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We pulled out all the stops when we started this pharmacy and made sure that patients got the best possible service from the beginning

West Elloe Pharmacy, a Lincolnshire independent, was the winner of the Team of the Year award in last year's Independent Pharmacy Awards (ICP, November 2014, p21). Douglas Simpson went to Spalding to meet pharmacy superintendent Ryszard Cygan to find out how he and the rest of his team go about their business

AMONG THE TEAM AT WEST ELLOE: (left to right) Pam Tillotson (pharmacist), Michelle Clarke (NVQ2 dispensing assistant), Keely Lucas (assistant manager and accredited checking technician), Julie Higgins (ACT trainee), Carol Walsh (ACT and health and safety officer), Sally Higgins (counter assistant and OTC buyer), Sarah Griggs (ACT), Elizabeth Helliwell (pharmacist), Ewelina Wirkus-Keivets (NVQ2 trainee), Ryszard Cygan (superintendent pharmacist), Ola Cygan (NVQ2 assistant and medical student)

West Elloe Pharmacy is a pharmacy with a difference. It is owned and operated by a private company (Stagedale Ltd) whose board includes doctors and Ryszard, and was established as a result of a surgery moving to new premises.

Ryszard was managing a pharmacy for a multiple in Spalding at the time and saw an opportunity to create a modern, innovative pharmacy in association with the doctors.

The result is a striking, purpose-built pharmacy alongside a modern surgery building, the Munro Medical Centre, where doctors on the board of Stagedale practise as senior partners. The arrangement is one that all concerned are highly content with.

The pharmacy and the centre opened in the same year, 1996. The pharmacy business has grown substantially since its inception and the premises have more than doubled in size.

The Independent Pharmacy Award was for Team of the Year. The winning team, at 18, is certainly a big one. There are five permanent pharmacists on the staff: Ryszard Cygan, Elizabeth Helliwell, Sharon Bartram, Pamela Tillotson and David Sykes. There is a team of five accredited checking technicians: Anne Hall, Carol Walsh, Donna Howitt, Miranda Richmond and Sarah Griggs. There are also two supporting teams of dispensing technicians and counter staff. Some staff members are multilingual, reflecting the make-up of the local workforce.

The checking technicians specialise in various professional areas €“ dressings, nutritional supplements, ostomy and special pharmaceuticals.

The pharmacy is equipped with an ARX Rowa VMax Duplo robot. It also has a 24-hour prescription collection point €“ a bit like a bank's cash machine. Patients are texted a pin number and they enter that at the collection point and can access their dispensed medicines.

In January 2010, Stagedale set up Pinchbeck Pharmacy, specialising in supplying care homes and monitored dosage systems to community-based patients.

There is a third branch, at Knight Street, Pinchbeck, on the edge of the town.

Ryszard graduated in 1988 from King's College London and did his preregistration year in industry (at the Wellcome Foundation in Dartford) and in hospital pharmacy (Leicester). This was followed by three years as production manager on a night shift at Dartford.

Next followed marriage and a move back to his roots in the Midlands and a spell as a locum pharmacist for eight or nine months. Ryszard arrived in Spalding in August, 1991, to take up a manager's post with a national multiple. He intended to stay with them for a short while but ended up staying for five years, when he saw his chance to branch out on his own as a result of the surgery move.

€I was aware that the doctors were moving. I knew that they wanted to open a pharmacy and I suggested that we join together and apply for a contract. And that is what we did.€

The doctors are dispensing doctors and they have a dispensary in the medical centre. How does Ryszard feel about that?

€It doesn't bother me. Their dispensary is small, but, at the end of the day, that is their business. I have achieved what I wanted to achieve, which is to run my own operation and work in an innovative way.€

Ryszard Cygan: saw his opportunity

Working relationships

From the start, Ryszard has enjoyed a close working relationship with the doctors. He has, he says, advised them on prescribing and helped them to be cost-effective and at the €cutting edge€ of medicines usage. €We led on statins. This practice was prescribing more statins in the 90s than Northern Ireland.€

Explaining the reasons for establishing the new parts of the business, Ryszard says that the Knight Street pharmacy was able to open because the then PCT decided in 2012 that Pinchbeck was part of Spalding and no longer rural in character, meaning doctors could no longer dispense for residents.

€We pulled out all the stops when we started this pharmacy and made sure that patients got the best possible service from the beginning. None of them have had reason to miss doctor dispensing.€

The separate pharmacy specialising in monitored dosage systems came about, Ryszard explains, because it is NHS policy locally that as many people as possible should be treated in their own homes rather than in hospital. There isn't enough hospital accommodation in this very rural area in any case. Again, the aim is for the pharmacy to provide a superlative service. Pharmacists, where necessary, visit patients in their homes. The company's drivers, who have had special training, get to know the patients and can report back problems.

