Putting the ‘community’ into community pharmacy
By Neil Trainis
PUBLISHED: August 7, 2017 | UPDATED: August 7, 2017
Naz Khideja has taken community health to new levels and is determined not to let the government’s funding cuts stop her in her tracks. The Pharmacy Business Awards winner talks to Neil Trainis…
Naz Khideja and her team put the community into community pharmacy.
“The key thing is to understand your demographics. Patients are people. They have a range of needs but their needs are different,” the Pharmacy Business Awards winner (right) says, enthusiastically pondering the qualities that make an accomplished pharmacist.
“We have a tailored approach. Where we are situated we’re not near a health centre so people tend to walk past us. Very quickly they are loyal to us. We know their name, we have their prescription waiting for them when they walk through the door. We run a personable service.”
To use a General Pharmaceutical Council yardstick, there are average pharmacies then there are good pharmacies. Great pharmacies, or excellent for the purposes of GPhC measures, are the ones that immerse themselves in their local populations.
They are the ones whose staff get out from the confines of the pharmacy and reach out to people. It is what has set apart A. Karim’s Chuckery Pharmacy, run by Naz in a deprived area of Walsall.
Naz and her team have been renowned for attending events around the town in an attempt to meet people who don’t access health services in the area for one reason or another. The kind of people who might have a serious underlying health condition and are in urgent need of a health check.
Yet somewhat bewilderingly the pharmacy has had to stop providing health checks out in the local community because, as Naz puts it, the service failed to sustain any momentum. There were occasions when three or four people would turn up to one of her health checks when she expected 40 or so.
Not that she has completely given up on health checks. Far from it. She plans to provide them from inside her pharmacy for people who are not her patients. Yet as she talks you can feel her frustration that, at least for the time being, she is unable to reach out to her local population in the way she once did.
“We get heavily involved in community events. We make the time. As part of our health checks we got out and met people although we had to stop offering health checks recently because we weren’t getting the footfall we hoped we’d get,” she says.
“We made a conscious decision to stop them because we weren’t completing the number of checks we wanted to. We were actually losing money rolling the service out. Sometimes only four people would turn up who were suitable for a health check even though we had spoken to 30, 40. We had to rethink our own sustainability for the future.
“Pharmacists have to balance the cost of running a service and the time it takes with the benefits of running that service. It’s all about increasing your brand loyalty.
“Now we’re looking to run health checks for patients who are not our patients if they come to our pharmacy. It is still a good model. We are in discussion with the local council to subcontract health check services to GPs.
“We’ve worked closely with community groups. We worked with the local temple where we managed to get in 14 health checks in three hours. We’ve gone to high-rise flats, we got involved in an annual festival here, we’ve really tried to think outside the box to see where we can access people who might not be able to access a pharmacy.”
Even from inside A. Karim’s Chuckery Pharmacy Naz and her team have been able to extend their healthcare tentacles to those in need, sending a letter to patients reminding them that their medicines use review is due. The desire to help people within the community remains as strong as ever.
“We sent 300 letters out in four weeks and about 65% turned up and received their MUR,” she says, adding that she has received an invitation to work with the local gym and “opened the pharmacy up to have a council health trainer come in.”
She offers locally commissioned services and a successful minor ailments scheme. Word of her success has spread. The local palliative care team refer patients to her pharmacy largely because of its opening hours and even outside of its opening hours.
Naz is on hand to open the pharmacy, whatever the hour, if the need arises while a local nurse uses her consultation room to provide cervical screening. Naz also finds time to deliver four clinics each month in the local treatment centre where she helps people stop misusing substances.
“(The area is) very industrialised, a lot of industries have closed down but there’s lots of factories. There are socially deprived areas and there are areas not so deprived. We have elderly, retired people come in who are very proactive in their own healthcare,” she says.
“We have young people, we have an eastern European community here, we have young mothers. It’s quite busy all day in the pharmacy. We’re known for giving sound advice.”
If that was not enough, Naz has spread her healthcare wisdom through local radio and television in a variety of languages familiar to her local community.
“There are five languages but some Asian dialects overlap. It’s quite nerve-racking. The studio set-up is quite comfortable and I’ve built up a rapport with the anchor.
“I did a Thursday morning TV show called the Women’s Show which has a phone-in. It’s a Loose Women type of show but rather then focus on current affairs I do a health slot. I’ve done another show called Health Matters which is run by Birmingham council where I speak in Urdu.
“Then there’s a phone-in radio show in Nottingham which I do live from my pharmacy and try and answer patients’ health questions.”
The more Naz reveals the more this comes across as community health on another level. She says the government’s funding cuts, which feels cruel in the context of everything she is doing for her community, has had an inevitable impact on her pharmacy. An apprenticeship scheme has had to be stopped.
“We’re having to restructure because of the funding cuts. I’ve worked hard to lobby my local MP. Pharmacy has been devalued into a dispensing process. It’s up to us to say ‘no, that’s not just our role.’ Traditionally GPs have been seen as the gatekeepers to the NHS but pharmacists are the lock-holders.
“The cuts have had an impact but we’ve been proactive in seeking to increase our turnover. We marketed ourselves in a community magazine although we did have to suspend our apprenticeship programme.
“We didn’t want to suspend it but we had to look at our sustainability and skill mix. We haven’t stagnated the programme but we need to look at where we can use our time effectively.”
Naz pauses momentarily. “I hope the programme will return in the future.”