Rachel Carter talks to Farheem Ahmed about the minor ailments service provided at Ahmeys Pharmacy in Oxford and Bicester

Service type: Minor illness.

Name of pharmacy: Ahmeys Pharmacy, Oxford and Bicester.

Name of pharmacist: Faheem Ahmed.

How long have you been offering this service? Since June 2018.

Why did you start offering the service? I came across a document in 2013 called ‘Now or Never: Shaping Pharmacy for the Future’ and it was like a crystal ball. It talked about pharmacy cuts, the role of the pharmacist being marginalised by technology, the need to up-skill and how other health professionals were moving at a much faster rate.

At the time, I ignored it all and thought it was never going to happen. But fast forward to 2015 - and it did happen. I set up my other pharmacy in Oxford around the same time and I basically thought this isn’t going to last, we can’t just focus on sticking a label on a box - to put it crudely. I started to research national and international policy and I realised there is a healthcare crisis everywhere in the world. There is a shortage of nurses and doctors, and resources are finite. Pharmacists are the only professionals who can be seen without an appointment, so I thought if we could offer a service that addressed minor illnesses, 50 to 60 conditions, then why wouldn’t it work?

I ran a survey in my pharmacy asking patients whether they would be happy if I started offering this service, and also how much they would be happy to pay. Patients were happy and said they would pay in the region of £25 to £30, so we went ahead with it.

How much did it cost to set up the service? The only real cost was my time. I also completed my non-medical prescribing qualification, which cost in the region of £1500 to £2000.

What, if any, training did you or other team members have to undergo? I completed my non-medical prescribing qualification.

I have also undertaken significant additional study to enable me to deliver this service. Finding appropriate courses has been challenging - there are few available and I have had to travel long distances to access them.

As a result of this, and following conversations with colleagues who have undertaken the prescribing course but do not yet prescribe in practice, I have conceived and developed a multi-disciplinary-led training programme. This programme provides hands-on education and skills for clinicians, provided by doctors, nurses, pharmacists and academic educators.

I complete any additional clinical training I need for the service with our local support network of doctors, which includes three GPs, an A&E consultant, an orthopaedic surgeon, a plastic surgeon, a dermatologist and an anaesthetist. I’m not a doctor so there are going to be certain things I’m unsure about, but this network means I’m not working totally alone in a chemist with no back-up - if I need advice, I can pick up the phone. For example, if I wanted to learn more about diabetes, I would go and sit with one of the GPs, start to observe cases and do my clinical training with them.

I have also provided training to my own staff in house.

In a nutshell, what does the service involve? The clinic is run by prescribing pharmacists and is operated on a walk-in basis. We also take referrals from the NHS GP pharmacy referral scheme. It’s open 9am to 7pm Monday to Saturday, with availability on Sundays as well.

It involves a consultation with the patient, where we take a detailed clinical history. We undertake an examination to ascertain the cause of the reported symptoms, and if identified, a diagnosis. We also offer a range of private blood tests, and screening and treatment for sexually transmitted infections.

We are able to treat conditions from the very common – like ear infections, STIs, bites and stings, and digestive problems – to things we see less frequently in pharmacy, like male and female pattern baldness, eating disorders and stoma care.

Any prescription-only medication supplied to patients after consultation is accompanied by notes to attach to their medical records, in order to maintain continuity of care between the pharmacist and local GPs.

All patients receive a follow-up call within 24 hours to check how they’re doing, and we can also book an appointment for a review, if required.

Are there any opportunities to sell over the counter or prescription products during the consultation or after it? Yes both, but anything we recommend or prescribe will be evidence based.

How have patients responded to the service? The uptake has been mind blowing, and I think that’s because we give value to our patients. We also ask all our patients to write a review, so if you go on our website you can see all of the feedback - a lot of it has been five star.

Roughly how often each month do you carry out the service? Approximately 280 patients per month.

How much do you charge for the service? It costs the patient £25 to be seen by one of the prescribing pharmacists. If they need a prescription there is an additional cost for that, but no more than £10. We also charge £25 to £30 for blood tests, and depending on what test the patient needs, the labs also charge an additional cost to process the test. For example, if a patient wanted a full blood count, the total could be £75.

Roughly how much a month do you make from offering the service? In the region of £8,500 per month easily.

Would you recommend offering this service to other contractors? Yes definitely. Amazon are getting a pharmacy license, so we know they’re going to come into the market. There’s a shortage of doctors and nurses, so for me it makes sense. How I see it is contractors need to redefine their business - if you’re just a pharmacy, you’re in trouble.