Bina Patel says she could be wealthy and driving an expensive car but who cares? She puts a smile on the faces of people in her local community. The public health pharmacist of the year talks to Neil Trainis…
To Bina Patel the confines of her community pharmacy must feel restrictive. The arena where the Pharmacy Business Public Health Pharmacist of the Year weaves her healthcare magic is Essex. Westcliff-on-Sea to be precise.
It is out in her community where the action is. It is where she feels most at home as a community pharmacist. The emphasis is very much on the word community.
“Get out there, spend more time talking to people,” she simply says when asked what pharmacists should be doing to make the most of public health.
Some pharmacists may be content to stay in the pharmacy and dispense medicines. Others may feel they don’t have the time or resources to get out into their community and actively search out health and social problems that might be solved with a little communication and a human touch.
After all, health issues do not always present themselves at a pharmacy. Social isolation and the social determinants of poor health even less so.
Bina has not so much involved herself in her local community but immersed herself in it. She finds the time to visit various events and establishments in the area to spread good health messages. She took part in a men’s health day at Southend United’s Roots Hall stadium. That saw her reach out to men who did not access health services for one reason or another.
She also talks about health topics with a local elderly group’s meeting and offers free services such as blood pressure checks there and then.
“We go to the local gym to test people’s lung health and lung age,” she says.
“They blow into my vitalograph and we can pick up patients who might have early onset of COPD (chronic obstructive pulmonary disease).”
Her business, Kalsons Pharmacy, is naturally a place where people come to address their health concerns and Bina also looks to go the extra mile for patients when she is there.
“A lot of people who come into my pharmacy have back pain. I do an intervention MUR, ask them questions and try to solve the cause. Patients with persistent migraines can get referred to the neurologist.”
As the Pharmacy Business Awards roving judge Richard Brown observed, “supporting patients is her forte.” She provides all the regular commissioned services and other services connected to her role as an independent prescriber.
When the local dermatology clinic which was struggling to prescribe approached Bina for help, she developed a service which allowed patients to be seen and prescribed for privately for the treatments they needed. If further advice was called for photographs were sent to consultants who would advise and see the patient to determine a diagnosis. The service is running at four to five patients a week.
“I prescribe for a lot of things, infections, dermatology, erectile dysfunction, travel medicines. If I’m out of my remit I examine the patient and refer them to the doctor,” Bina says.
“I had an elderly chap whose leg had swollen to double the size. He could’ve gone to A&E. I rang the doctor and told them ‘if you wait until Monday he will be in hospital.’ The GP saw him straight away. We run a triage system here which works well.”
One school of thought is that more community pharmacists should be prescribing. “It would be good if they could prescribe in their pharmacy but it’s not about more pharmacists prescribing, it’s about having the skills to do so.
“It’s like a dangerous weapon in the wrong hands. If it’s done in the right way it’s fantastic to have alongside the GP service.”
Other public health services she offers include weight management, vascular health checks, stop smoking, sexual health, mole screening, flu immunisation and supervised consumption for substance misuse.
Yet it is the impact she has on people’s lives outside of Kalsons Pharmacy that resonates more than anything else. It is tempting to think that the time Bina spends out in the community means she has a big pharmacy team to support her.
“Not really. I have an interest in people. I talk to people, I put myself forward. I make sure my staff are trained to do that. I ring people a lot to find out what’s going on.”
She works with a variety of stakeholders including local council public health leads, a respiratory disease steering committee and Dementia Action Alliance. She reveals she is usually the only pharmacist at the health and wellbeing board (HWB) meeting. That is an indictment of other pharmacists in her area given pharmacy’s clamour to be involved in HWBs.
“I attend meetings where I talk up for pharmacy. Quite often I’m the only pharmacist there. At a Health and Wellbeing Board meeting they wanted to test ideas for remodelling their health system and I thought ‘we should get involved in this.’ They didn’t know what pharmacy does. They thought we just give out tablets,” Bina says.
She does not take long to ponder if the government is making the most of community pharmacy’s public health role. “No not at all. There’s reluctance, there’s competition from GPs which is unnecessary. The government needs to recognise what we do, they need to come out and say ‘not all pharmacies are the same.’
“The government is giving mixed messages. It says pharmacy is important and says it has all these plans for pharmacy but on the ground they are not taking advantage of it. If they came out and actually saw what we do, they would be stunned.
“I’m a prescriber. The GP refers patients to us, we do our own treatments for patients. We stop two to three patients every 48 hours from going to A&E. I refer patients to the right health practitioner.”
One of community pharmacy’s more recent bugbears has been Sustainability and Transformation Plans (STPs), the government’s way of moving care out of hospitals and into communities. The principle is engaging. But community pharmacists have not found it easy to get involved with STPs.
Some within pharmacy suspect pharmacists are being marginalised by GPs. Bina has struggled to get involved with her STP but she insists she will not give up.
“I sit on the south Essex respiratory group and they talk about STPs. I have made enough noises about how we as pharmacists can engage in this agenda. If I don’t make that noise, nobody will. Somebody has got to do it. I’m involved in a drug and alcohol service. I try to engage with people all the time.”
There is no time for pessimism in Bina’s world. No time for self-pity. Of course there have been struggles. But there have been successes too. And she is doing what she loves. Changing people’s lives.
“My motto is ‘if there’s a door shutting in front of you, there’s two opening behind you.’ I could put a towel over my head and cry but this is my livelihood,” she says.
“I’m not going to be driving a top-of-the-range Range Rover but who cares. I enjoy what I do. I put a smile on people’s faces.”