Travel health is growing in community pharmacy and pharmacists can make significant revenue if it is carried out properly, as Jignesh Patel explains…
Pharmacy is evolving! Pharmacists have for too long relied on generating revenue from dispensing, selling OTC medication and other non-pharmacy goods. I became a pharmacist with the aspiration of becoming a clinician who serves my community and supports patients with their long-term conditions.
I know that I’m not the only one. There are those who are content with what they do and there are those who want to be and feel like real clinicians.
I felt like a real clinician in January 2010 when I qualified and started my own travel health clinic. This period was the start of my new career and the catalyst for a prosperous new pharmacy business.
When I started my travel clinic, there was very little support and advice for me. I had to learn through my own research and accept that I would make mistakes. Now with so many training providers out there and national organisations like the National Pharmacy Association to help you, information and advice is more readily available. However, the decision to start a travel clinic is yours.
For me, it was an easy decision. I wanted to feel like a clinician and generate extra revenue. Some pharmacists see the benefits while others continue to be apprehensive about the clinical aspects of the service. Actually you couldn’t be more wrong.
The difference between a flu clinic and a travel clinic
More than 90% of community pharmacies now administer flu vaccines and if you provide this service, starting a travel clinic is just a small step from what you currently offer. The key differences are:
• Completing a risk assessment.
• Considering/taking patient history.
• Giving advice on prevention measures to avoid ill health when travelling.
• Preparing and administering vaccines.
You’re already trained to administer an injection so nothing really changes. It’s just spending more time with the patient to understand their medical history, completing a risk assessment and giving them good travel advice so they stay fit and healthy.
There is another key difference. With flu you’ll earn an average £13 for 20 minutes consultation. With a travel clinic consultation you’ll earn an average £40 for an extra 10 minutes with the patient. That’s over 300% more revenue.
How do you become a travel clinic?
If you’re now considering starting a travel clinic you must be trained before you administer travel vaccines. This includes:
• Selecting the clinical services you want to provide and Patient Group Directions (PGDs). PGDs define the specifics of a particular treatment including how the treatment should be tailored to different patients. For clinical safety PGDs would include inclusions and ex-clusion criteria.
• When administering any vaccinations, pharmacists should always refer to their individual PGDs and the specific training they have received in providing the travel vaccination ser-vice.
• Training should include how to provide certain vaccines, including different injecting techniques, which in the case of basic travel vaccinations should include, subcutaneous and intramuscular injections.
There are several training providers out there so do your research in finding the right one for you. I’ve always looked for ones which are established, will support you in setting your clinic up, capacity of on-going support and also advise you on how to generate revenue because at the end of the day you want your return on investment.
The patient consultation
Once a patient has booked an appointment, you should have them complete a comprehensive Risk Assessment Form – your training provider should be able to provide a template for you to use. Once the patient completes the Risk Assessment Form:
1. Scrutinize the form before you give any advice, vaccination and/or anti-malarials.
2. Use the completed Risk Assessment Form to look at different disease states and public health aspects of travel, including what people need to know before they travel and how to individually assess patients in terms of their travel itinerary and any medical conditions.
3. Categorise what is important for customers’ travel health needs. This includes evaluating the risks of diseases people could contract overseas and specific vaccinations they would need.
4. With the patient discuss the potential side effects and the importance of taking a risk as-sessment before giving vaccines. Also, ask about medical conditions, medications, aller-gies and any previous allergic reactions to vaccinations.
5. Once the patient has been assessed, you must get the patient to consent to administering a particular vaccine. Remember, we can only advise about the highest risks of conditions for an area they are going to. If they have not been vaccinated for a condition prevalent in a specific country it could result in the patient picking up that condition which may be dif-ficult to treat overseas.
Generating revenue from you travel clinic
When I was establishing my travel clinic, I identified four key points that I continue to use to this day to ensure I focus on generating revenue.
1. Know your market
Your market is split in two – private and NHS. If you’re located outside of Greater Lon-don, you will have NHS flu patients. If you’re within Greater London, you will have NHS flu, pneumonia and meningitis ACWY patients.For your private market understand your demographics, specifically ethnicity groups. These groups frequently go back to their home countries to visit friends and relatives (VFRs). You must stock these country vaccines because they will make up a huge per-centage of your revenue. As an example, my pharmacy is located in one of the most de-prived areas in London yet I see eight to 12 patients a day who require vaccines to visit their home countries. Additional vaccines to stock are Hepatitis B for occupational health workers and Meningitis B since there is a huge drive by pharmaceutical companies to in-crease awareness of this disease. Once you know your market ensure you select the cor-rect PGDs but at the minimum ensure you cover Flu, Pneumonia, Meningitis ACWY, Hepatitis B and Meningitis B.
2. Train your staff
If you’re trained to administer vaccines ensure that remains your focus. Train your staff to help you achieve this. Delegate tasks to your staff to free up your time. Also, teach your staff to inform patients of the service offering, especially older patients who require NHS vaccines.
3. Premises and environment
Nobody wants to enter a dirty, cluttered clinic. Get your clinic as close to a surgical room as possible especially your consultation room. Private patients are paying for an expensive service so ensure they walk out feeling they’ve received it.
When it comes to marketing, your patients will fall into two categories – walk-in patients and online patients.Walk-in patients are only going to know that your pharmacy is a vaccination clinic if it is clearly signed and it catches their eye. What helped my pharmacy was removing all other posters and clutter from the windows so it looked clinical, clean and ensured passers-by saw the vaccination centre sign only.I know many pharmacy owners are not confident about how to advertise using the inter-net and even more apprehensive when it comes to cost. You must first and foremost ac-cept that you have to advertise online because that’s where patients are searching. For many, cost will be an issue, so look for a referral website that allows the patients to book an appointment at your pharmacy. A good site will charge a nominal fee but will generate average sales of £100-£150 per patient. This will start to give you an online presence and most importantly start to drive patients to your pharmacy with no upfront cost. It’s a win-win solution.
The future can be very bright
Since 2015 the NHS has been observing how community pharmacies have responded to help them achieve their immunisation targets. We have surpassed last year’s flu figures and I believe we are ready to take on even more services to help the NHS. At the same time the private vaccination market is growing exponentially with over 70 million people travelling from the UK every year and almost 50% seeking no travel advice at all.
The opportunity for pharmacies to earn revenue from starting a travel clinic is substantial and the risks to enter this market are now very low.Excluding anti-malarials, a full travel PGD course will train you to administer 23 possible vaccines. If you’re starting a travel clinic, then you don’t need all of these.
A good first step is to go for the high demand ones – Flu, pneumonia, meningitis ACWY, hepatitis B and meningitis B. This will help you understand what it’s like to administer vaccinations and the impact it has on your staff and business. It will save you upfront training costs but most importantly it will get you feeling like a clinician.
For pharmacists like me who feel that the real passion and income is the full travel clinic…go for it! You will utilise your clinical skills to its highest potential and in return earn lucrative revenue as well as professional satisfaction.
Jignesh Patel is a community pharmacist in Newham and co-founder of Traveljab.co.uk.