Surviving the cuts…naturally
By Neil Trainis
PUBLISHED: March 27, 2017 | UPDATED: March 27, 2017
Funding cuts, patient care, natural health…it’s all in a day’s work for Minesh Patel. The Natural Healthcare award winner talks to Neil Trainis…
“Gosh, where has all the time disappeared?” Minesh Patel says, momentarily looking back on his long career in community pharmacy. This year is his 30th in the sector. His early days as a pharmacist feels like a long time ago.
“I qualified in ’87 from Bradford university. There’s been so many changes. Could I have foreseen that things would have turned out the way they have when I first started? No, not at all,” the Pharmacy Business Natural Healthcare award winner says, quietly-spoken and measured.
“Things have changed tremendously, such as the NHS structure. But the (pharmacy) contract, it was very straightforward. We’ve seen it develop slowly, not to the extent we would have hoped. That has been to the detriment of remuneration.
“Look at the cut on the establishment payments. It has left many pharmacies short. The buzzword at the time was skill mix. But then the government pulled the plug. It has been a tough blow.”
The cuts threaten to severely cut independent community pharmacy, once described by Sigma Pharmaceuticals managing director Bharat Shah as the lifeblood of pharmacy. For some independents they will inflict mortal wounds. Closures are expected.
Minesh is asked to what extent his pharmacy, C.E. Harrod, a tidy-looking business on the New King’s Road, is imperilled by the 12% reduction to the community pharmacy budget. He maintains his poise.
“Yes, with any business, it’s a big part of remuneration, 12% or more. We’re a smaller volume-based business with a fairly low dispensing volume. We’ll look to increase our funding from other sources,” he says. He is asked if the cuts could force C.E. Harrod to close.
“I hope it does not come to that of course. We have a steady counter and our OTC we’ll develop even more to keep going.
“We will look at PGDs as well. We’ve started anti-malarials and we’ve seen a steady uptake in that. And erectile dysfunction as well in line with flu vaccinations. But in terms of flu vaccines, you question your role with neighbouring surgeries.”
Why question that role? “Because you can feel like you are stepping on their toes but it has gone past that now.”
Minesh concedes he has not yet managed to strike up a collaborative relationship with his local GP surgeries because the GPs have not demonstrated a keenness to work with his pharmacy.
“I haven’t tried to visit them. It didn’t go past first base. I don’t really know why. They were set in their ways. But it is not a closed door. We will certainly go there again.”
Six staff, including Minesh, work at C.E. Harrod pharmacy. He hopes the cuts will not force him to reduce that number.
“I have got three counter staff and two on the dispensary. I hope we will be okay. We also have someone who comes in to do prescription admin three hours a day. We will see how the year pans out.”
The government’s attitude to community pharmacy has infuriated the sector. Minesh describes the way they have approached their efficiency plans as “crude.”
“The government has got this misconception I’m afraid. They’ve gone down the route that pharmacists hand out medicines like Smarties and that’s it.
“If you look at it, there are three or four pharmacies in short vicinity of each other. In other areas it is not apparent. They apply the ruling (on clustering) to everyone. It does not apply to every pharmacy. It has been made on a crude basis rather than look at what each pharmacy does to help its own local community.”
To see the pharmacy Minesh has spent years building up reduce in capacity or close would be a shame. The business provides a range of services which are important to its own community. He has been at pains to ensure his team alter the way they think about nutrition. Natural, he insists, should not automatically mean bad or ineffective. Let the patient decide.
“We do homeopathy to a small extent. It gets a bad rap. Prominent people have campaigned against it. As long as people are not looking for cures. We say it is okay to be open to those treatments. Keep an open mind.
“It is not a cure. It can alleviate acute symptoms. But it is very different to offering paracetamol for short-term pain relief.”
Homeopathy, Minesh insists, is popular among his clientele. “People come in and ask about it probably two, three times a week. People who say homeopathy has no clinical merit, I can see where they are coming from because the science behind it may not make sense.
“But if products have a placebo effect, some OTC medicines fall into that category as well. As long as patients are relieved, there is no harm and we are not promoting something that is way beyond the product, (it is okay.)”
Minesh has impressed upon his team the importance of getting people to change their lifestyles in order to achieve better health. Irritable bowel syndrome is an example. Patients may be given an anti-spasmodic and told there is little else for them. Minesh’s view is it is important to understand the individual patient and look for trigger factors such as stress, poor diet or gut flora.
Treating the underlying condition has allowed him to recommend a natural product and that has brought significant improvements. Indeed, there have been improvements in other areas such as staff training, which is supported by manufacturers whose representatives talk to Minesh’s team on ways to broaden their skills.
“We do out-of-hours training and functions during the evening across natural products as well as OTC medicines. Staff attend two, three-hour seminars usually in central London where reps talk about products and conditions.”
C.E. Harrod was also the first pharmacy to introduce protein ice-cream although demand for that in supermarkets over the last year has seen it disappear from the pharmacy’s shelves.
“We were selling 20 to 30 a week,” Minesh reveals. “As soon as it hit supermarkets and the mainstream, we lost out so we no longer sell it. That was a year ago. It gradually fizzled out.”