Tuesday, July 28, 2009

Winning partnership


For someone not keen on large business development from a young age, it comes as a surprise that Jayesh Patel now has a group of 12 pharmacies and winner of The Pharmacy Business of the Year Award 2008. Faras Ghani traces Jayesh's humble beginnings, travels across the world in order to pursue a pharmacy career and how support from family has played a key part in his route to success...

From being the first independent pharmacists to win a private contract in an NHS hospital to receiving his second Pharmacy Business Award in three years – The Pharmacy Business of the Year Award 2008 – Jayesh Patel has vehemently labelled it a result of hard work, dedication and teamwork.

While he travelled from his native Kenya to India in order to pursue his love for the pharmacy world – where he not only completed his pharmacy degree but also met his wife, Illa – it was not until the completion of his pre-reg year from Sunderland that Jayesh thought about owning a pharmacy himself.

'I always had an interest in science and I wanted to pursue a career in medicine hence the trip to India following my O'Levels in Kenya,' Jayesh said. 'However, such was the competition for medical courses in India that I failed to achieve the required grades and took up the next best option: Pharmacy. And it just happened that I got a chance to pursue that degree in India.'

Following that, Jayesh made a trip across the continents to England, where his parents were residing and with a helpful qualifying procedure for overseas pharmacists in the 1980s, Jayesh qualified in 1982. 'We had to go through a procedure and couldn't just practise as an overseas pharmacist. We also had to apply to the Society to ensure that they were happy with the pharmacy degree while meeting various criteria. Thankfully, both me and my fiancé met that criteria and it was after qualifying that I realised I had aspiration to go into business but never imagined I'd develop such a successful group.'

The group, Delmergate Limited, now has 12 pharmacies scattered across Kent and employs around 70 full-time and part-time staff. And it all began, following his three-year stint as a locum, in 1986 withb Jayesh's first pharmacy, situated next to a Tesco superstore. Due to Jayesh's conscientiousness and continuous efforts to community service, it built up a good reputation and things went uphill from there.

'I was at the pharmacy all the time thus being able to answer questions whenever people had them. This allowed the trust between the pharmacy and the community to grow and we never looked back.'

With business running successfully, more and more pharmacies came as a result of recommendation by local GPs. Jayesh opened his first healthcare pharmacy in 1988 – by sheer coincidence, as he put it – and then decided they wanted to be 'very, very specific'.

'We thought that rather than open pharmacies here, there and everywhere, maybe our forte was in developing health-centre pharmacies. And now that we look back, in the 14 years that Delmergate has been in business, all 12 of our pharmacies are very specifically linked to health centres.'

Much of the success is owed to his supporting family, especially his wife and elder brother, as well as an accomplished senior team.

'Following my pre-reg in Sunderland, I lived as a joint family with my brother in south-east London. My wife, too, was in England following her degree as her parents lived here as well.

'I had never thought I had the business acumen. Even if I did, it never transpired I would own more than one shop. My first pharmacy [next to Tesco's] was a very large pharmacy, especially for a first shop. But we ensured it became a complete shop as we had an extensive range of products, including fragrances and even had a photo-lab.

'Following that successful venture, my outlook broadened with tremendous support from elder brother and colleagues who have been with me for 20-odd years. We worked very well as a team and felt that if we could do a fantastic job in one unit, why not go further afield.

'That is why I became a bit bold and by chance and recommendation from one doctor to another that we got interested, we got invited to join other health-centres as well.'

With a tremendous and hard-working team complementing a successful group of pharmacies, the only thing that remained was recognition from a wider audience. Jayesh did win the Pharmacy Business Enterprise Award 2006 but the team felt that the group needed something bigger given the determination and discipline that is on offer in every single Delmergate pharmacy.

'I tend to shy away from publicity but my team felt we deserved the award and they insisted they want to go for it. They felt that the business as a whole had everything in place that would possibly give us the edge over others in order to win the award. The simple reason being the work ethics right from the top. The directors pass it onto senior managers who then pass it onto the staff. Thus the entire group benefits from it and works like a family. Since it was the business of the year award, the whole group had to be involved including staff, people who we deal with, doctors, suppliers. I owe it to the whole team.'

