Sunil Kochhar, consultant pharmacist and IP at Regent Pharmacy in Gravesend, Kent, talks to Saša Janković about partnering with a neighbouring osteopath to help customers tackle pain.

Service type: Pain referral service.

Name and location of pharmacy: Regent Pharmacy, Widnes St, Gravesend.

Name of pharmacist: Sunil Kochhar.

Why did you start offering this service?

I started offering this service in January 2019. We’d been connecting our customers in pain with osteopath Elliot Reid for about 5-6 years, but last year we decided to make our arrangement a referral pathway rather than an ad hoc service. Making it a more formal way of doing things in a systematic way means we can collect outcomes and data, and see the patient through the whole journey.

How much did it cost to set up the service?

The cost to us was zero because the remote work we do for other clinics operates in a similar way. We use the Livi platform for bookings, which is free for healthcare professionals, and although we use JotForm electronic referral system – which costs about £200 a year for the licence – we already had that for other services so it wasn’t an extra expense.

In a nutshell, what does the service involve?

Elliott’s Revitalize Health and Fitness Centre is just a few doors away from us in Widnes Street, so if a patient sees him and needs painkilling remedies he’ll refer them on to us to help.

Elliott will send me a summary of their notes via an electronic referral form, and because he has already done a face-to-face assessment with the patient I ring them for a remote consultation and recommend the appropriate products or medicines. Because I am an IP this opens up a different field of treatments as not only can I advise on OTC products but I can also prescribe naproxen, for example, which the patient wouldn’t be able to get over the counter. Plus, it’s not always necessary to prescribe a painkiller – we can suggest a toolkit of massage balms, supplementation with vitamin D or collagen based products that could help, and I can also refer them on to their GP as well.

We have an online booking system, so patients can plan ahead for when they want to come in to collect their medicines. Alternatively, I can send any necessary prescription to the pharmacy closest to them if it isn’t us – and send the patient the original in the post – but if we dispense the medicine for them I don’t charge for the private prescription. This makes it as easy as possible for a patient who is already in pain to access the medicine they need.

The good thing about us linking up like this is that it provides safety netting for me that I haven’t missed anything with this patient, and he has the reassurance that someone else is looking at his patient from a different perspective.

Outreach like this is part of what I’m trying to do to change how community pharmacies, especially IPs, are perceived, by empowering people to self-care with things they can’t usually get from the high street, and at their convenience.

Are there any opportunities to sell over the counter or prescription products during the consultation or after it?

There are plenty of opportunities to link sell. As well as the prescriptions we offer add-on services such as vitamin B and D injections if that’s something the patient needs and wants.

How have patients responded to the service?

It’s gone down really well and patients appreciate it. The type of clients who visit an osteopath tend to be quite affluent, and often open to exploring further services. For example, we had one person referred to us last year for blood tests, which showed he was low in vitamin B, so we were able to give him B12 injections.

Roughly how often each month do you carry out the service?

We see two or three people a day under normal circumstances, but Covid stopped Elliott’s clinic during the first lockdown so this was reduced. Now we see maybe three to four people a week.

How much do you charge for the service?

There is no charge to access our service, so if Elliott refers someone to us the consultation is free, but if I write a prescription or we carry out phlebotomy services we charge for that. Similarly, if I refer someone to Elliott there is no charge for a consultation with him, but they then pay for a service.

Roughly how much a month do you make from offering the service?

It adds on another £400-500 a month in general OTC sales, but more importantly it brings in new clientele who get to see a different side of community pharmacy. It showcases our prescribing skills and then they tell their friends and relatives that I can write a prescription, which they probably didn’t realise.

Would you recommend offering this service to other contractors?

One hundred per cent. We are working with local practitioners to help the community, and in a Covid secure way, keeping everyone safe and keeping people healthy. If you don’t interact with HCPs in your own locality that’s silly because it’s the same patient you are looking after. Funding from the NHS is small, so community pharmacy needs to wake up and create an ecosystem like the NHS has with GPs referring on to others, because this makes patients feel they are being cared for in their community by joined up HCPs who work together and talk to each other.

Read more case studies on pain services.