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

Focus on the pharmacist

The ninth annual Avicenna Conference in April reminded pharmacists to provide increased, and relevant, services to the patients. In addition to our coverage in the last issue, Pharmacy Business revisits two key presentations from Las Vegas focussing on PIS, Generics and the need for delegation...

Pharmacists are control freaks, Trevor Gore, sales development controller at Reckitt Benckiser, claimed during his presentation in Las Vegas. According to Gore, the urge to undertake every task themselves, and not trusting colleagues and staff, is something that pharmacists need to consider and work on immediately in order to be more productive, both individually and financially for the business.

Presenting the changing face of pharmacy – comparing the trends in 1999 to how things stand in 2009 – Gore stated that ten years ago, majority of pharmacies were independent, had a single GB contract and had central funding. While the contracts were based on supply, location was the key for pharmacies back then.

However, according to Gore, since the turn of the century, not only are majority of pharmacies multiple-owned, but the focus has shifted drastically towards services of relevance to the community. He also added that there now exists local funding, devolved contracts and the contract is based on service provision.

'Judging by the changing face of pharmacy, it is important that pharmacists provide the services that are relevant to the locality and are financially beneficial for the business,' Gore said. 'However, what we see now is pharmacists providing services that have no value in the eyes of customers. They provide those services because they think it's good for the customers but in reality, you're not catering to the audience.

'Don't sell what you've got. Instead, sell what they want,' was the services-related message sent out by Gore to not only the 100-plus attendees at the Conference but also the pharmacy world in general. He also urged pharmacists to 'drop the admin tasks', something that the professionals are keen on performing in their pharmacies, as that was not why they took up the profession in the first place.

'Pharmacists did not become pharmacists to be a book-keeper, or even a dispenser. Robots can do all that and there is no need to qualified pharmacists, entrepreneurs, to be delving so much time into book-keeping and dispensing as there are far better things they need to be involved in.'

With regards to efficient time-management, Gore emphasised on the great role staff training and delegation plays in improving the overall standard of the pharmacy, in terms of customer service as well as improving the financial side of the business.

'You need good staff. They are your biggest asset. You also need to spot business patterns and act accordingly. In order to achieve that, you need to define the task, select the individual or the team, depending on the task, and asses the ability and training needs before assigning the task.

'When dealing with staff, you need to define success and measurements and what resources are required and will be utilised for the tasks to be carried out. It is important that adequate planning is done beforehand otherwise the time and resources spent on delivering on time will be wasted in the end.'

There is also a great need to ensure pharmacists provide the support and have a thorough communication process while staff is busy undertaking the tasks, according to Gore.

Gore also cited the Pareto Principle to encourage pharmacists to invest time wisely and where it is needed the most.

'As, according to the Principle, also known as the 80/20 rule, eight per cent of your time spent working on something produces twenty per cent of your results. Looking at that closely, it would simply mean that twenty per cent of your time therefore delivers eight per cent of your work. It is imperative to look closely at that twenty per cent of time that you spend working on tasks.

'You need to put the right things in the right order in the right amount of time, basically. And moving forward, it would also hold true for the services you offer. There is no need to offer an array of services that you might think are relevant to the community.'

Earlier, Bharat Shah, managing director of Sigma Pharmaceuticals, delivered a timely reminder into the need and benefits of parallel distribution.

'Parallel distribution allows original, innovative medicines to be available at a lower cost to the patient,' he said. 'Parallel distribution also enhances competition, ensures internal supply chain assurances and external regulatory checks for patient safety and gives pharmacists and patients a choice.

'Adding to that, parallel distribution supports existing medicines distribution systems and the distribution creates new businesses and new jobs and improves margins for pharmacies.'

Bharat Shah also touched upon Parallel Imports (PIs) and assured one and all that PIs are a completely legal economic activity, re-affirmed many times both by the European Commission and by the European Courts.

'The PIs are exclusively limited to the borders of the EEA (27 member states of European Union plus Norway, Iceland and Liechtenstein) as regards both source and destination and it is where the parallel distributors hold wholesaling and manufacturing authorisations and deal in authorised medicines only with other parties holding wholesaling and/or manufacturing authorisations.'

Detailing the basic principles behind parallel imports, he said that each and every parallel-distributed medicine is tightly controlled by national and European regulatory authorities (either under a national marketing authorisation, or under European parallel distribution notice).

'In the UK, BAEPD represents a trade association representing 12 of the largest and longest-established parallel distributors of EU imported medicines in UK. There exist seven major legal basis of Parallel distribution – major and foremost Treaty of Rome: ‘free movement’ principle/exhaustion of IP rights.'

Shah also took time out to introduce and explain the basics of SigXchange, where the seller lists item and/or responds to a requested item. Once the enquiry is made, Sigma contacts seller and buyer before collecting goods from seller and delivering to the buyer. The lead time, according to Shah, was usually 24 to 48 hours and the fee the seller is charged depends upon the seller's monthly spend on SigXchange. For example, a seller with a monthly spend of less than £2,500 will be charged a handling fee of 12.5 per cent whereas a handling fee of ten per cent will be charged is the seller's monthly spend exceeds £2,500

'It is astonishing that an average pharmacy has approximately ten per cent dead stock lying within the premises. Therefore, SigXchange provides an opportunity for pharmacies to get rid of that dead stock and make money on it rather than leaving it there.'

Shah also summarised the world of generics and the issues surrounding the industry.