Jayesh had not realised the true worth of the award he had won, the biggest award of the night. But he confirmed that he was ecstatic after receiving it. 'To win the award in front of good and the great in the pharma industry was very special, a moment we'll always cherish.

'We're tucked away in the part of the world where maybe people don't know of us. We quietly develop our own business so it was nice to be acknowledged.'

Jayesh's staff turnover is 'next to nothing' and that helps his business move forward. 'My staff is extremely proud to be working with a company like ours. I have staff who has been with me for a number of year purely because we pride ourselves for the kind of services that we provide.'

Looking after 12 pharmacies, Jayesh has an eye out on the future as well, both in terms of his own business and the future of the pharmacy world. He has welcomed the de-merger of the Society, labelling it a 'welcome move' and one that 'couldn't have come any sooner' and has ensured that recent graduates are drafted into his business so Delmergate can benefit from fresh ideas.

'With new services coming in, we also have a new breed of pharmacists coming in as well. They don't want to be termed mere dispensers and are keen to undertake a bigger role. Fortunately for me, I have a lot of new pharmacists..training up and joining up as the older ones retire and make way.'

Jayesh also lends his support to the Medway School of Pharmacy whereby first and second year students from the School have been training in his pharmacies for the last three years. He also has one of his pharmacists visiting the School and giving a lecture to first-year students every year.

'We not only train students but also our own staff. We have our own pharmacy training, dispensing training and counter training that we pay for but get an outsider to deliver. We normally hold three to four of such events every year and we've asked a law company from London to provide training to our staff regarding the Responsible Pharmacist regulation coming up later this year.'

Despite improved performance complementing the growth, Jayesh has adopted a cautious approach for the future. We try not to acquire new pharmacies but see if we can get new contracts. We've not rapidly expanded into a group of 30 to 40 pharmacies and rack up huge debts but waited for opportunities and rather than paying someone for the goodwill, we create our own.'

A goodwill that has landed awards, recognition and acknowledgement and by the looks of things, it may well carry on for quite some time.

Jayesh's advice to all..
A lot of my colleagues, even with single pharmacies, have embraced the change really well and are adopting to it really well as well. Therefore, if you don't follow suit, your income will drop, you won't earn as much as you used to and you'll be left behind. There might come a time when you'll be forced to do these services and if you don't, the PCTs may decide to withdraw your contract in the future.

This is a forward-looking contract. I see now reason why pharmacists can't adapt. You have to find time and do all the services the PCTs have asked you to do. You also need to delegate to a senior staff. Carry out MURs as they can now be done online. Most of the paperwork can now be done online as well so you have no excuse not to do it.

Be very prudent in your business relationship and cases as the current economy should make you think think twice before going into business. The current economic climate doesn't give anyone any confidence, especially when it comes to newly-qualified pharmacists. Therefore, it is quite risky to invest in a new venture. Everyone is cutting back and the best advice would be to work as hard as possible for now. You should save as much as you can, get enough cash behind you so if you have a very strong biz plan and you went to the bank or a financial institution, first thing they look at is how much of your own capital are you willing to risk. The more you have the better your case becomes.

Then you have a better chance of fighting the nationals as well.

© Faras Ghani 2009
Published in Pharmacy Business July 2009

Steadying the ship


In a time of tumultuous change, pharmacists are repeatedly advised by industry experts to adapt the change into their businesses in order to stay afloat. Pharmacy Business reports a similar message that was delivered at the CAMRx Convention 2009 as it eased the growing concerns and reminded individuals to watch out for the 'ice-berg'...

In times when the profession is moving forward with more and more responsibilities handed over to a pharmacist – with customers more inclined to showing up at pharmacies rather than GP surgeries – industry experts are worried at a lack of planning on the individuals' part.

According to Rajni Hindocha, managing director of CAMRx, goals that pharmacists set themselves are not clear enough; Progress, by the looks of it, is not measured or specific; The fun element of work is missing. And as attendees at the CAMRx Convention 2009, held in Southampton last month, found out that knowing what to do was not enough and it was important to do what is known by remembering that a small effort can end up in giant results.

Apart from Hindocha, speakers at the convention included Jonathan Mason, national clinical director for Primary Care and Community Pharmacy DoH; Rob Darracott, chief executive of Company Chemists' Association; Mike Holden, chief officer of Isle of Wight Pharmaceutical Committee; Stuart Ward, clinical director of NHS Hampshire; Fin McCaul, chairman of Independent Pharmacy Federation; Arthur Daines, associate director CAMRx.

With the conference adapting a Titanic theme, Daines aptly launched the event by reminding delegates, and the greater pharmacy profession in general, that it is easy to sit back and laud the strengths while forgetting weaknesses and the 'invisible' factors that are hurting businesses.

'While pharmacists are easily accessible – at the heart of the community – and offer fast and efficient service, they are affected by internal problems such as poor delegation of work and reluctance to change that, ultimately, affects the business in general,' Daines said. 'We also offer instant and friendly service, without the customer having to book an appointment, poor marketing and time management as well as lack of training and development within the business may bring all the good work down quite easily.'

Echoing the message, McCaul spoke about how pharmacists need to realise the objective and harness the opportunity. Passing on his pointers for survival, he stressed that pharmacists need to accept that change was inevitable and rather than opposing it, they must adapt it and share paths.

'The other thing to remember is the current economic situation,'McCaul said. 'The financial roller-coaster is here to stay and we need to prepare and maintain an adaptable business plan that takes into account how the financial world is shaping up.

'While keeping one eye on the market situation, we also need to ensure that we introduce budgeting and forecasts into the business plan and prepare something that impresses the funding banks and wholesalers. In the end, you must ensure that you measure what you do, measure the progress you've made and list the drawbacks in order to be successful.'

Citing the iceberg example, McCaul reminded pharmacists that it was only known issues that were visible on the surface and easy to tackle. The 'hidden part of the iceberg, one that causes most damage' is generally invisible to the naked eye and cause the most damage if not countered.

'Personalities, emotions, hidden issues from the past, interests, needs and desires are all issues that can damage the business if not tackled. There is also the hidden expectation, self perception and self esteem that needs to be looked at for the business to be successful,' he added.

Highlighting the strength and popularity of community pharmacy in the recent years, Darracott said that the number of prescriptions dispensed in community pharmacy has increased by 53 per cent in the last nine years. The value of the prescriptions dispensed has increased considerably as well; 91.7 per cent rise in the last ten years to just over £8,000m.

Alluding to the strengths of community pharmacies, Darracott highlighted its position to reach healthy and well people as well as adding value to existing patient interaction that involves medication something pharmacists need to utilise effectively.

'With that in mind, we need to work together with practitioners, our partners in delivery,' Darracott said. 'Working together on shared goals and shared vision will only help the profession move forward. Pharmacy bodies' work on the White Paper is an example but others need to be engaged. It's a welcome first step in the right direction.'

The idea of collaborative working was explained further by Ward, a GP himself who started with the reminder that primary care is not restricted to GPs alone as it covers a number of trusted professions, namely dentists, optometrists and pharmacists since these professions have the first contact with the population.

'The number of patients is increasing and they are becoming more demanding,' Ward said. 'In order to manage this, healthcare messages need to be aligned. Working as a team will reduce workload, stress and improve your life as well as the patients'.

'The simplest way of improving standards is to utilise the MURs and use them imaginatively, minimise waste, maximise efficiency of repeat prescribing and ensure safe prescribing.' Ward added.

By following the basic guidelines and working together, according to him, the profession can provide better healthcare, develop new services, reduce hassle and annoyance and make life easier for all parties concerned.

As the word 'fun' echoed around the business session, used repeatedly by Hindocha to emphasise its need in a pharmacy, it was deemed important show delegates a glimpse of that. And as the business session terminated with the message of enjoying work, ensuring it does not become a burden, a Titanic-themed gala dinner followed with attendees urged to spark a moment of change in their respective pharmacies the next time they enter them.

Adapting to the change
Since we are surrounded by a huge amount of change, it is essential to provide this kind of support otherwise people are set in their habits. We do this by ensuring that they adopt to the new direction of travel. The major shift from supply to service function means that you need to change your behaviour as well as how you are going to work with the whole team, the interaction, especially, has to change.

