Pharmacy.Biz News

Natural born pharmacist

Jonathan Burton had a natural interest in science and healthcare when he gained various work experience assignments in the pharmacy industry as a young man, writes Nusret Khan...

Having worked in a pharmacy at a hospital, as well as holding down a Saturday job at Boots, the experience Jonathan gained drew him to the idea of a career in pharmacy. “I didn’t really fancy the blood and guts of being a surgeon or a dentist, so that’s what cemented it in my mind as a good career option,” he says. “I think the security behind a pharmacy degree is that you’ve got yourself a good all-round science qualification, so if you happen to change your mind all is not lost.”

Whilst studying at university Jonathan became heavily involved in the British Pharmacy Student Association (BPSA), and it was through this association that he became aware of a company called Pharmacy Plus. Pharmacy Plus was a pharmacy group that consisted of people he knew from the BPSA and the university in which he was studying. This pharmacy group did things differently; they were the first company to have consulting rooms. Jonathan felt very lucky to have gained a pre-registration placement with them in Bristol and thoroughly enjoyed himself. During his pre-registration year, he was president of the BPSA, which meant he had to travel a lot.

Flexible

“The company was very flexible so I got a good invite into independent community pharmacy in a busy inner-city shop,” he says. Jonathan believes the transition between classroom and pharmacy was made far easier due to the work experience he gained during his academic life. “If you’ve had any real cold faced exposure as a student then I don’t think there’s any major shock or surprises in your pre reg year.”

After Graduating in 1998 and completing his pre-registration year in 1999, he went on to do eight months as a locum community pharmacist. “I was still the president of BPSA so I needed flexibility,” he insists. In May 2000, he and his good friend Noel bought a small pharmacy at the sterling university. “We basically built the business from there,” Jonathan says. “That was the point I moved to Scotland.” He admits it was a “big move from the south west to central Scotland” but felt that “it was the only opportunity we were going to get if we wanted to run a business together.” Taking risks most graduates wouldn’t dream so soon, Jonathan went from graduate to successful pharmacy owner in only two years. “Many of our friends at the time thought we were bonkers,” he laughs. “But we saw it as a once in a lifetime opportunity to get our foot on the ladder.”

Jonathan's involvement in the BPSA proved invaluable as it gave him the ability to organise himself and speak to banks and solicitors. He felt the only experience they did not have was in running a business. “The rest we learnt as we went on so it was a bit of a leap of faith,” he says. Attaining their first pharmacy was also difficult as they had very little funds. “We had to buy a very small business for as lower amount of money as possible,” he says. After much hard work and determination Jonathan, alongside two other directors and co-owners, has 11 branches now. “My specific role is superintendant pharmacist. I handle the professional and operational side of the day-to-day running of the business, and I share ownership with my two co-owners.”

Successful

Like all successful business men Jonathan and his colleagues have a set of rules they try to stick to when deciding where to buy the pharmacies. “We wanted them to be in the central belt of Scotland as there are good travel links. We’ll have the ability to partly manage the pharmacies ourselves and keep an eye on them. We’d also get to know the staff,” he says. The next rule is to look for businesses that are not too big. Jonathan explains this is because “we’re still a growing company with not an awful lot of resources, so we look for medium sized pharmacies which need tlc.” The new pharmacies purchased by them were opened in areas with a high population of elderly people but a lack of pharmacies. “The vast majority of our pharmacies are in village locations with high levels of deprivation, so although they might be geographically miles apart, they are very similar in their needs,” he adds, highlighting an appreciation of the difference between pharmacies on the high street and pharmacies in the village. “We have a couple of branches which are more retail focused. These are of high street location, whereas in the villages, the focus is on having well organised dispensaries and offering a wide a range of NHS services as possible.”

Some of the services provided by Jonathan's chain of pharmacies include a stop smoking service “providing a nicotine replacement therapy, provision service with advice and carbon monoxide monitoring,” a public health package “providing emergency contraception, advice and testing,” monitor dosage systems and many others. They put a lot of emphasis on minor ailments and smoking cessation because “the clientele that use our pharmacies are very keen on accessing them.”