'Approximately £1.4bn taken out in last four years and almost a billion pounds directed to services which means the balance is lost forever. It started with 478 products and now stands at 515 with the minimum price of generic being 80p (subject to revision). Approximately 110 Category M product above brands. Cat M, in fact, is three to six months behind market prices and there is no way we can have a generic product less than 80p after Cat M.'

The concluding message given out by both presenters was to encourage pharmacists to take time out of their routine tasks and see what is really happening in the world of pharmacy. With pharmacists stuck dispensing and undertaking admin tasks, it will not be possible for them to undertake all that.

© Faras Ghani 2009
Published in Pharmacy Business June 2009

The love affair

Prakash Patel fell in love with pharmacy as a young customer. Moving from Zambia to England to pursue his love further, Patel now owns four east London pharmacies. From a youngster to the Pharmacy Business Entrepreneur of the Year 2008, he shares all with Faras Ghani...

Owning his own pharmacy at the age of 21, that was the top entry on Prakash Patel's to-do list as a pre-reg. Not many aim for such heights in early days and the ones that do are not taken seriously by sellers. Fortunately for Patel – aided in part by his determination and conscientiousness – one seller did, albeit for an east-London pharmacy, and Patel has not looked back since.

'I was still young at that time and based in north London so when I spoke to people about this opportunity in east London, I had cold water poured over it and I was advised to stay away from it,' Patel said. 'However, pharmacy is a patient-oriented profession and east London was poorly supplied. The prices were much lower compared to the north and since I did not have a huge capital base, I wanted to buy something that I could effectively build up.'

Building up his dreams from a young age, Patel was particularly influenced by the clean and professional image a pharmacy had. Visiting several pharmacies in his native Zambia, Patel was impressed the pharmacist wearing a white coat and decided on a 'career that was well-respected and something that the public looked up to'.

It was not easy fulfilling his dreams though, as Patel explained. Following his move to the UK in 1974, the school he attended did not offer GCSEs and despite continued insistence, Patel, together with five other adamant individuals, would need at least 75 per cent in their mock exams to be put forward for GCSEs by the head-teacher.

'I knew that I had a very slim chance of achieving what I wanted without GCSEs but luckily that all went through fine until my pre-reg year when I was quite short on funds. The fact that I also wanted to buy my own pharmacy within six months of qualifying, I worked at another pharmacy till midnight, saving as I earned.

'You had to put down 30 to 40 per cent of equity down to buy a pharmacy and even at that age, I was quite committed. I would go through listings to pick out interesting ventures in the areas I was looking at but at times had to clarify my genuine interest to the sellers due to my age.'

With a keen eye for business from a young age as well, Patel knew early on that in order to reach the goals, he would need a lot of capital and would have to put aside majority of his earnings. 'Luckily, I was a single person at that time and did not have many expenses so was quite easily able to put away a chunk of what I was earning at that time. '

The helpful interest rates at that time also helped Patel and when he turned up for his appointment with the bank manager with his business projections ready, his 75 per cent loan application was approved. 'I told him I had done my projection and by that the business will definitely be able to support the loan . And all the hard work paid off then.'

Although his first acquisition, and the following three later on, was based in East London, Patel was convinced that he had what it would take for the business to flourish – an interest in caring for the patients. Which is probably the reason why Patel now owns four pharmacies, all based in east London. While he runs around taking care of all four, he has ensured effective delegation while keeping his clinical knowledge in constant use.

'I have managers at all four of my pharmacies but since they do five days a week, I'm on the shopfloor during their time off. I get to stay in touch with what I learn at pharmacy school while also planning ahead for the businesses. I actively actively participate on the PCT and am also the vice chair for the Propharm group. So all in all, I keep myself busy and am quite excited in the direction this profession is taking.'

Excited and confident, which is why Patel has got his family involved in the pharmacy profession. His eldest daughter and her fiancé are both pharmacists. The second daughter is currently studying at pharmacy school and his nephew, niece, and nephew's wife are all in the same profession. 'It probably has become a family business,' Patel joked.

But he is also quite excited at how pharmacy is progressing through the current climate, from the talks of a new body to all the other changes taking place.

'The profession is moving forward as a service-based profession. The ones able to lock into services will be successful. Pharmacists one of the most trusted professionals according to a recent survey and If we believe in that, that is our biggest asset. To achieve success, it is important that pharmacists go out and be the face of pharmacy, not be stuck dispensing but be in the front where patients can see them.'

It is perhaps the inclination towards being seen that led Patel towards applying for, and winning, the Pharmacy Business Entrepreneur of the Year Award 2008.

'Our pharmacy won an award for our stop-smoking service as we were putting up consistent figures in the area. One of the PCT members nominated us for the Awards and I didn't know I was going to win as the competition was really healthy. However, upon receiving the Award I was really chuffed as it was a pleasant surprise, something I really treasure quite a lot and it did put a big cherry on top of what I've achieved so far.'

Patel offers free MURs and prescription collection and drop-services at all his pharmacies, and have been providing the latter since the 1970s. 'From a person on a bicycle, we now have three delivery drivers and provide free drop-offs. The patient can either phone us or tell us what surgery the prescription is at, we pick it up..get it delivered in a radius of five miles. It's mostly for eldery patients who can't venture out to pharmacies regularly or for the working ones, who are at work till late in the evening.'

