It's a sunny day at MedicX Pharmacy's newly opened branch in Thingwall, Merseyside, and CEO Steve Jeffers is feeling equally bright about the independent chain's prospects.
Despite the economic gloom, the chain is planning to double its number of branches from 10 to 20 over the course of this year. At a time when even Boots is posting limited growth in its pharmacy division – citing pressure on dispensing income as a major factor – it's no mean feat. And all of this, Mr Jeffers says, is underpinned by the chain's overriding customer offering: "providing excellent services in a clinical environment".
As PSNC urges pharmacists to embrace services, the MedicX model seems a perfect fit with the negotiator's vision for the future. Positioned strategically in health centre settings, the MedicX teams are able to work more closely with GPs than their colleagues on the high street – enabling them to build those all-important relationships. It seems an undeniable advantage as the NHS moves towards GP-led commissioning. So is this the direction pharmacy should be taking in the new-look NHS?
Mr Jeffers is not in favour of a one-size-fits-all model. Although he is clearly passionate about the direction MedicX is taking, he acknowledges that not everyone will follow suit.
MedicX in the news Many 100-hour pharmacies could go under 'over the next five years'
However, he does believe every successful pharmacy should centre around on one thing: meeting local patients' needs. "One of the problems with the big multiples is they don't really segment their offering to suit their location," he argues. "I do think the pharmacy sector has to stop trying to be everything to everyone and think about what it wants to provide in a particular location – in some areas that will be selling lots of shampoo but, where we are, it's about providing professional services rather than being a retail business."
Looking around the Thingwall branch, it's clear to see services are a cornerstone of the MedicX brand. Each of its pharmacies – one of which was a prizewinner at this year's C+D Platinum Design awards – displays a menu of the clinical services it offers. It's a strategy that has recently been mirrored by Boots, which unveiled its new-look health and pharmacy areas complete with service iconography last month.
And Mr Jeffers sees this promotion of professional services as vital to a healthy income stream. "The word ‘professional' doesn't mean you don't have to promote them – it's a business like anything else and you have to tell people about what you do," he says. "If you create the right environment in the patient's mind that it's a healthcare setting and tell people what services you offer, there's a good chance you'll make a success of them."
Despite MedicX's success with services, Mr Jeffers does understand the more cynical attitude towards them – admitting the company has had to work "very hard" to generate a substantial profit from this side of the business. And he stresses that any new contract should adequately reward the dispensing aspect. "A safe, efficient dispensing service should be the bedrock of any pharmacy," Mr Jeffers says.
But he does advocate a move towards more quality-led funding. "Pharmacies that provide quality services should be paid more than just those who do dispensing and retail and nothing else. It could be measured through inspections and patient satisfaction surveys and it could go towards a contract like the GPs with QOF points," he argues.
A focus on quality would appear to be in line with the new NHS, which ministers have repeatedly described as "outcomes-focused". But will the new commissioners really reward quality, or simply look after their own? Mr Jeffers shares the sector's fears that clinical commissioning groups (CCGs) – run predominantly by GPs – may overlook what pharmacy has to offer.
"I'm worried about the fragmentation of commissioning because, at the moment, all services are commissioned through one body – the PCT. In the future, they will be commissioned through NHS commissioning boards, health and wellbeing boards and CCGs, who will commission mainly from GPs or nurses employed by GPs," he says.
Mr Jeffers cites flu vaccination as an example of what can happen when GPs have control over a service. Despite pharmacy being able to do "amazing things" with flu vaccination – providing accessibility and convenience – GPs still take the lion's share of NHS patients.
And this is why Mr Jeffers is strongly in favour of more nationally commissioned services. "That's really essential for pharmacy in the future, because things like a national minor ailments service or EHC should be commissioned with standard requirements across the country," he argues. "It's insane that in certain PCTS a mother on benefits can get paracetamol suspension under the minor ailments service, but in a neighbouring PCT you can't."
Despite these concerns, Mr Jeffers remains resolutely optimistic about the future of pharmacy – stressing that the sector could save the NHS "a fortune". "We've got a lot to offer in terms of patient care within the NHS, and we can enhance patients' health by managing medication for long-term conditions," he stresses. "We can also give a lot more control over what GPs are prescribing – it still astonishes me that the net ingredient cost varies so widely between products."
So for Mr Jeffers, the future of MedicX is clear. The chain's focus on service, health centre locations and a clinical environment seems set to be a successful model for the changing landscape. But Mr Jeffers believes there is still a place for a wide range of pharmacies in the new NHS. "It's competitive to secure a location in a new health centre but it's up to the pharmacist to work out whether that would work for them," he concludes.
"Sometimes you are better off staying where you are and providing a good service to a loyal patient base, and many pharmacies are very successful at that."
... 100-hour pharmacies
"Unfortunately there are a lot of people who opened 100-hour pharmacies in the last few years and are now locked into a lifetime of struggling to make a half-decent wage. That said, in a number of areas they are actually damn good for patients in terms of access."
... control of entry
"I do fear the new PNA-based system may just maintain the status quo for pharmacy provision – PNAs aren't really written with the patient in mind. They could refuse to grant a new pharmacy contract even in an area where there's currently a monopoly, and without competition, I think patient services will suffer."
... stock shortages
"I think the manufacturers are trying to control a market they don't understand. It's not their responsibility to control where their drugs go because there's something called a supply chain and they have no understanding of that – particularly the last bit of pharmacists supplying to patients."What is MedicX Pharmacy?
MedicX, formerly known as Primary Asset, is an investor in and developer and manager of healthcare property in the UK. Its pharmacy arm specialises in health centre locations and at the time of publication lists 13 branches from south of London to Blackpool, with four more "coming soon". Its focus on premises design has seen it shortlisted in two consecutive C+D Platinum Design Awards, coming third in this year's competition. And its focus on service development saw it take home the trophy for Clinical Service of the Year for an HIV scheme in last year's C+D Awards.
View the full video interview Steve Jeffers below: