Big interview: Well super Ifti Khan - ‘We are pure pharmacy’

January is unequivocally the most depressing month of the year. The festive spirit subsides as the guilt treads in for not starting your new year’s resolutions.

But for Well Pharmacy’s superintendent pharmacist Ifti Khan, the month kicks off two anniversaries for him.

His birthday is on January 6, but it’s also a reminder of an important career milestone.

“My birthday coincides with when I started working for the Co-op, and I’m on 21 years now,” he tells C+D (in 2014, Co-op pharmacies was acquired by Well’s parent company, Bestway).

Khan started out as a pharmacist in the early 1990s. Even though he lives in Bolton he’s a Manchester United fan, and he served former United and Wales winger Ryan Giggs when he was a youth player.

“I did my pre-reg for Boots in Swinton and he used to live close by and come in on a Saturday,” he recalls.

Taking on manager positions at the Co-op and being Well’s NHS standards manager for over a decade, he was also a Company Chemists’ Association (CCA) rep for Bury Rochdale LPC and is a Community Pharmacy Greater Manchester LPC board member.

Now, he works closely with Well’s chief retail officer Andrew Caplan and chief executive Greg Pateras.

His role is “setting the professional standards” for 700 pharmacies and ensuring everything Well does is “safe and effective”.

“If there are any changes to our process or the way we are working, that would come through my team.”

The Synmed Ultra machine which automates MDS

Automation

Khan was involved in the final sign off of Well’s “new, state-of-the-art pharmacy” that opened in December in Warrington, which includes a wellness range from Holland & Barrett.

“It’s a very busy pharmacy in a shopping centre, the patients love it because it saves time, and there’s that convenience of round-the-clock collection,” he says, referencing the collection machine that patients can pick up their prescriptions from using a PIN number.

Khan says Well has “half a dozen or so” of these automated machines, and he’s equally proud of the automation happening at Well’s hubs.

Its central fulfilment hub in Stoke was launched in 2019. Khan says its pharmacies send around “65% of repeat prescriptions” through there, but as there are no caps on how much can be sent, some send more depending on their dispensing levels.

After Well bought Knights Pharmacy, which had monitored dosage system (MDS) capability, the multiple expanded its automation even further.

“We introduced MDS dispensing last year that serves around 160 of our pharmacies. Some 40% of our MDS activity goes through there and there are plans to expand that to 60% by the end of February.”

Khan says using MDS and central fulfilment hubs makes dispensing 15 times safer, but it all comes down to Well using these systems to “free up time in our pharmacies”.

Performance

This has been most evident in Well completing a record number of vaccinations in the recent flu season.

“We’ve done more flu vaccines than we did during the height of Covid. When I’ve gone to some of our pharmacies over Christmas it’s been very calm, because a lot of the dispensing has been done elsewhere. It gives the team time to get involved and deliver services.”

With community pharmacy becoming a more services-based business model, Khan is happy there’s more emphasis now for Well’s pharmacists to “spend time operating at the top of their licence”.

“One of the things that used to frustrate the hell out of me was, how can I get into the consultation room and provide more services? We know that’s something pharmacists want to get involved in.

“We create the capacity using the wider team. Our services results for the current financial year have been fantastic.”

Well's new Warrington branch sells vitamins, supplements and wellness essentials (JON SHRIMPTON)

Staff

Something else the superintendent is overseeing this year is skills. Khan says each pharmacy will have its own specific staffing model depending on how busy it is, but one of the first changes under the supervision legislations changes that came in last week has been “a little bit challenging” for him.

“It doesn’t go far enough. The first bit of it, the authorisation of handout, isn’t going to make a material difference. Later in the year when you can authorise technicians to take over the running of the dispensary, that will start to make a difference.

“We’re looking at how we support our technicians, so we’ve got a development plan to enable them for what is needed in the future.”

In 2024, Well offered 75% less English foundation trainee places for the 2025/26 cohort because of a lack of designated prescribing practitioners (DPPs).

But Khan says as more pharmacists are prescribing, he is hopeful there will be more DPPs to help manage the influx of graduates who will enter the job market this year with their independent prescribing qualification.

“The initial way the foundation pharmacist recruitment was set up proved quite challenging. We only went into locations we knew we had a DPP and if we didn’t have one, we didn’t put locations forward.

“Independent prescribing is a big focus area for us. We’ve got plans and we’ve seen a big movement in people joining our business.”

Services

Well introduced a new hearing service last year, and created an expanded digital offering through its new online doctor service.

The online doctor is done with a third-party partner and covers 16 conditions, but Well has retained sole provision of the weight management services it offers as the market continues to grow.