Offering free MURs not only helps us achieve the target of 400, but also allows us to interact with customers and offer the best advice and guidance. The PCT has given some sort of criteria: Those on medical conditions, long-term conditions, where pharmacists intervention would be good. Those are the ones we concentrate on and last year we achieved target of 400 at all our pharmacies.

'We have also included an incentive for our pharmacists as well which obviously helps the whole process. It orks well with counter staff as well and the patient benefits in the end too.'

'While our pharmacists are really busy, we've allocated different tasks to different staff so that frees up the pharmacists' time and that allows them to undertake the MURs.'

Despite having the business, its development, training and staff to look after, Patel still gets time to look into how the profession is shaping up, and support Arsenal in their home games as well.

Speaking of the new professional body, Patel agreed that it had caused 'a lot of uncertainty in the profession and has brought a lot of worry.'

'I think whatever happens, it's important that leaders in the pharmacy field get behind the people who are in the know. There is some apathy in the profession as well and voting was quite poor in the last elections. It's imp that each pharmacist takes responsibility in the profession if they want to take the profession forward. We need right leaders with the right vision, to steer the profession forward.'

Confident and in love with his profession? Most definitely. 'It's a profession I'm absolutely keen for. In another life I'd probably come back as a pharmacist as well.'

© Faras Ghani 2009
Published in Pharmacy Business June 2009

Change of guards

Tony Mottram joined Numark last November as its commercial director, a new role created by the interim managing director John D'arcy as he thought the business needed a 'second role for it to be effectively operational'. Not a pharmacist by profession, Mottram joined the pharmaceutical industry as a sales representative for Pfizer at the age of 22 and has spent the last 18 years working his way up at Ivax, Ashbourne Pharmaceuticals and Napp Pharmaceuticals, where he spent ten years.

Trained as a medic after joining the forces, it seemed a natural fit to follow a pharmaceutical path, according to Mottram. Wanting to go into a sales role, he also spent a few months at a bank, coming up to grasp with the requirements of the finance world before joining Pfizer.

Appointed commercial director at Numark – to ensure that the business operated the right way commercially, as he put it – Mottram answers questions related to the Nucare takeover, Numark's business model, how life will change following his promotion and the benefits pharmacists can obtain by joining hands with him.

The Adolf Merckle suicide made headlines soon after you joined Numark. Was that a difficult period for you and the business and was Numark as a business affected greatly?
The loss of anybody will have an impact on certain parts of the business at a senior level. However, we are a credible business in the UK as well as being sustainable. Phoenix might change ownership in the future, nobody can say yes or no at this point in time but I can confirm that it's a solid business as things stand.

Following your appointment as the managing director, how will your job change on a day-to-day basis?
It's a bit difficult to say what changes will be made right now. John D'arcy and myself, we worked closely and he gave me a brief of what he wanted. My job is in the title: managing director. I need to manage the business and ensure it heads in the right director and making sure people are directed in order to deliver what is required. As we move forward, I'll be working with the Numark board to ensure we head in the right direction.

When I joined, the team at Numark underwent a review of where we're at. We have clear aims, what is it that we're about and what we want to do. Each department has tactics that seem to be working well. I don't think I need to change anything if we're going in the right direction. There are a few things to develop and that is all work-in-progress. Our aim to create a profitable and sustainable independent pharmacy. But, as before, I won't be making any changes in the way this business is run as I believe we're heading in the right direction, aptly depicted by our membership numbers which are at its peak right now.

Phoenix took over Nucare in 2007. How easy was the transition for Nucare members and what percentage of members did you manage to bring into Numark?
We managed to retain 33 per cent of Nucare membership into Numark. For me it's irrelevant whether you're a Nucare member or a Numark member. You need to belong to an organisation which is going to lead and support you in the delivery of your business model. If you can't have a commercial deal with the wholesaler and if you're not prepared to move the wholesaler, then it is what it is.

A lot of pharmacists cited high membership fee as a reason for not joining Numark. How would you justify the £100 per month fee?
The £100 membership fee has been in existence for a long time. Nucare member wishing to join Numark were given discount but that was through a rebate. This fee is paid by 2,067 members and the members who access a range of services will get about £1,400 in rebate. You need to access what we offer in order to justify the fee. If you merely pay the fee and not engage and utilise what we can do for your business then you're not going to benefit.

How would you then convince pharmacists to join Numark?
The answer's quite straightforward. Independent pharmacy is in a massive place of change. It is very difficult at times to see the opportunity in front of you and develop your business locally to make it happen for you.

Numark offers a range of services and solutions which you need to engage in to maximise benefits. The more you access Numark, the fitter you and your team will become. It's a difficult time for pharmacy and we provide strategies that you can implement locally in order to be successful.

Our USP is the pedigree of delivery. We have sustainability in the business and have delivered to our members Some members leave because they don't see value in being a member. That is because they do not access what we do and provide. On the other hand, we get new members because they see a potential of what we can do for them.

Is there assistance provided to members when it comes to tendering for services?
We have provided assistance with a number of members on an individual basis, and with success. Our professional services team does a lot to support members who are in a position to commission for positions. It's something that as a model we're developing to offer to a broader base of the membership. Tender assistance includes key therapy areas such as vascular checks, diabetes care and weight management.

We will support individual members with individual service submission or tenders. The key thing is that we have members who understand how to develop a service and we have members who have a will to develop services but don't know how to do it. So we can help both types.

