How we set up a back pain service in our pharmacy

Alan Abid from Al Noor Pharmacy says offering a back pain service has allowed him to better support patients, rather than constantly referring onto a GP.

Service type: Back pain.

Name of pharmacy: Al Noor pharmacy, London

Name of pharmacist: Alan Abid

Why did you start offering the service?

I started offering this service in 2019 because it stopped me having to refer to a doctor so often for simple cases where I knew exactly what was needed. It allowed me to provide more services to patients rather than constantly referring. So, I found it to be very, very handy.

If we've got somebody in who has tried every over-the-counter option, we then step it up. Once we get to the stage of Ibuprofen and Codeine, I think being able to prescribe anti-inflammatory medication for a week is very helpful to see if there is any improvement.

How much did it cost you to set up the service?

The whole package of clinical services from Pharmadoctor was £999.

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

I had a lot of reading to do. In the beginning, I was referring to the Patient Group Direction (PGD) while serving every customer. I made a list of services we were offering and the medications that could be used. I gave this to the staff so they could also have something to refer to.

In a nutshell, what does the service involve?

If someone were to walk into the pharmacy with back pain, I would approach it stepwise from Paracetamol to Ibuprofen to see what would help. Ultimately, it can get to the stage where they need a course of anti-inflammatory medication.

You have to ask the patient a few questions beforehand to see what their overall health is like and what medications they're taking to see if the medication is appropriate or if they have any allergies, kidney conditions, high blood pressure, stomach issues or red-flag symptoms. You have to see if what you're giving is OK for that person.

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

I haven’t really gotten around to advertising it as a service yet. I’ve just been incorporating it into my existing pharmacy practices.

How have patients responded to the service?

Two I never heard back from. One came back and said it helped them a lot because they ended up going to A&E and waiting for a referral from their GP. Because I had all that information, I was able to give them a week’s course of medication. The patient was waiting to see their GP for a good five or six days, so this ended up being very useful for that person. It’s very handy for patients and for pharmacies.

How much do you charge for this service?

It's £25 for a week's supply of treatment.

Would you recommend offering this service to other contractors?

Yes, it allows you to offer far more clinical services. I find it helps me keep my knowledge up. Because we offer so many PGDs, every time I'm unsure, I read NICE guidelines. As a result, you have deeper clinical knowledge.