Ashley Cohen is maximising revenue opportunities outside of NHS remuneration. The founder of Pharm-Assist talks to Neil Trainis…
“I’m not your traditional community pharmacist,” Ashley Cohen says with a mixture of self-effacement and pride.
The Pharmacy Business Enterprise Award winner is certainly not your stereotypical white-coated healthcare professional who dispenses drugs to patients and talks people through their medicines regimes.
The founder of Pharm-Assist Healthcare Ltd, a family-run Yorkshire-based business which has five pharmacies, one in York, four in Leeds, and provides clinical pharmaceutical support to care homes and intermediate care units, is well versed in managerial pharmacy rather than clinical pharmacy.
“I can’t sit in a pharmacy. My skills are business development, liasing with stakeholders. I don’t rely on the NHS for 95% of my income. I have other revenue streams, which I think are essential in our industry,” he says.
“It’s really important to maximise the revenue being offered by the NHS but look for other services outside the national contract.”
Ashley is pleasant and articulate and very keen to talk about his successes with Pharm-Assist. He qualified with a pharmacy degree from Liverpool John Moores University in 1992 and although, by his own admission, he is not the quintessential community pharmacist he has been mightily effective at “finding gaps in the market.”
“I know how to put in tenders. I know what businesses are looking for. I’m not like these very good, innovative clinically-led pharmacists who do great work within their own pharmacy practice and develop excellent local services. I find the right people to do the job, I find gaps in the market.”
A glance at Ashley’s LinkedIn profile reveals a list of directorial roles. Director at Pudsey Medical Ltd, Priory Medical Ltd, Ilkley Moor Retail Ltd. That list may fail to draw in anyone with a love of clinical pharmacy practice but what it also fails to do is reveal Ashley’s desire to create something that would improve the lives of people. There is an entrepreneurial flair to him.
“I came quite late into community pharmacy. I wanted to build a tangible business. I was in consultancy and I was 35 when I went into community pharmacy which was quite late,” he reflects.
“I did some clinical work as a pharmacist in hospital then worked for a health authority in the early 1990s in London. Then I did a health MBA and some secondment work for the Department of Health. I had political skills and skills that were more suited to a civil service-type role.
“I was there seven years. I was using my pharmacy skills in a management environment, doing things like formulary management and cost effective prescribing. I was there at a time when viagra was coming out and we had (new) Alzheimer’s drugs, looking at quality indicators, all the things embedded in GP land now.
“I then went to work for an American consultancy firm doing healthcare consultancy. I wanted to get better rounded management skills. I was there two years. There were things I had learnt and I saw that the community pharmacy sector was being squeezed. I wanted to use my management skills, I needed to understand the business and commercial world.
“I saw the good, the bad and the ugly. I locumed in every sector of pharmacy but I knew what would work well around family values and I wanted to build a business.”
Having bought his first pharmacy in March 2006, he has carved out a reputation for being a clever identifier of patient needs and shrewd tenderer of health services.
An illustration of those skills was his successful bid to deliver medication and pharmacist and technician support to local intermediate care units and a prison.
That saw him achieve two things. Beat the large multiples to contracts they normally wrap up with little fuss. And, crucially, ensure his business is not reliant on NHS remuneration, which might be the death knell for many a community pharmacy given the government’s funding cuts.
His journey with Pharm-Assist was not without its difficulties but the memories give him plenty of satisfaction.
“(Pharm-Assist Healthcare Ltd) grew very rapidly. I bought a very run-down pharmacy doing 3,000 items a month and soon we doubled that to 6,000 within eight months. We quickly got recognised as a mover and shaker. Soon I got a call from a local GP asking for our help.
“We went from one pharmacy to four pharmacies within eight months. It was about stabilising the business. I spent two, three years embedding the team. We made mistakes on the way, we chose the wrong wholesaler, we did things wrong, but we got the right finance people, we had a head office, we did training, payroll. We became a small regional group. The pharmacy side looks after itself.
“Now we have five pharmacies (one in York, four in Leeds), three are 100-hour, and 70 staff. We do a mixture of weird and wonderful stuff. We became a care home hub. We were doing auditing, training, we would go into care homes and support them to understand good management, medicines management.
“We employ a care home pharmacist who works across our group. She spends most of her time in care homes doing training. She’s employed by us and we charge the care homes a small fee. It’s another revenue stream.”
Ashley also reveals “a major national domiciliary group” which cares for adults with learning difficulties approached Pharm-Assist for support. Alongside the intermediate care units, care homes and GPs who have sought help, it seems the business is in much demand.
“We were asked by a major national domiciliary group who provides care to adults with learning difficulties to write all their medicines management policies and train all their staff, which we did and on the back of this they asked us to provide medication and annual training and audit to all of their 45 homes in north and west Yorkshire. We are currently looking at a model of rolling supply out across the whole country.
“I was confident (the care home initiative) would work out. We are doing work for intermediate care units and we have a hospital contract. We have two intermediate care units in Leeds. We do discharge planning, stock control, weekly ward rounds and medication support.
“We were being paid by the local trust and I built up a team to deliver that training. That was an open tender and we’re now supplying prisons as well.”
Ashley insists he is not keen on expanding his business beyond five pharmacies, at least for the time being. It is hard to imagine he will never expand Pharm-Assist because he is not one for procrastination.
“(Do I want to acquire more pharmacies?) Not at the moment. I’ve still got a young family, I don’t want to miss those times. Never say never, maybe I will expand again one day. But I want to get what I’m doing now right.
“And if we expand we could become a small regional chain and lose that family business feel. Day Lewis are the gold standard. They’ve still got that family side to the business and remained large. But I don’t want to lose that family side to the business. I want to build other revenue streams, not add more pharmacies.”
Ashley and Pharm-Assist, like all other pharmacies across the country, will have to work to the backdrop of potentially crippling funding cuts. There is no hint of apprehension in Ashley’s voice as he considers how it might affect the business he has built.
“I know we are well prepared to manage it. We are squeezing every penny out and we’ll maximise the quality payments. If you don’t like it, do something else. So long as we do better than our competitors we can attract new business.
“I tell my staff ‘keep supplying a great customer service.’ We will tighten our belts. I look at it as an opportunity. Because we’re not 95% attached to the NHS but 75%, we’re well prepared.”
Some community pharmacies will have to cut back on staff to cushion the impact of the cuts over the next two years. Others will be forced to close.
“(In terms of enforced redundancies) we have had a couple of people leave but we look at it and say ‘can we replace them with an apprentice, is this a good opportunity to look at the skill mix?’ We were looking at our staffing costs. It’s not about people who didn’t want to go. It’s natural wastage,” Ashley says.
“My job as a business owner and motivator is to differentiate from everybody else. Look at the potential in providing a service.
“I did an analysis of the pharmacies in west Yorkshire and found that the majority of them had not done a single NMS (New Medicine Service). There are still a significant number of pharmacies not embrancing MURs, flu vaccination and other additional services.
“You can moan but how can you justify that? The quality payments are a pain in the backside but you need to consider every option.
“I want our branches to do it. You can’t be a doom merchant if you’re not doing your NMS, MURs and the services.”