Merchandising has been cited as a key issue for pharmacists, something they don't pay much attention it. Does Numark offer support in that area as well?
Merchandising is indeed a key area. Pharmacists need to make themselves appealing on the high street and that is what will attract customers inside the shop. Once inside, whether it's consumer or around prescription side, the merchandising has to be spot on as providing relevant products in the right areas will increase basket spend. That is part of our role, to help improve the OTC element.

You mentioned appealing to customers on the high street. Has re-branding from a chemist to a Numark store helped increase sales?
Yes, it has. We collect data for re-branding and it not only increases the OTC sales but also affects prescription side of things as well. The model would suggest that the change has attracted new customers that have turned into patients. We have a team of pharmacy development managers whose job is to do a full business review for any member who wants to pay for that service. Out of that review, they'll get an action plan which will be marketing commercial and services. We analyse the complete pharmacy environment to competitors, surgeries and how the existing customers perceive the business to be. This business review is like a ten-step plan to improve their overall profitability and sustainability.

Do you get regular feedback from members and do you get time to visit them personally?
I have undertaken 64 member visits in the last three months. One thing I said when I joined Numark was that I'd be accessible as I work for the members. I don't sit in office and become unapproachable. I will see them and sit down with them and help them and my team make their business work for them. I need to be visible to members and I am. However, I also have a responsibility to direct the business in the right way so there might be a change in the number of visits undertaken as I am only one man. Having said that, I have a very strong and professional team with a very strong skill-set. Pharmacists aren't scared to approach me, and they shouldn't be. They pay a membership fee and if they knock on our doors and ask for help, we will do our best to provide that.

Does staff training come as part of Numark membership?
Training has been part of Numark's pedigree for years and years. We have always been a strong organisation in leading, training and developing people. We hold 32 training events per year which are free to members and their teams. The focus of these events lies on relevant skill-set and business needs. We give the owners some skills and knowledge to effect changes. They know how to dispense. Where they need help is being a manager, a coach and a leader. Sometimes they need help stepping back, refuse the urge to fix all the problems themselves.

Do members have a choice to buy from other places or are they restricted by a membership contract?
Membership is about choice. Our job commercially is to negotiate preferred deals with suppliers and source those deals. The member always has a choice where to buy their products from. But if we've done the right thing by negotiating a good commercial deal that gives profitability to members and business growth to manufacturers and suppliers, then it's a no-brainer they should be buying form our deal. If they choose not to then it goes back to what do I get from my £100.

We have compliant members who make in excess of £8, 500 per month in terms of rebate. They understand the model and deals we have and they lock into it. We negotiate on behalf of the members and we work for them.

What advice then would you give to pharmacists having problems in the current economic conditions?
Have a plan. If you don't know where you're going, you'll end up somewhere else. You need to find time to make a plan. Make sure you have the right staff, you train them well and develop them in the right way.

You don't need to constantly change plans. Have one eye on the climate and acclimatise to it. Only engage with new services if they are relevant to you, for example there is no point jumping on a bandwagon for diabetic service if you don't have diabetic patients. You need to asses whether it's relevant or not to your locality.

© Faras Ghani 2009
Published in Pharmacy Business June 2009

Quick off the blocks

Aniket Parikh joined Clockwork Pharmacy straight after his pre-reg year. Brimming with ideas and enthusiasm, he undertook extra responsibilities and remained active right from the start. Faras Ghani examines his route to success, the Pharmacy Business Newcomer Award 2008, despite his recent arrival into the profession...

As with most students embarking upon university life in their late teens, Aniket Parikh too was not quite sure of the future. While a science-related career seemed almost certain, particulars and the exact path that he would followed stayed unclear.

‘Due to the uncertainty, I did some research into different professions I could go into and realised pharmacy was one of a change,’ Parikh said. ‘I wanted to be part of something which was in transition and where I could make an impact and that is what decided it for me. I had a feeling that I can make a difference and take it to another level and that is probably the main factor that brought me into pharmacy.’

True to his word, Parikh managed to take it to another level and only a year and a half into the profession, he became the winner of the Pharmacy Business Newcomer Award 2008. Despite being new in the field, Parikh became one of the most active pharmacists in the area while also improving the design of his pharmacy to make it more customer friendly.

‘It was weird how the journey to receiving the award began,’ Parikh said. ‘My dispenser had applied for an award and was being interviewed with regards to that. I got talking to the interviewer and told him about my daily routine and day-to-day tasks that I carry out and all of a sudden he told me to apply for an award myself as he seemed quite impressed.

‘I had thought about applying but just hadn’t gotten round to filling out the forms. However, this push was what I needed and I went ahead and filled out the forms. That is all history now and here I am with the award.’

Although Parikh did not expect to win the award – have we not heard that before? – he, and his staff and customers, felt really proud of the effort, especially considering his rawness in the profession. ‘I’m really modest so I didn’t really shout across the floor that I had won an award. But I’m quite proud of my achievement actually. In the short space that I’ve been practicing, to win an award is quite pleasing. It did take a while to sink in but I feel very, very proud.’

Despite the award, it has not been all that easy for Parikh since stepping into the real world.

‘The real world of pharmacy is completely different from what we learnt about at university. While at college or university you can’t really tell what it will be like after you graduate.’

Terming people skills as the biggest requirement in order to effectively deal with customers, Parikh was wary of the fact that it was not taught during the course. ‘That [people skills] just comes with experience to be honest and you learn that with time.