Greatest challenges

Jonathan describes the greatest challenges in running a pharmacy business to be the “sheer amount of change. The NHS throws new things at you every year, you just have to adapt and re-train your staff and re-organise yourself. The pace of change for the past five years has been pretty relentless.” Other challenges he speaks of are from a business angle. “Managing the staff, making sure that not only their needs are met but they meet the needs of the business at the same time.” He also finds the financial uncertainty in the current economic climate to be very challenging for a pharmacy business. “NHS is being restructured and the pressure on budgets combined with the banking crisis we’ve had to endure has been very challenging for medium sized businesses, so you have to try and plan for the future as best you can. And manage your financial position as best you can.” Jonathan believes that in order to be successful in running a business you must be able to “think on your toes, look out for new opportunities and try and manage the threats as best as possible.”

Jonathan encourages anyone looking to become a pharmacy owner to get plenty of advice beforehand. “If you want to get the reward from being a pharmacy owner you have to work very hard and you must appreciate the sacrifices you have to make as an owner,” he suggests. “If you appreciate that this is the way things are done, you can have a good career in pharmacy.” Jonathan considers these as the “golden rules” and goes on to explain the level of commitment required in this industry. “When you’re young and developing your business, there are lots and lots of different pressures on you. In particular, it can be very demanding on family time, trying to balance that with the needs of the business is incredibly difficult. The buck stops with you. When something goes wrong you don’t call somebody else, you have to deal with it yourself.” He believes that all the usual pressures of a business ownership are present “with a few extras thrown in just because it's pharmacy.”

Reflecting on his work of three to four years ago as superintendant, Jonathan focuses on how important patient safety is to him and his pharmacies. “I decided to put a lot more emphasis on near-miss reporting and tidying up the error reporting systems,” he says, adding that “we re-did all our paper work for error reporting and tried to have a culture of openness as far as reporting errors and near miss reporting was concerned.” Jonathan developed patient safety information safety cards for different types of medication, “just to give them a little more advice on their medicines.” His efforts were to heighten the patient’s awareness of the dosing schedule. “They introduced measures like this to make their dispensing process as safe as possible,” he says.

Patient safety

Jonathan firmly believed that the issue of patient safety “deserved quite a lot more attention than it was getting. And I work on the assumption that we’re human and we will make mistakes, so it’s about how you reduce the frequency and severity of those mistakes. We have to think in practical terms of how we can minimise harm.”

His entrance into the pharmacy world was awe-inspiring; the progression of Right Medicine Pharmacy and patient safety in general, having been nurtured by him, confirms how much of an asset Jonathan Burton is to pharmacy.

Fact file

Full Name: Jonathan Burton

Pharmacy Name: Right medicine pharmacy

Years in pharmacy: 11

Staff: 60

Lives: Alloa

Family: Wife and two children

Hobbies: Running and spending time with his family

Favourite Football Team: York City

Scripts: 3000 – 4000 a month

Business tips:

1. Must be in it for the long term

2. Must be prepared to work very hard

3. Must be prepared to make sacrifices

Greatest challenges:

1. Adapting to change

2. Managing staff

3. Financial uncertainty

Driven towards pharmacy

With great determination and a keen eye for business, it wasn’t long after Raj Rohilla graduated in pharmacy in 1989 that he took on the role of superintendent in the family business, writes Nusret Khan...

As a young man, Raj Rohilla decided he wanted to do a degree that was vocational. “Like most Asian families they wanted me to do something science-based,” he laughs. He wanted a career that involved both science and healthcare, since “studying medicine takes too long, it takes far too many years to become a qualified doctor.” Raj felt that it was “a long procedure to get where you want to go.” Finding medicine to be an unattractive career path, he looked to pharmacy. “Pharmacy fitted both bills for me; it fitted the caring side and the science side. And I felt that I would also be reasonable at the business side of it.” Raj then went on to study a pharmacy degree in Brighton and completed his pre-registration with Boots.