Amid news of the General Pharmaceutical Council (GPhC) taking action against online pharmacies who failed to carry out full checks when prescribing weight loss jabs, Khan is confident Well is offering a “safe and effective operation” that does not rely on images being sent to prove someone’s weight.

“Our service operates between online and in-person, then the actual consultation is a video or in the pharmacy. One of the challenges is how the regulations are enforced and you hear stories about people who’ve been able to get a supply who shouldn’t be entitled to.

“Where we found patients not suitable or are close to the borderline, we’ll signpost them elsewhere and provide that holistic care patients need.”

Quick Facts

Age: 56

Status: Married to his pharmacist wife with two daughters

Best piece of advice you’ve ever received: "Learn from your failures"

Best advice you’d give: "Use every day as a learning opportunity"

Favourite book: CEO Excellence: The Six Mindsets That Distinguish the Best Leaders from the Rest by Carolyn Dewar, Scott Keller, and Vikram Malhotra

Favourite film: The Shawshank Redemption

Favourite medicine: "Cetirizine – I could not live without it. I suffer from hayfever and allergies, and it’s a godsend"

Least favourite medicine: "From childhood, it’s penicillin. It still traumatises me the taste of it"

Death row meal: Steak

Funding

But despite making progress with these services, Khan stresses NHS funding is creating challenges for Well even after last year’s contract settlement.

“Even though we got an uplift in England, it still doesn’t cover the core costs. We’ve had an additional £100m margin put in but it doesn’t go up far enough.

“What happens is we see quarterly adjustments when there’s additional clawback because there’s over delivery and that puts pressure back on. The clawback in category M impacts everyone and it makes it very difficult to manage a pharmacy business."

Khan wants “more to go into the retained margin” and says the new category H to be introduced in March “doesn’t address the overall state of play”.

And he sees how community pharmacy can make a “big difference” in prevention through having greater responsibility in providing vaccinations.

“We’ve already demonstrated as a sector we can do more, through Covid and with the flu vaccine. There’s a strategy in the medium-term plan for the NHS using community pharmacy for HPV catch-up. That’s not enough, we can do a lot more.

“If we provided more of the adult vaccinations, that would release capacity in primary care and help the government address some of the funding challenges moving money pots around.

“The prevention space is really big and we’re currently not even touching the sides with it. Patients love coming to community pharmacy and recognise it as an accessible point.”

Khan is proud of leading Well in Covid and introducing the hypertension service (Drew Forsyth)

Selling

It remains a challenging climate to do business in, however, in last year’s annual accounts ending June 2024, Well named “inflationary pressures on global supply chains” that “increased the price of generic medication” and “increases in the national living wage” as challenges facing the company.

Khan says Well remains opportunistic to purchasing new pharmacies if it’s “a good strategic fit for us”, but it shuttered a net 49 pharmacies from the previous year.

Khan’s remit is to look after patients during this process.

“We’ve got to make sure patients are supported right up to the day we hand over to a new owner. That’s important. Alongside that, there’s various records we need to retain so we make sure our handover process is really tight.”

The multiple will “constantly review” pharmacies that are having difficulties, whether it’s due to its location or difficulties with recruitment, and “where necessary, we’ll offload pharmacies where opportunities arise”.

Khan explains further that a lot of the pharmacies Well has sold have been in England because of the contract and the “historic 10-year underfunding”.

He adds: “There’s been further increases to national insurance, so that has a knock-on effect, and the national living wage increasing again. And although the contract global sum has increased in England, it doesn’t cover the underfunding that the independent economic review highlights in terms of what we should be paid.

“And the disappointing thing is we still haven’t seen how that gap is going to be addressed. Labour has given the highest increase, but it still doesn’t go far enough.”

Achievements

Khan became a Royal Pharmaceutical Society (RPS) fellow last year, and he attributes his work during Covid and introducing new services as his biggest achievements at Well.

“Leading the business through Covid, giving direction to what our response looked like. It needed a lot of resilience, quick ways of adapting.

“And then launching the hypertension service. We were the largest pharmacy operator who started delivering it and were ready before everyone else. We had it live across our pharmacies within weeks.”

Expanding services remains a priority for Well, along with growing “the bread and butter of pharmacy” by increasing the number of items it does.

But Khan understands how his role helps to keep Well as the biggest multiple with primarily pharmacists as its key workers.

“We’re looking at everything we can to make Well a place that people want to come and work. Anyone working for us is working for a pharmacy organisation. A place where pharmacists can be recognised and contribute their clinical skills to support as many patients as possible.

“Boots have health and beauty, some of the others have got supermarkets – we’re not in that space at all.

“We see ourselves as the biggest pharmacy provider who is pure pharmacy.”