my bid fails, I can still have the AZ vaccine to fall back on which will be less work intense.
Either way I will be working in, and for, public health and for me that’s good business.
Terry Maguire is a leading community pharmacist in Northern Ireland.