Rikesh Patel, Independent Prescriber and pharmacy manager at Amin Pharmacy in Hounslow, talks to Saša Janković about setting up a Covid-19 PCR testing ‘Fit to Fly’ service.

Service type: Covid-19 PCR testing (Fit to Fly service).

Name and location of pharmacy: Amin Pharmacy.

Name of pharmacist: Rikesh Patel.

Why did you start offering this service?

We started the service in October 2020 in response to a few local patients who needed to travel. Many countries now require a Fit to Fly certificate to prove the patient has had a negative Covid-19 PCR test. Our patients said they could only find clinics towards the centre of London and their prices were high (£200+). We were still not sure about offering the service as we didn’t know much about the accuracy of the tests, plus the tests themselves are quite expensive. However, after doing some research and understanding the whole process I was happy to give it a try, especially as more patients started to ask us about it.

How much did it cost to set up the service? 

There was no specific set up cost. The main requirement was to create a Covid-safe environment, which we already had in place. The Randox kits cost us about £93.50; special delivery on a week day is £6.70, or Friday for Saturday morning is £10; so that’s about £103 in total, and we charge £150 for the test. 

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

The service is provided via PharmaDoctor so I read all their training and familiarised myself with their e-tool. Staff members were trained on the details of the service and the questions to ask about the patient’s travel plans.

In a nutshell, what does the service involve? 

The first thing we need to know is when and where the patient is flying. Each country has its own travel requirements and this changes frequently (most require the test to be done within 72 hours of travel but some have a longer time frame such as 96 hours).

Once we know their travel details we can work out when their test needs to be done and if the results should be back in time. I always make it clear to the customer that it’s their responsibility to check what their destination requires (some countries require a certificate and a signed written letter from a healthcare professional). We also reinforce that some parts of the service are out of our hands and we are reliant on firstly the courier (Royal Mail special delivery) and secondly the laboratory, to deliver and analyse the test in time. We usually go through this part of the process with the customer over the phone or via email, and if they’re happy we book them in for an appointment. We also ask for them to bring their passport or a copy so we can record their identification details correctly. 

When the patient arrives for the appointment, we taken them into the consultation room, ask them to fill in a consent form with all their personal details, and enter these onto the PharmaDoctor etool and the Randox Health kit registration website, which is then submitted after the test with their specific URN (unique reference number).

We use the Randox Health PCR testing kit to swab their nose and throat, and send this to the laboratory. The sample should arrive at the lab the next morning and will then undergo analysis which takes roughly 12-24 hours. The lab normally sends the results/certificate later that evening or the next morning, which works out as a 36-48hr turnaround for us. I receive a PDF document containing the results/certificate which I forward on to the patient and follow up with a courtesy call to make sure they’ve received it.

Each consultation takes around 10 minutes, with a gap of 30 minutes between each patient to allow time to clean the consultation room and set it up for the next patient – unless it is a family, in which case they are scheduled together.

Over the last couple of months we have carried out tests for patients travelling to all parts of the world including South America, Central America, Africa, Asia, Europe and the Caribbean. The majority of tests are for patients who are travelling but we have had a few who required the test for work purposes. We have recently also done one test for the new ‘test to release scheme’ which allows patients to have a test done five days after they have arrived back from abroad.

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

Not specifically, although a few patients have bought hand sanitisers and face shields.

How have patients responded to the service? 

We advertised the service with local GP surgeries, travel agents and online through our website. So far all our patients have been very pleased with our service and spread the word to their family and friends. We have had a number of patients mention they knew someone who had previously used our testing service and as result felt reassured and confident to get their test done with us.

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

We average around five tests per day but there have been days were we have done more, and prior to lockdown we were averaging around 10 per day. I think the most we have done in a day is 16 tests and as a result I had to employ a second pharmacist to help with my normal pharmacy workload.

Would you recommend offering this service to other contractors? 

It depends on the locality of the pharmacy and if there would be a likely demand. The tests can only be ordered in a minimum quantity of five so you need to make sure you can utilise them all. The service does come with added stress, as you’re reliant on other parties to make sure the results come back in time and the patient’s anxieties pass onto you. However, if the service starts working well and you make it clear to the patient of the risks involved I think it’s worthwhile.

Read more case studies on travel health services.