Mita Thakrar, owner and superintendent pharmacist at Greywell Pharmacy in Havant, talks to Saša Janković about running a microsuction clinic/service.

Service type: Microsuction

Name and location of pharmacy: Greywell Pharmacy, Havant, Hampshire

Name of superintendent pharmacist: Mita Thakrar

When did you start offering this service? In 2020.

Why did you start offering this service?

We have quite an elderly population round here, but even young people have issues with their ears and want to get them looked at, and with GPs not offering ear irrigation or microsuction anymore, they had nowhere else to go.

I found people were coming in to buy earwax products for issues in their ears without being aware that it could be something more, so it’s good to be able to explain to them that it needs a closer look, and we can do that for them. If earwax turns out to be the problem the microsuction works really well, and cleaning the ears helps a great deal.

How much did it cost to set up the service?

The cost varies depending on what you need. We had to buy all the products and kit, the microsuction pump, and also to get the consultation room set up and lit properly as I need to be able to see clearly into the ear, and we want people to feel comfortable in there.

What, if any, training did you or other team members have to undergo?

I attended a two-day course in a London audiology department. At the end of it we got hands-on experience with patients, with the consultant supervising us. After the course we were left to our own devices, but the backup is always there at the end of the phone.

In a nutshell, what does the service involve?

Once I was trained we put up a poster in the pharmacy window advertising the service and couldn't believe how many people were interested. We run it as a bookable service as I set aside a certain time in the week for the clinic.

If I do microsuction not only do I take the earwax out, I also do clinical checks to make sure there is nothing else going on in the ear. Before I offered microsuction I already had a private PGD to supply drops for infected ears, but adding microsuction has really helped me with diagnosis and improved my knowledge on how to check what is really going on.

Are there any opportunities to sell OTC or prescription products during or after the consultation?

Yes – I still have the private PGD for infected ears, so can supply drops for that where appropriate.

How have patients responded to the service?

Customers are so pleased they can access this service in the pharmacy as they can’t get it from GPs now, and I have been able to help some people who had different problems with their ears than they thought.

I recently saw a young patient who booked in for microsuction, and revealed he’d been using cotton buds to clean his ears as he couldn’t hear clearly and thought he had a wax build-up. Aside from immediately advising him not to put anything in his ears, once I had a closer look with the otoscope I saw he had a really dry ear drum. I asked if he suffered from eczema and he said no, but I thought it was eczema in the ear so I did the microsuction to clear the ear and then referred him to his doctor. He came back to let me know it was eczema, so his whole diagnosis and treatment changed and he’s a lot better.

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

I do about eight consultations a month. Demand is high, and increasing, so there is definitely scope to do more but I limit it to a Friday clinic as it takes about an hour, and we are running a Covid clinic as well so we are super busy.

How much do you charge for the service?

I take an initial deposit of £25 which I explain to the customer is the consultation fee. I found charging a deposit is a good ideas as when we started we had lot of people who didn’t turn up for their appointment. If I proceed with – or they insist on – microsuction then the charge is £50 for two ears.

Would you recommend offering this service to other contractors?

Yes, absolutely, everyone should be offering it. If the doctors are not providing it where can people go? Plus there are so many things you can add to the service if you want – audiology equipment to check people's levels of hearing, for example. This is a great example of a service where pharmacists can use their skills and knowledge to meet a need in their community, so why not do it.