How is the company's business as a whole doing?

Says Ryszard: €We have always outpaced trends in prescription numbers growth. That is due to the service we provide. Our robot means that the dispensing process is very quick, even with multiple item prescriptions. Our two delivery vans cover a wide area and our 24-hour automated prescription collection point works brilliantly. It suits a lot of people. We have over 1,100 patients a month using it. It is secure as a bank's ATM.€

What makes his pharmacies stand out from the crowd?

€As well as the service we provide, it is the people who work for me. I provide the best working conditions I can and pay above the odds. I don't want the staff to regard themselves as employees, but as part of the team.€

Migrant workers

Clientele for the pharmacy is mixed. Spalding is a prosperous town and many people choose to retire there. There are also many migrant workers from Poland and the Baltic states drawn by employment opportunities in agriculture.

How does Ryszard go about meeting the needs of these clients?

€I and two of my assistants speak Polish [Ryszard is of Polish extraction] and we also have Swedish and German speakers on the staff. This brings clients to us because they know they will not have problems in making themselves understood.€

How does he go about recruiting staff?

€I rarely have to advertise. We have a lot of people who write in and say they would like to work here.The vast majority come but never leave. I had my first retiree back in March. A few staff have left for personal reasons, but that was my first retirement. Three members of staff have been with me for 19 years.€

What about training?

€If people want any sort of education related to their work here we will fund that. We support staff in getting NVQs and any training associated with pharmacy. We see the return in the quality of the staff and their work.€

Who does he have to help him run the team?

€I have an assistant manager, Keely Lucas (also an ACT), who helps with staff rotas, holiday arrangements and general administration. I also have a procurement pharmacist (David Sykes) who sources all our products. Even if the whole country is out of stock of something David will find it. That is another reason people come to us.

 The 24-hour collection point

€We have a team of seven pharmacists covering the three pharmacies. We rarely have to call in a locum. Our pharmacists know the business and are able to cover all eventualities and are able to deliver all the services we provide.€

How does he go about keeping the team in shape?

€The most important thing is to be part of it, working alongside the other team members. Staff want you to be around. If there is a problem they want you to be in there with them. And you have got to be the first one in and the last one out.€

Is there any special type of reward structure?

€The staff get remunerated well above going rates. I expect a lot from them and that is the understanding.

€There are regular social events for the team: meals out on the company; an evening at the races; and the annual Christmas party, which is very important.€

What kind of commissioned services does he provide?

€Not many, due to the type of area, the tightness of budgets and the fact that the CCG is dominated by dispensing doctors. It is disappointing. We don't get the chance to take part in such things as minor ailments schemes and smoking cessation programmes that are available in other parts of the country. Things were no better before, under the PCT.€

So, while other pharmacies are able to build up their professional offering through services, Ryszard has had to look for opportunities elsewhere, hence the monitored dosage systems and domiciliary services for patients who might otherwise be hospitalised.

What change would he like to see in the contract to help him do a better job?

€I would like to see electronic prescriptions be made compulsory. About half of our prescriptions are electronic at the moment. Some GPs, particularly dispensing doctors, don't want to adopt them because they see them as a threat. They should not have a choice.€

Will the promised access to summary care records help him provide a better service?

€Yes, that will be great. We have a good relationship with the doctors here but that would make things better still. Although SCRs are essentially a record of prescribed medicines, that is often all we need to see.€

Would he like to see the full medical record?

€With the level of pharmacist training that we have today that would enable us to maximise our contribution in ensuring proper use of medicines.€

What other kind of challenges does he see pharmacy facing?

€Mail order is a big threat. I don't ever go shopping. If my wife won't get me something I will order it on line. What pharmacists have to do is innovate and provide the service that beats that. People want to see the person delivering the medicine. We need to see people face-to-face. You have got to be better than mail order.€

Any other threats?

€We had a 100-hour pharmacy open in the town and I was determined that we would not lose out to them. So that is why we pioneered the 24-hour machine. I also did a huge door-to-door marketing campaign. That pharmacy closed after three months. €As an independent, I have great freedom and I use it to counter threats and grow the business. Print and publicity materials are cheap. I had high quality materials promoting the pharmacy delivered door-to-door. €We can market as well as any big company. I promise independents that, whatever effort they put into it, they will get it back 10 times. The multiples don't know their areas in the way that independents do.

€Our door-to-door campaign prior to the 100-hour pharmacy opening cost almost £10,000, but we managed to take 2,000 items off the multiples overnight. Every pharmacist should be doing this.€

What is his ambition for the future? €To put the multiples out of business.€

Any final comment?

€I have had the best 19 years of my life here.€