We have been getting feedback from our members with regards to our conventions and roadshows and they have been excellent. We are glad to be of help to our members by providing this interaction that helps them to understand that it is just not their problem, it exists across the boards. Since these pharmacists work in silence, they think it's their problem only. Interaction and an event such as this helps break the ice teaches them how to work smartly. They talk to to each other, they talk to us, and they get a full message of interdependency between multiples, independents and the professionals.

Although we compete with each other, we have to learn to work in partnership and while we compete, we should be able to create our own USPs. That's also the overall message — to work in partnership because we have a backdrop of monopoly purchase of services. If we can't be united then we will end up as the biggest losers. We only have one purchaser, if we're united then we will be seen to be one provider and therefore the profession needs to unite.

CAMRx itself is in a very strong position. We are not about numbers but about quality and support. There exists passion in the centre, a quality service that we provide and how best we can support our members' businesses.

R Hindocha
Managing director, CAMRx

© Faras Ghani 2009
Published in Pharmacy Business July 2009

The travel bug


With international travels increasing considerably, there exists a worrying lack of awareness within travellers with regards to vaccinations. As swine flu grows from a few worrying cases into a pandemic, a recent briefing into travel vaccines passed on the experts' concerns...

The ease of travel in the current age has been blamed as a significant reason behind the spread of swine flu (H1N1) as it moved from the first reported cases to pandemic in just five weeks. Despite the global recession that has seemed to affect businesses and individuals globally, and in the UK, there were 68 million trips made abroad by UK residents in the last 12 months.

Worryingly, however, are the results of a TNS survey, showcased in a travel health briefing held in part with Novartis Vaccines, that one in four travellers questioned had no vaccination at all despite travelling to locations where it was required. Of the 334 questioned – of which 110 had visited Asia, 110 had visited Africa and 111 had visited Middle East – 63 per cent spent only half and hour thinking about protecting their health while travelling.

Commenting on the findings, Carol Fraser, representing TNS who carried out the survey, said it was worrying how only one in ten would leave their luggage unprotected but one in four were leaving their health unprotected. She also added that 25 per cent of travellers failed to seek any health advice prior to their travels, thus making themselves more vulnerable to falling ill when abroad.

'What was more surprising that of the 75 per cent that sough medical advice, 7.5 per cent did have the vaccinations that they were advised and a third of those said they were prepared to take the risk,' Fraser added.

According to Dr Richard Dawood, medical director of the Fleet Street Clinic, people were taking advantage of the economic climate and travelling while between jobs or a career change.

'There is a lot of travelling going on right now, especially to exotic locations in Asia and Africa,' Dawood said. 'Travel to Asia has increased three folds in the last 18 years while travel to Africa has doubled in the same period and travel times are less than the incubation period of most diseases.

'Holiday-makers will spend hours choosing their swim-wear or their beach bags or even their flip-flops, but barely minutes thinking about the viruses, bacteria, or other health information and advice that could ruin their trip, or even kill or cripple them. It is therefore advisable for travellers to obtain good health information and advice for each trip from a reliable source.'

The briefing carried a general consensus that a lot more was required by all concerned parties in order to increase public awareness.

The figures speak...
Nearly two-thirds (62%) were holiday-makers while 23% were visiting friends and relatives and 15% were travelling on business.
63% spent less than half and hour thinking about protecting their health and only 3% spent half a day.
25% were no vaccinated against any disease
25% fail to seek any medical advice prior to their travels
Of those that sought advice, 7.5% vaccination that they were advised
Despite 98% being aware of Meningitis, only 16% of those travelling to Africa – known as the Meningitis Belt – were immunised against Meningitis
51% of those visiting Asia were travelling to its rural areas but 34% were unaware of the vaccinations recommended for those areas
TNS survey, 334 respondents

Novartis' H1N1 vaccine production
Novartis has successfully completed the production of the first batch of influenza A(H1N1) vaccine. This vaccine monobulk will be used for pre-clinical evaluation and testing and is also being considered for use in clinical trials. More than 30 governments have made requests to Novartis to supply them with influenza vaccine ingredients.

© Faras Ghani 2009
Published in Pharmacy Business July 2009