Award-winning pharmacist Reena Kanda strongly believes that an independent community pharmacy such as hers should put the local population at its very heart. Over the years, she has “strived to create a family atmosphere which is inclusive and one that reflects my family vision.”
Reena has worked within the London borough of Barking and Dagenham for almost fifteen years, both as a manager for a large multiple and as an independent community pharmacist.
“When I joined an Asda Pharmacy branch in Dagenham, I got to know the demographics of the local area, its people and their health and care needs. I realised how in some parts of the borough there was a great deal of deprivation, lower socio-economic status, a lot of health conditions and not enough people who could actually do anything to tackle the health inequalities.”
This knowledge made her decision to purchase a pharmacy in Barking easy. Incidentally, in her previous role, she had served an entirely different community in North London, at the Southgate branch of the pharmacy chain. Moving to Barking was “a bit of a culture shock” at the start, she admits, adding: “The possibilities to make a difference were overwhelming, but exciting and inspiring.
“If anybody had told me to make a choice, I would have definitely selected this area. I do feel that there are so many inroads we have made with helping people – a sexual health initiative was one of them.”
Traditionally the borough has had a higher conception rate than the national and London average. What started as a small-scale emergency hormonal contraception (EHC) supply service at Reena’s pharmacy gradually grew into a much wider initiative.
“I felt that our pharmacy could take on a bigger role in prevention by educating our younger clients to take control of their sexual health and removing barriers for them.
“Passionate about improving health outcomes in this field, I approached various organisations. I felt it pertinent to offer more than just a supply of the ‘morning after’ pill to the customers, who were young and often seeking further advice and guidance, but little existed at that point.”
After witnessing the rate of STIs in the local area increase significantly, Reena put forward various suggestions to the team leads at her local primary care trust (PCT) to enhance the service offering. She approached charities such as the Terence Higgins Trust who happily came on board.
“Through close collaboration with them, we were able to establish the C-Card scheme in our pharmacy and fully embraced the young people friendly (YPF) ethos. And the initiation of chlamydia and gonorrhoea screening from the pharmacy enabled us to take a larger role in reducing STIs.”
As a result, there has been a month-on-month increase in the number of people accessing the service. The patients are diverse, and from many backgrounds.
“The very nature of this topic can therefore often be a taboo, especially in various ethnic groups, so we are in a prime role to help to break down barriers and facilitate open discussion.”
She said young men who traditionally did not seek advice from a pharmacy soon felt at ease with the service at Thomas Pharmacy. Increasingly these initial, isolated encounters have led to young people seeking advice on topics connected to their general health, and social circumstances.
Reena’s intervention, wholly embraced by the pharmacy’s younger clients, has proved to be a great success. The feedback she has received – through various patient surveys, mystery shoppers and personal conversations – has been “overwhelmingly positive”.
Her customers have been very satisfied with the pharmacy’s non-judgemental attitude, ease of access, high degree of professionalism and sensitivity.
The beginning of Reena’s journey at Thomas Pharmacy coincided with what she called “a very exciting time for pharmacy when things were new and they were being developed – local commissioners were getting involved with pharmacy, Public Health England was suddenly coming on board.”
Immediately after purchasing the pharmacy she implemented smoking cessation, NHS health checks, minor ailments, travel health – “Everything that I could do, I grabbed it,” she recalls.
“A lot of people thought I was crazy but even back then my emphasis was not on prescription numbers – it never has been. It was on service provision, providing a local hub to the community to use whichever way they want. Because I do not regard this pharmacy as my own, I regard this as the community’s.”
Born in Leicester, Reena’s introduction to the world of pharmacy began in earnest when she was quite young.
Her observant eye took in every detail when she visited a local pharmacy to collect her mother’s monthly medication. Her mother was unwell at the time, so visits to the pharmacy were frequent. She recalls the pharmacist as someone who was always accessible, a kindhearted person, well-known, respected and trusted by all.
“I remember less about her medication, but that the pharmacist was always there for the patient – smiling, welcoming, just a great person. I loved to see all these people come into the pharmacy. I loved the whole environment, the whole buzz of it.”
Indeed, it was perhaps this sense of nostalgia and fondness that had a bearing in shaping and moulding Thomas Pharmacy’s ethos, to forge such close links with the local population.
Being migrants, her parents taught Reena and her younger sister to be disciplined about education – one thing they were adamant about was: “Whatever you do, take your education seriously.”
That meant Reena developed a love of learning from an early age – she loved her maths, science and the arts so much so that at one point she was torn between what she wanted to pursue for a career.
“I did toy with the idea of an English degree, but just that me being quite personable and growing up in a small business environment, pharmacy was something I was naturally drawn to.”
“And today I feel I made an absolutely right choice of pharmacy in regards to what I can offer, the flexibility the profession has allowed me up until now and what I’ve been able to achieve in terms of interventions with patients, the relationships I have built up throughout my career – it’s been an amazing journey so far. It was the right choice.”
Post her pharmacy degree and a brief stint at Boots, Reena started off her professional journey with Asda, which back then was a much smaller company and its outlets had “the approach of an independent pharmacy”.
“They taught me how to become a retailer,” she said, adding that it was here that she learnt a great deal about focusing on sales and targets and developing the business side of things – a steep learning curve for a young pharmacist trying to find her feet.
“They would run product promotions and set targets, but they would also motivate and teach the importance of profit margin, teach you how to look at P&Ls, business figures, stock – most of which you don’t see in a lot of multiples.
“In Asda, which was still in its infancy, there was lots of transparency. Every quarter, we would see our P&L from the whole corporate store, let alone the pharmacy. I learnt a lot from there. I worked in a small pharmacy and I saw it grow, exponentially every year.”
Several years later, when Reena felt she was ready for a new challenge, she decided to go into her own venture – a service-led pharmacy.
“When you are such a pharmacy you are leaning a lot heavier on your team than you would be if you were a dispensing-led pharmacy. Much of my work is away from the main dispensary so I have to rely on my team to keep things going smoothly and safely at all times, whatever I may be doing.” “In this pharmacy, I have to stay quite free because I could be called to do a stop smoking, flu jab, travel clinic, EHC, anything and this happens all day long. But that’s where the core team comes into play and I just leave them to it because they know what they are doing, and they have a great organised approach to work with a great attitude.”
She says her six-member staff in the pharmacy pride themselves on “looking after each member of our patients’ families, often we tend to be involved at many stages of their lives.” She trains them on focusing on what is important, and they understand the vision and ethos fully.
Admitting that the recent cuts did have an impact on her business as well as the local population, Reena said the changes envisaged in the new national contract, however, weren’t as big a surprise.
“Being a service-led pharmacy right from the beginning, I believe it set me up so that things weren’t such a shock to me. The way my pharmacy is, it’s not altogether different from what the NHS wants. What they put down on paper is pretty much what we have been doing, so it’s not a huge shock. “But ever since I have joined pharmacy, it’s been changing and evolving. I joined at a time when the heavy-dispensing pharmacy model was eroding a little bit and this new model was coming in. And it’s been a period of flux ever since – no two months are the same.”
This article also appears in the December/January issue of Pharmacy Business.