He found that the course he did at Brighton proved to be incredibly useful to him both during his pre-registration year and throughout the rest of his career. “I was lucky because in the course I was doing at Brighton we did a module on dispensing which we had to pass for each of the three years we were there. It was quite unusual because not many universities had that.” This path of learning eased the transition from classroom to pharmacy because “we did a fair amount of dispensing all throughout the degree course so I didn’t find the transition that difficult.” Raj goes on to explain “the bigger transition was the actual counselling, having to give advice to patients. You feel that the tiniest slip-up could have major implications.” He has found over the years that locum pharmacists who come from Brighton seem to do conduct good dispensing “and this is ultimately our bread and butter.”

Looking back to when he completed his pre-registration year in 1988, Raj speaks of how there were both pros and cons to the experience. “The pre-registration was good because I worked at a variety of stores and I was very lucky as I got to work in the big Brighton store for eight weeks.” He felt that those eight weeks were invaluable to him. “It was one of the top nine stores in the country and the manager was pretty special. I respected what he did there,” he suggests.

After graduating in 1989, Raj worked as a locum pharmacist. He did a day’s locum work at his parent’s pharmacy - “they’re not pharmacists themselves but they run a pharmacy with a pharmacy manager,”- and was covering for the manager at the Richmond branch. He did such a great job that when the manager could not return due to ill health, Raj was taken on as superintendent pharmacist, a role which he still assumes today. As a young pharmacist the promotion from locum pharmacist to superintendent was a steep learning curve. “It was quite a daunting prospect at quite a young age to become superintendent pharmacist,” he insists.

Raj feels that pharmacy itself is a very “lonely” profession because “we are very insular in the way we work. Pharmacists are very competitive; they don’t want to give away business secrets, you don’t share experiences with each other. And that’s the poorest bit about pharmacy.”

Soon after becoming superintendent of the family pharmacy, he became actively involved in the Local Pharmacy Committee (LPC). “There are a lot of people who moan about pharmacy but not a lot of people get involved in it. In those days the younger pharmacists never got involved in it, most of the LPC’s were made up of quite established pharmacists,” he says. At one stage in his career Raj became the LPC chair for Kingston Richmond. The LPC negotiate on behalf of local pharmacists and because “they have worked with what were the health authorities but are now the primary care trust” they are responsible for negotiating things like payments of oxygen to rota services to the extra services that are done in the pharmacy. “Their role has increased now because we do a lot more extra services,” Raj explains.

He feels strongly about pharmacy politics and states that “if you’re going to whinge and complain about pharmacy you can’t do it on the sidelines, you need to get involved and try to change it, otherwise don’t complain about it. The LPC always want young pharmacists to get involved, and they still do, but people don’t want to get involved in the politics of pharmac.”

Raj believes pharmacists are not inclined to join because they are so busy. “It’s an incredibly long day. It’s not like working in an office where you have a few minutes off and you go and have a coffee. If a counter sale is made and it’s wrong, I am the one responsible,” he adds. The responsibilities he holds are incredibly large and important in the successful running of the pharmacy. “We’re constantly on our guard for nine-and-a-half hours a day, and after doing nine-and-a-half hours no-one wants to go to an evening meeting.People have family lives as well. When you get involved in pharmacy politics it effects both your family life and your business and that’s why other people don’t want to get involved.”

Reflecting on the differences between life as a pharmacist when he graduated and now, after 21 years of experience, Raj describes pharmacy's progression in terms of legalities. “I have to show four different inspectors what I’m doing, and there are 18 different inspections that you could be subjected to,” he admits.

He came to Battersea pharmacy in September 2008 and over the years he has been superintendent of five to 10 different family pharmacies. Battersea pharmacy, Raj explains, “didn’t fit their business model, they were holding the same sort of products that they do in all their other pharmacies and it wasn’t fitting here, they weren’t maximising its potential.” Yet with a keen eye for business Raj and his team realised that there was potential to reach great heights in this pharmacy. “We held two focus groups with the mums and babies as there is a big mum and baby population here. In one square mile it’s got the greatest concentration of mums and children under five in the whole of Europe,” he maintains. After taking into account exactly what the community at Battersea needed, Raj adjusted the pharmacy to suit the people using it. “We’ve got the widest selection of organic baby food and eco-friendly baby items; the other area they wanted was skin care. We concentrated on those two items and reduced all the normal things you see in a pharmacy because the pharmacy is quite small.”

This change in service completely transformed the face of Battersea pharmacy, making it a huge success. “We’ve resurrected the minor ailments scheme and other advanced pharmacy services, and they have been very well received. With that we’ve increased the sales during the week three-fold, and on the Saturday we open, it’s increased four-fold.”

Raj appreciates the freedom of an independent pharmacy and believes that the downfall of multiples is the rigidity of the pharmacy structure. “In terms of services and being able to change or adapt to the local environment, only an independent pharmacy can do that. If I decide not to keep a particular service by tomorrow it will be done, but with multiples you’d have to take it to your area manager then your regional manager then up to head office.”

The number one priority for Raj is providing the services that are required by the local people. Some of these services include minor ailments, emergency hormonal contraception, asthma service, stop smoking help, flu vaccinations, cholesterol testing and much more.

He and his family bought a succession of pharmacies, outgrowing them, moving up to bigger ones, and selling and buying more along the way to suit the needs in the community. His responsibilities involve guiding and monitoring the work of pharmacists caring for patients in the other pharmacies. With immense consideration and compassion for the people in the area, the staff at Battersea pharmacy are truly experts in family health.

FACTFILE

Full Name: Raj Rohilla

Pharmacy: Battersea Pharmacy

Years in pharmacy: 21

Staff: 15

Moto: Experts in family health

Lives: Richmond

Family: Wife and 2 children

Hobbies: Skiing, golf and photography

Nature is calling

A natural affinity for science took Ketan Agravat (pictured) up the career ladder in the pharmaceutical industry and saw him scoop the Pharmacy Business Best Practice Award 2009, says Nusret Khan.

In 1990 Ketan Agravat graduated in pharmacy, getting his first job in Boots as second pharmacist in 1991. He advanced through the pharmacy hierarchy exceptionally fast, making store manager in 1997. By 2001 he decided to move to an independent pharmacy and became area manager for MediPharmacy in 2005. In 2009 Agravat’s talent secured him the position as director of retail operations for both UK and India.

As a child Ketan had “a huge interest in chemistry”, and it was therefore his “favourite subject” at school and college. “I was leaning towards chemistry and biology, it seemed natural that I wanted to learn about medicines and to get involved in the healthcare field,” he said.

This curiosity played a vital part in the subject he chose at university. “I wanted a degree that was career orientated, which consisted of large amounts of chemistry and biology, pharmacy really hit the spot.” Ketan felt he had something of a “calling” into healthcare, considering his interest in science, and his attraction to pharmacy was inevitable.

He felt that his natural skills suited him to the pharmacy profession “I’ve always been an excellent communicator even when I was a youngster and that marries up with the role of a pharmacist,” he insisted. He gained an excess of experience prior to entering university, holding a Saturday job at a pharmacy and helping behind the counter at local shops.

At the age of 16, helping at the counter involved “cash and wrap and normal till transactions”, but Agravat gained invaluable experience in how people worked together as a unit “from what the pharmacist does, to what the counter assistants did.” He added: “All of that gave me a real appetite for being in pharmacy.”

Upon starting university Ketan's knowledge of pharmacy grew in great abundance. In his first and second year he went on an eight-week course with Boots. This was designed to give students hands-on practical experience in pharmacy. He spent the entire summer working for Boots, increasing his passion for pharmacy further.

In his third year at university Ketan worked alongside post graduate students to help them conduct clinical trials and clinical assessments. He eagerly explains that he made this choice because he “wanted to gain some experience doing something entirely different.” And in his fourth and final year, he completed his pre-registration at Boots. The work he had previously done for the company had secured him a pre-registration placement at Boots in Lewisham, South East London.

Ketan believes that gaining such practical experience was imperative to being a successful pharmacist. The assessment during the year is “based around your ability to be a pharmacist”. Students are evaluated on their competence, as he explains. “For example, counselling on coughs and colds. Your tutor would have to see you do that at least five or six times before he’d sign you off.’”

When he completed his pre-registration there were no final exams. He was trained to run the whole shop, including how to open up the shop and how to stock and clean the shelves. Ketan feels that it was “much more practical” when he completed the year although now “it is more exam orientated.” This practical side to pharmacy was not taught at university, which was why the pre-registration course was designed to give students “an all-round experience” of working in a pharmacy.

Ketan believes that the transition from university to pharmacy was easier when he was a student because of the eight-week course he completed in years one and two at university. “The degree course was clinical but those eight weeks gave me practical experience,” he said. And this practical experience included some of the more basic things, such as stocking shelves and pricing labels, along with the clinical side which involved dispensing medication.

Ketan now trains pre-registration students at MediPharmacy. “We train our pre-reg students on performance management, we try to give them a little bit more than the pre-reg exam,” he said. He believes that in order to be successful in pharmacy you need to gain a hands-on education. Students shielded from this “may be great pharmacists but they’re often not good managers of people.” He feels that this is because they don’t quite understand the business profile of it, and that’s where the shock is.

Although the patient always comes first, especially in a clinically-based profession as such, the business aspect must be considered otherwise the pharmacy is doomed to fail. “There will always be pharmacists that want to run their own pharmacy or branch, and they should have that learning curve,” he maintained.

After graduating in 1990, he got his first job in the Boots chemist in Bromley, where he was the second pharmacist. From 1991 to 1996 he went up the career ladder within Boots, becoming the dispensary manager, then the pharmacy services manager and then the pharmacy manager.

The focus of a pharmacy manager is driving the healthcare business, prescription business and the counter business. Bromley Boots, at the time, were in the top 10 Boots branches in the UK. “It’s a really big pharmacy counter business, that’s where I gained my stripes, not only as a pharmacist but as a business manager,” he said. Ketan was superior to two other pharmacists and took care of everything in the pharmacy department.

Soon after becoming pharmacy manager, he went into solo Boots management. In 1997 he was appointed store manager. This involved managing “all the different departments in the store”, although his branch was one of the smaller ones and is known to be the first branch a person goes to when they become a solo Boots store manager.

Within a year of this appointment, Ketan was promoted to the next highest branch, which was Putney in 1998. He spent a year working in Putney and was then promoted to the New Malden branch in 1999.

“This was a special appointment because Boots wanted to try out something called the concept store roll out. They selected four branches across the UK to develop a concept store which was the new- look Boots for the 21st century,” he suggested. The other three branches were located in Blue Water, Newcastle and Wales.

He had an intermediate sized branch. “I was involved in the changing of the existing stores to the concept stores, I was involved in the design, the methodology behind it and I was fully accountable for the transformation,” he said. He also had the responsibility of getting staff up to standard and this comprised both recruitment and training. He took staff to established branches to see how they were run. Ketan was accountable for what the customers would see and how it would make them feel, his vision and support during the six-month project helping to create the successful business that stands today.

He had a “very successful term” at New Maldon and was then promoted once more in 2000 to a bigger branch in Epsom. His official title was hub manager for the Epson cluster and he was responsible for a “further five to six stores in its vicinity as well.”

For these stores Ketan had to spend two to three days a week managing the business deliveries. In 2001 he felt there was “a huge knowledge gap around pharmacy because being in the corporate environment, one is shielded from what happens in the independent sector. I wasn’t very good at knowing how stock was bought in and what the profit margins are on stock.” At that point Ketan decided to take a leap of faith and moved from corporate Boots to an independent company called Dejure.

“This job intrigued me because it was about looking at other things which I had no knowledge of, things that Boots' head office would have done. And this I felt was something I really wanted to engage with because you couldn’t possibly understand pharmacy if you stay with one company,” he said. “It was an excellent decision I made, but a very scary one.” He was shocked by the contrast between the two environments, the pressures that needed to be dealt with and the things that needed to be learned that he was not aware of.

In 2005 Dejure combined with River Mead/ Khos Pharm to form MediPharmacy Limited. Along with other experienced pharmacists Ketan was interviewed for the post of area manager. In this year he went from pharmacy manager to area manager. In the following year he was promoted to business development manager and in 2008 he became the director of retail operations for UK. Finally, in 2009, he was appointed director of retail operations for both UK and India. “During that time we had established a chain of pharmacies in India,” he said.