‘In that sense, university doesn’t really prepare you for the real world and customers. Also, the scientific knowledge that you gained over the years, you don’t really need much of that during your daily tasks here at the pharmacy. You tend to keep that at the back of your head and hope it comes in handy when required.’

While Parikh enjoys the business aspect of running a pharmacy, he is more keen on providing increased services to his patients that walk through the pharmacy doors. Terming himself a people person, he loves interacting with patients and building a strong relationship with the community as a result. ‘I think that is where the profession is heading as well [towards the services side] rather than being stuck dispensing all day long.’

Considering himself lucky in the sense that his script numbers are generally lower than a lot of other colleagues, Parikh can, as a result, concentrate on providing the various services in his pharmacy. ‘I see someone who is doing five to seven thousand prescriptions per month and I can understand how they find it difficult to concentrate on other tasks and services. I think that is something that needs to be ironed out.’

Although wanting a greater role in public healthcare for pharmacists, Parikh admitted the rewards should complement the work done. ‘Although it is beneficial for the profession as well as the individual that an increased number of services are being offered, the reward does seem unfair. I like the fact that I’m doing more and more for the patients but at the same time would like some sort of reward.

‘The GPs are rewarded highly for work they do, and quite rightly so. But I think emphasis should be put on the pharmacy sector as well.’

Terming MURs a great way of interacting with and getting to know the patients, Parikh reminded fellow pharmacists of the reward they carry as well. ‘It is labouring in terms of all the paperwork that follows the consultation and it can affect the number of MURs a pharmacist carries out. However, it is a useful act to carry out and enables you to get involved with patient care on a higher level. It also gives you more of a voice than the GP.’

Despite being low on his own MUR numbers, Parikh has indeed planned an improvement in the coming weeks, trying to balance pharmacy life with the dispensing and the services he provides. ‘Sometimes it can happen that I advise patients verbally but don’t get time to do the paperwork, especially during busy times. That is something that I can relate to. However, there are always quiet periods where you can go and do all the paperwork and make sure the verbal consultation is accounted for.’

Parikh, although being successful at everything he has done so far, is wary of his rawness to the field. Content with establishing himself as a pharmacist before chasing up his other ideas, including an enhanced diabetes management role, he has left much of the shopfloor aspect of the pharmacy to the more experienced staff that he has.

‘When I started work here, the pharmacy was well established anyway. I did bring in a few ideas for the front and the displays, as well as useful information leaflets from the PCTs. It’s still quite early on in my career and I'm still trying to establish myself as a pharmacist. Therefore, for me it’s more important to focus on the pharmacy side which is why I tend to leave shopfloor staff to take care of their sections. I will take on a more active role in the business side of the pharmacy but that will come later.

‘The other side of my profession I’d like to get involved is diabetes management. I come across a lot of patients with diabetes so some time in the future I’d like to branch out in that direction. Obesity, too, is a huge issue nowadays and it is something like that I’d devote more time to in the future.’

Critical of the new pharmacy bodies to be launched next year, Parikh feels that things are too vague as they stand. ‘In theory I think it’s a good thing as I feel strongly about pharmacy having a strong voice, one that is widely recognised and appreciated. And, if by the current setup that is achieved, then that can only mean it’s beneficial for the profession. But like I said, that’s in theory as things are really vague at the moment and I don’t really know how it’s going to work out.’

Moving forward, Parikh insisted new roles and responsibilities for pharmacists was a given vision. ‘You have pharmacists with a special interest, something they enjoy doing more than the rest. That will enable a more effective community service and a prominent role of pharmacists in the society. Therefore, as a profession, it’s definitely moving in the right direction.’

As for his own direction, Parikh – who got married recently – is busy balancing his nine-to-seven work life with time for his personal life, including sports.

‘You can’t just work 60 hours a week and not have time for yourself. If you work during the week, take the weekend off to recharge yourself. Enjoy things that you really enjoy and that will help your work life as well.’

© Faras Ghani 2009
Published in Pharmacy Business May 2009

A note from Vegas

Over 100 delegates flew across the Atlantic for the ninth annual Avicenna Conference held last month. While the emphasis remained on providing increased, and relevant, services to the patients, the future of healthcare in the UK was also looked upon as well as the impact of IT on the pharmacy sector. Faras Ghani revisits the business sessions, complemented aptly by the social events in Las Vegas...

Emphasis on providing increased services was the aim of the ninth annual Avicenna Conference in Las Vegas last month. Salim Jetha, Avicenna’s CEO, made this point very clear by repeatedly uttering ‘services, services, services’ before explaining how that is the way forward for not only the members but also pharmacy in general.

While speakers presented on a variety of topics ranging from generics, parallel imports (PIs), and implementation of technology in the business to discussing the Health Bill 2009, it was the ‘services for the future’ message that was highlighted throughout both sessions.

Sharing results from a survey undertaken recently by Avicenna, Jetha said that the biggest issues facing the pharmacy world were stress, Category M and administration burden. ‘While the financial and time-management issues are weighing pharmacists down greatly – with both being inter-related – you need to ensure that your time is spent in the correct places,’ he said.

The message – of freeing up valuable time to spend on more effective tasks for the business – was echoed around the hall by Trevor Gore, sales development controller at Reckitt Benckiser, as well. ‘Pharmacists are control freaks,’ Gore said. ‘You need to drop all the administration tasks and cut down on dispensing as well. That is not why you became pharmacists. Book-keeping and dispensing can be done by computer programs and robot. You need to invest time offering services that hold value for the patients, delegate tasks and inform your staff – your biggest asset – of news shaping the pharmacy world.’

Earlier, Bharat Shah, managing director Sigma Pharmaceuticals, highlighted issues facing independent pharmacies following the changes in the NHS pricing and commissioning. The absence of a mid-term review, supply shortages, on-going margins inquiry, and the lack of price per dose were some of the concerns raised in the presentation.

Keeping in line with the concerns, Shaun McCormick, direct of sales (south) for Cordia Healthcare Group, termed 2008 as the ‘year of tumultuous change’. ‘We have witnessed a worsening exchange rate, generic price deflation, and fierce competition among shortliners,’ McCormick said. ‘With PIs falling away, less time should be spent on price negotiation and more on offering increased services in order to survive.’

The emphasis on undertaking more and more MURs was also emphatically delivered to the attendees by a majority of the speakers. It was not just the financial benefits that pharmacists can obtain by undertaking the reviews but also place trust in patients’ minds and ensure pharmacy becomes the first stop for health-related queries.

Terming the conference a great success, David Gration, chairman Avicenna, predicted a strong showing from Avicenna in the coming months and remained optimistic of its continued upward performance despite the economic gloom engulfing the world.

View from the top
Pharmacy is a very isolated profession and seldom do pharmacists get a chance to network and interact with their colleagues. One of the objectives of this conference was to allow pharmacists with an opportunity to do exactly that. And learn from each other. The other objective was to hear from and talk to industry experts which will benefit them greatly. We also tend to involve business with fun because pharmacists are always discussing work so we thought we’ll make this enjoyable for them. It acts as a useful bonding exercise and the conference turned out to be a one big family affair. Listening to comments from the attendees, it was welcoming to hear what is going on nationally as well as across the Atlantic, as portrayed by our speakers from USA and Canada. From the business sessions, I’d ideally want our members to go back and realise that to stay in the game, yesterday’s work practice will not suffice. They need to consider new things – this is where services come in – and new innovations. The industry is heavily burdened via administration tasks and I would advise pharmacists to release the time spent on those tasks and utilise for tasks beneficial for their own self and the business. There is a general consensus that we need to work together; adopting an interdependent model rather than an independent model. The need to get together and discuss issues was greatly felt and this conference has allowed us just that. Salim Jetha CEO Avicenna plc


It’s Vegas, baby
The conference is not just about business networking and presentations, Salim Jetha, Avicenna’s CEO, had made it clear prior to the event. He wanted the members, having endured the 11-hour flight from Gatwick to McCarran International with their families, to experience a family atmosphere and enjoy their stay.

Judging by reactions and the looks on everyone’s faces, enjoy it they did. On the menu for the next five days was an Italian dinner amid a Lamborghini galore; a rather drizzly rafting experience down Colorado River drenched not only by the spray (and the rain that we had seem to carry with us across the Atlantic) but also the history of the area; a traditional subcontinent dinner – declared the best he has ever had by Uma Patel, director Avicenna – and drinks on the 51st floor; and a farewell date with the Rat Pack.

In between those and the business sessions was a tour of the Grand Canyon – a must, according to experts, for anyone stopping over in Las Vegas – regular visits to the roulette tables and a walk down the neon-lit Vegas strip.

Welcome change for the pharmacists from the daily hectic rituals and the verbal mauling – albeit justified – they received from the speakers at the business sessions. For the wives – a fair few were partners in their husbands’ business – and children, it was a welcome Easter break. And with Elvis making a surprise visit his presence felt in the house during the farewell dinner, it served energy enough for the long journey back home.

Future of healthcare
‘Direction of travel cannot be changed but it is important for pharmacists to align themselves with the direction’ were Ajit Malhi’s words of wisdom during his presentation at the Avincenna Conference in Leas Vegas. Malhi, director of marketing services at AAH Pharmaceuticals, stressed that the UK health market will undergo major changes as UK’s population increases 12 per cent between 2004 and 2031, especially as the over-65 age group has seen a two per cent increase since 1981.

‘Life expectancy is ten per cent higher than it was in 1960 and over-60s account for 58 per cent of all scripts dispensed,’ Malhi said. ‘On average, thre are 38.4 items dispensed per year for that age-group, much higher when compared to under-60s (that stands at 14.3). The number of elderly patients will rise by 5.5 million by 2040 and will form a huge segment of the healthcare market.’

Speaking from a pharmacist’s point of view – his Saturday mornings are spent in a pharmacy – Malhi, in a similar manner to the preceding speakers, urged others to focus on developing their services. ‘While performing your daily tasks, you also need to focus on aspects of marketing and improve your skillset. You need to take your business into local establishments like schools and engage with NHS and PCTs by talking to them.’

© Faras Ghani 2009
Published in Pharmacy Business May 2009

Curse of the counterfeit

It is estimated that business in counterfeits will be worth £75 billion this year. The ‘Combating counterfeiting’ conference held by the RPSGB highlighted major issues and techniques affecting the industry as well as procedures undertaken to fight against it...

Counterfeit medicines have become a growing global problem. According to the World Health Organisation, sales of counterfeit medicine range from approximately one per cent of sales in developed countries to 10 to 30 per cent in developing countries.

In a recent conference held at the Royal Pharmaceutical Society of Great Britain (RPSGB), industry experts highlighted the intensity of the problem as well as current status of new technologies in order to raise public awareness.

‘The counterfeit drugs are now being made to order and for a range of products instead of a single product,’ Dr John Kerridge, EU regulatory advisor, Eli Lilly & Company, observed at the conference. ‘The trend has gradually moved away from lifestyle drugs a few years ago to life-saving drugs now and that change is of huge concern to everyone.’

Citing examples from raids undertaken frequently, Dr Kerridge emphasised the need for ‘closer look’ as although the ingredients and chemical composition may be far off the mark, the finer details that counterfeiters go through while packaging may make the products hard to identify from the genuine ones.

The same point was illustrated by Dr Tesh Patel, senior director of quality assurance at Astellas Pharma Europe UK, as he displayed striking images comparing genuine and counterfeit packaging. Dr Kerridge also raised the concern surrounding the increase in the number of internet pharmacies that have cropped up in the recent past and although a lot of them carry icons – including VIPPS, RPSGB and Legitscript logos – things may not always be what they seem.

Examples were provided by Jane Nicholson, executive director of the European Industrial Pharmacists Group, of purchases from an online pharmacy that have resulted in deaths. ‘While there exist enforcement problems due to lack of sufficiently trained inspectors and funds for laboratories, we also need to look at legislation governing counterfeit drugs,’ she said while noting that the United Kingdom Medicines Act is now over 40 years old.

Highlighting the Medicines and Healthcare products Regulatory Agency’s (MHRA) battle against counterfeiters and counterfeit products, Nimo Ahmed, head of Intelligence, Enforcement Group at the MHRA, discussed how much importance is being placed on packaging. ‘We have examined computers and found that people from the EU and UK have sent sample packs with details and requested them to be made to order.’ The worrying thing according to Ahmed, however, was the amount of active ingredient in the counterfeit product which depended on the amount of money that was offered.

‘Worryingly, we have seen a lot of professionals, wholesalers, pharmacists, people who have operated in the industry for a number of years and know the system and have observed where the gaps are have then tried to penetrate those gaps.’

Counterfeiters, as Ahmed pointed out, have a great understanding of how the supply chain worked and that has made their task easier. Picking on the same point, Dr Patel highlighted a risky assumption that if a package is secured through the supply chain to the pharmacist, it is assumed that the medication is secure.

Quoting Jim Chrisitan, VP Global Corporate Security at Novartis, Dr Patel said: ‘In almost every case, the technology, be it a hologram, tamper-proof labels, embossing, thermo-reactive ink, RFID tags, DNA markers, and the ikes, enables companies to track cardboard, not product. It is not unsual to find genuine product in counterfeit packaging and counterfeit product in genuine packaging.’

Ahmed also reminded the attendees – as well as wholesalers and pharmacists on the whole – of the MHRA’s 24-hour hotline (020 7084 2701 or by emailing counterfeit@mhra.gsi.gov.uk) where discrepancies and irregularities can be reported.

According to Ahmed, counterfeit products are mostly manufactured in China and can then be dispatched to anywhere in the world. ‘We have had to recall a lot of products targetting the parallel trade market and hence are implementing strategies that also includes speaking to healthcare professionals, doctors and nurses who deal with medicines regularly.’

With a network mapped across the world, Dr Patel admitted it was a difficult task preventing the trafficking of illegal drugs. ‘If we cannot as yet prevent trafficking of illegal drugs why do we think we can prevent counterfeit medicines? However, we may not be able to prevent it, but we can be prepared for it.’

Preparation via vigilance, mass serialisation, and even an international convention, according to the speakers.

© Faras Ghani 2009
Published in Pharmacy Business April 2009

Plan young, aim high

Kishor Ragha’s successful journey as a pharmacist started at a young age. From the days of playing around with chemistry sets to leaving his native country to obtain pharmacy qualifications, Ragha has remained committed and confident. Winner of the Pharmacy Business Clinical Excellence Award 2008, Ragha shares his success trail with Faras Ghani...

In the life of many pharmacists across the country, these are the days of regret. Long working hours, low pay, pressure to provide increasing number of services, and stagnant OTC sales. As a result, many pharmacists are reported to be fed up of the profession, planning a career switch and a rethinking.

With Kishor Ragha, who left his native Zambia in order to pursue a pharmacy career, life is smooth at his Vantage Pharmacy. Growing business, lust for knowledge, striving for improvement, complementing accolades, and a prevailing sense of satisfaction. Developing an interest in pharmacy from a very young age, Ragha’s commitment to what he wanted to achieve has been a driving force behind his success and his achievements.

‘Pharmacy is something I’ve been deeply interested in from a young age,’ he said. ‘Even as a child I had my own experimental sets at home that I would spend time with. Therefore, it is a gradual progression.

‘Although my family wanted me to become a doctor, more so due to the status symbol than anything else, my interest in chemistry and pharmacy was stronger than becoming a doc. And for precisely that reason, I left Zambia to come study in the UK as the University of Zambia did not cater for a pharmacy degree. That is how strong my commitment was towards pharmacy.’

Although Ragha did go back to Zambia after his qualifications to start a pharmaceutical industry, conditions proved adverse for the plans and prompted a swift return to the UK. An interest in industrial pharmacy was what gave birth to those plans initially, but as he realised his zest lies in the business side of things, it was not long before he realised what he was cut out for.

‘It was the clinical side of pharmacy that interested me in the beginning but obviously as you get older and once you have your qualifications, the focus changes slightly. It still remains towards pharmacy but you then narrow down your options.

‘In my case, I narrowed it down to community pharmacy. Following the abandonment of my industry plans in Zambia, I realised I wanted to work in community pharmacy the most and that is the reason I came back.’

It was due to Ragha’s desire to be his own boss that he decided to go into community pharmacy. Signing up with a franchise scheme that AAH had in the early 90s, Ragha developed this interest further and opted to buy out the business as the franchise contract came to an end.

‘Looking after a business is what I’m interested in besides the pharmacist aspect of it. I’d always wanted to be my own boss. I did get offered fantastic salary at the places I worked at in the past but the fact that they were able to offer me that made me think that I’m capable to making much more by just having my own business.

‘I did locum work in central London and worked as a manager for two years following my return from Zambia. While I was still working as a locum, the AAH offer came up and I became one of the few lucky ones to get on board. And when, at the end, I had the option to buy out the business, I didn’t think twice. It was an excellent decision I made and I’ve never looked back since.’

Apart from being the pharmacy owner and the pharmacist at Vantage, Ragha is also a qualified Independent Prescriber and sits on various local committees as well as the LPC. A respect individual among customers and local surgeries, Ragha is contacted by nurses, GPs and patients alike for advice and guidance.

‘I do help out patients in my batch but it does not stop there. The GPs and the nurses would phone me up for advice if they are not 100 per cent sure on something and need a a second opinion. We have that rapport with local GPs that we are quite proud of and we respect each other for that.’

Ragha won the Pharmacy Business Clinical Excellence Award 2008 for his specialisation in the treatment of diabetes. He undertakes the full range of tests for diabetes and also advises patients on how to improve their lifestyle. But how did the interest in diabetes develop?

‘Around five years ago, we had a diabetes improvement scheme is Hillingdon where we undertook basic tests and advised patients over a period of six months. It was so successful that we, as a group, won a care award for that. Working with diabetes then was what got me interested.

‘A Warwick diabetes course came along after that which I enrolled in and passed. So, the more I learnt about diabetes the more fascinated I became and the more I wanted to know. As a result, I wanted to do more than that just prescribing and wanted to look after the patients myself. So I went to King’s College and did my course in supplementary prescribing. Following that, I went further and became and IP the following year so now all the decisions will be mine.

‘I was happy, prepared and confident to make changes to the medication and it was this confidence that drove me.’

Despite having his hands full and complaining that ‘there are not enough hours in the day’ to do what he wants to, Ragha has built up a successful business and he attributes a lot of success to the skills of his staff and the training they underwent.

‘You can’t keep an eye on everything that is happening in the pharmacy. I have dispensing duties as well. Therefore, it is essential that you give staff the ownership of particular sections and product range. Delegation is the key to success but for that to work effectively, adequate training must be provided beforehand and constant review must be undertaken to ensure a common goal is being aimed at.

‘We have regular discussions with staff and at times, even I’m not aware of products they order since I have given them full authority following the training. I followed a similar path en route success and I’m all for giving them ownership and letting them little entrepreneurs.’

Apart from providing diabetes services, Vantage Pharmacy also provides chlamydia screening and smoking cessation services as well as offering the morning-after pill together with the required consultation.

Ragha’s workload is ever increasing. ‘I’m busy all the time, the script numbers have shot through the roof and on average we do 8,000 scripts per month. I can’t possible do all this on my own and that’s where backup and well-trained staff come handy.

‘Without backup, you can’t do all these services and it’s dispensing or the paperwork or services. They all take up a lot of time and the only way you can do this is if you have very good staff.

‘I’m quite happy doing the services since I know other parts of the business are in capable hands. I enjoy dispensing, especially when I’m giving out the medication and as the verbal interaction takes place.’

Despite the workload, Ragha’s interest in diabetes and diabetic patients is on the rise and he is coming up with ideas and advice to help patients all the time.

‘The main aim is to change the patient’s attitude towards diabetes. I change the mindset of that person from day one by giving him/her the ownership of the problem. Put restrictions on and list things they should not be doing. Give them all the facts as opposed to just the medication and I find that this works better.’

Although Ragha has his hands full with dispensing, training and offering services, he still has time to ponder over the future of pharmacy. He envisages it to change no doubt but warns of repercussions with the government’s desire to see more and more services being undertaken by pharmacists that increase the workload. ‘We just don’t have the time. For example, I’m giving advice on MURs verbally and not claiming for it as I do not do the paperwork due to not having much time.

‘With Category M and all that, it has become a political issue that will take time to settle down. It will be tough and you can’t reply on income from dispensing alone. The sooner the colleagues of mine realise that the better.’

Doing so much can sometimes affect the quality offered, something that Ragha was quite wary of. However, the Award provided the confidence that he needed to strive towards improvement in patient care.

‘I never realised my work was of a reasonably high standard until another pharmacist asked me to apply for the award. It was a fantastic evening and, as every other award-winner, I never expected to win it.

‘However, it was really funny because everyone told me, after I had won, that they expected that to happen sooner than later. It is nice to be appreciated and is satisfying when your work gets recognised but I never undertook all the additional work for the sake of an award.

‘I just love helping patients.’

© Faras Ghani 2009
Published in Pharmacy Business April 2009