Travel health: 'If you want to increase revenue it's a good place to start'

Rachel Carter asks Leeds contractor Solomon Abuede about the benefits of Midway Pharmacy's travel health service.

Name of pharmacy: Midway Pharmacy, Leeds.

Name of pharmacist: Solomon Abuede.

Why did you start offering the service?

We started offering this service in 2019. We noticed we kept having customers enquiring about it because GP surgeries had stopped offering travel vaccinations and also it was something that we looked at to help increase the profit margin of the pharmacy. We are looking to push down the route of private services, so it was a mixture of wanting to increase revenue but mainly because we had the demand for it.

How much did it cost to set up the service?

The PharmaDoctor Patient Group Direction (PGD) was £449 plus VAT to start off with, and we also paid to attend a training on yellow fever, which cost in the region of £400.

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

I completed the yellow training with the National Travel Health Network and Centre (NaTHNaC) - this was a one day training in London, basically going through yellow fever as a disease, any contradictions, side effects and the inclusion and exclusion criteria of the vaccine itself, and also what you can and can’t give it with because it is a live vaccine, so it’s slightly different.

The training also covered the recording that needs to be done - we have to send annual documentation to NaTHNaC on the number of vaccinations administered. Because of the associated costs, we decided to start with one person doing that and then we’re looking to roll it out to the others in future.

All of our eight pharmacists have also completed an online training for travel vaccinations and a training on administering vaccinations, so that they can run the consultations and administer the vaccinations. All counter staff have done their Numark training on helping to identify patients. The majority of our customers are coming to us asking for this service, so the counter staff have to take the patient’s details and then refer them to the pharmacist.

In a nutshell, what does the service involve?

At the moment, patients generally phone up to enquire about the service but our website is being updated so we can offer appointments online in future.

If a patient contacts a branch regarding travel vaccines, the first thing we do is take a £10 deposit and that’s basically to secure the consultation slot.

We then take their details in branch - those are passed onto me and I will make contact with the patient to go through the consultation. The consultation takes about 20 to 30 minutes per patient, depending on the itinerary that they’ve got. We run through all of the questions and requirements in terms of where they are going to be staying and what activities they will be undertaking while they are there.

At the end of that consultation, we are able to advise them on what diseases are present in all of their destinations and also advise on the vaccinations needed and any anti-malaria or traveller’s diarrhoea medication, for example.

I go through each disease in detail with the patients and basically explain how it presents, what it does, the level of risk and how it is transmitted. If they are happy to proceed based on that information then I let them know the cost so they can make a decision about what vaccinations they want.

If they do decide to go ahead, we ask the branch to contact them so they can attend to make a payment for the required vaccines. Usually 24 hours after payment is made, we can start vaccination. The £10 deposit is knocked off the overall price of the vaccines. It is non-refundable if a patient decides not to go ahead, or if they do not turn up for the appointment.

If they decide not to go ahead with any particular vaccination, or any at all, then we would always document the reasons for that.

Once the vaccinations have been administered, this is recorded in the PharmaDoctor system. The patients have access to their PharmaDoctor records, so as part of the consultation we take an email address and they get a link to register for an account. We inform them of that and we always recommend that they do that so that they can access their records.

We don’t send a record to their GP, but we always recommend that they inform their GP of the vaccinations they’ve had, including the batch numbers and dates and we will provide a printout if requested. The reason for this is that the pharmacy and PharmaDoctor are private organisations, whereas the NHS health record held by their GP is the only guaranteed lifetime record.

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

There are a variety of products that we can sell during or after. What we’re putting together currently is what we call a travel pack and this will be offered to patients after the travel health consultation. This has basically got all the basic things we think patients will need when going away on holiday, such as anti-histamines, insect repellant, and anti-diarrheal medication.

How have patients responded to the service?

The patient response has been great - up until about a month ago, we hadn’t done any advertising at all. All we’d done was write a letter to the GP surgeries, informing them that we were starting the service and practically all of our referrals in that time have been directly from the GP surgeries.

There has been a good uptake of the service, patients are happy that we’re doing it and our appointments are convenient for them. We run the service throughout our opening times - we are open until 11pm at night and on the weekends as well, so they have found that very convenient.

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

At last count, I think we did 58 patients in total between March and November. December was a very busy month. We didn’t expect that, but we’ve noticed that at this time of year people are going to more tropical places and further away, which tend to be the destinations requiring more vaccinations. We probably did eight to 12 patients within each of our branches that month and each patient had three to four vaccinations on average.

How much do you charge for the service?

There is no charge for the consultation. We charge the £10 deposit to secure the slot, because we don’t want to take an appointment and have the patient not turn up. The lowest vaccination we do costs £35, and there are three or four within that range, and the highest we do is £89 and that’s per dose.

We want the patient to make an informed decision, so we inform them of all the risks. Whether or not to get vaccinated or which diseases to get vaccinated against is ultimately up to the patient. We tend to get a lot of patients asking, ‘which one do you think is the most important’ but of course we always make it very clear that these diseases are in this country and therefore it is important to get vaccinated against them.

The most expensive consultation I’ve probably done was a couple going on a cruise and they paid just short of £1000 for their vaccinations. We’ve had quite a few of that range. It’s anywhere between £35 and that, really.

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

I don’t have the figures available, but I would certainly say it is profitable.

It obviously varies depending on the consultation, but typically I’ve had consultations that have been around £700 and the actual cost of those vaccines to me has been just over £200. However, you do also have to factor the time for the consultation and for administering the vaccines into that.

Would you recommend offering this service to other contractors?

Yes, absolutely. I think ultimately for most contractors now in the current climate, if you want to increase your revenue then it’s a good place to start.

Obviously you’ve got to be passionate about what it is and why you do it as well - it’s not easy money. I’ve sat down with a number of people who don’t go ahead. I’ve also had to vaccinate a couple of children and that’s not fun, so it can be quite consuming but we do it because there is a need for it.

There are easier ways to make money in pharmacy. Delivering this service does mean stepping out of your comfort zone. I would recommend it but I would also make it very clear that it’s not always straightforward.