MediPharmacy, he added, is “bench-marked as one of the best providers of services within the independent sector, our performance management structure is robust and is geared around delivery of NHS items and NHS services.” This pharmacy provides services such as smoking cessation, super fast methadone, chlamydia testing, diagnostic testing, cardiovascular screening, BMI weight management, allergy testing, blood pressure testing, blood glucose testing, cholesterol testing and much more.

They currently have three contractors dealing with the dispensing of disability aids. The passionate and insightful nature of Ketan allowed to him to transform his interest in chemistry and biology into a tremendously successful career in pharmacy, providing exceptional services in healthcare to communities in the UK and India.

FACTFILE

NAME: Ketan Agravat

PHARMACY: MediPharmacy

YEARS IN PHARMAMCY: 20

STAFF: 200

MOTTO: Delivering healthcare in the community

LIVES: South London.

FAMILY: Wife and two sons.

HOBBIES: 5-a-side football, badminton and reading about natural history.

FAVOURITE FOOTBALL TEAM: Liverpool FC

Living the dream

John Goes came to England with only five dollars in his pocket. Last month he was crowned the Pharmacy Business of the Year at the prestigious Pharmacy Business awards. Sarwar Alam spoke to him about his award winning pharmacy…

John Goes came to England from Kenya as a 17-year-old with worries about what the future held. A lifetime of hard work culminated in John standing on the stage at the Pharmacy Business Awards taking in the adulation of the audience as he was crowned Pharmacy Business of the Year.

It was1969 and Kenya was still trying to establish itself after gaining independence from Britain six years earlier. John and his family had to choose between taking up Kenyan or British citizenship. He reveals that although it was a very important choice to make, it became pretty obvious what his family had to do.

John, whose family is of Indian decent, could see that non-Kenyans would struggle in the county if they decided to stay on and take up Kenyan citizenship.

“We had to look at somewhere other than Kenya. Even though I had done well at my OLevels I knew there was no chance I could go to university as if you weren’t Kenyan citizens then we weren’t allowed to go to university. So I decided to take up British citizenship,” said John.

John’s parents could see there was no future for their teenage son in Kenya and fully supported his decision to move to England.

“My story is no different to a lot of Kenyans who came to the UK in those days,” says John. “A lot of Indians came as we had little choice and we had to separate from our families. There were no issues about doing it as families thought their children were going to better themselves. And there would be some benefits in the future.

“But to be honest with you I really didn’t know where I was going to go once I got to England. It really depended on admission to school or places in higher education. I managed to get into Bolton County Grammar School.”

The cost of living was in the 1960s and 70s was high and struggling families often took in lodgers to help them get by.

It was a difficult time for John when he came to the country as he practically had no money in his pockets. But, luckily for him, he had an older brother in England, who had come to the country a couple of years earlier and was lodging with an Indian family in Bolton and it was he who managed to take John in.

“The Patel family took in strays like us who had come into the country,” says John. “They were actually really good to us and became like family. We paid them, but it was minuscule compared to how they took care of us.”

John studied at Bolton County Grammar School, but found it tough going as the style of teaching was very different to what he had experienced in Kenya. But he was still thankful for the support he received from the school.

“One of my biology teachers would ask me to go and talk to her as she could see the difficulties of a 17-year-old having no parents or anyone to guide them,” reveals John.

Despite having the ambition to go to university, John couldn’t afford the fees and wasn’t eligible for a grant from the local council as he hadn’t been in the country for three years. Luckily for him the school came to his rescue.

“The school were extremely helpful as it was through their foresight that I ended up going to university. They managed to speak to the council and got me a discretionary grant.”

FACT FILE

Name: John Goes
Pharmacy: Goes Pharmacy
Opened: 1983
Years in Pharmacy: 32 years
Staff: Four
Lives: Burbage, Leicestershire
Family: Wife and two kids
Hobbies: Golf
Football team: Leicester City
Motto: If you can come to work and make
one person smile then your day is fulfilled.