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'Difficult' Lloydspharmacy decision to charge for screening and tests

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Patients will be charged £5 for diabetes screening and £3 to have blood pressure checked
Patients will be charged £5 for diabetes screening and £3 to have blood pressure checked

Lloydspharmacy has made the “difficult, but necessary” decision to start charging patients for diabetes screening and blood pressure tests, C+D can exclusively reveal.

As of yesterday (May 22), patients are being charged £5 for diabetes screening and £3 to have their blood pressure checked. Customers who pay for one of these services will receive a £5 voucher when they next spend £15.

The multiple will periodically run campaigns – such as Diabetes Week in June – where these services will be made free of charge for a set time, it stressed.

Nigel Swift, retail and marketing director of Lloydspharmacy parent company McKesson UK, said he is “proud” that the company has delivered more than two million type 2 diabetes and blood pressure checks “completely free of charge”.

“However, with continuing pressure to make efficiencies, this model has become unsustainable for us,” he told C+D.

“We understand that this change may take some time to get used to for our customers, but it’s not a decision we have taken lightly,” he added.

“Many businesses continue to feel the impact of funding reductions – and all are having to make tough, but necessary, commercial decisions.”

“The stark reality is that we need to be commercially sustainable in order to continue to provide the best possible care to our patients.”

When asked by C+D how the multiple predicted charging for these services would impact uptake, Mr Swift said: “Where possible, we will signpost customers to alternative free services – which we understand may impact the number of services that we deliver.”

You can read Mr Swift’s full explanation to C+D for charging patients for these services.

It is not the first time Lloydspharmacy has made significant changes to its business model to cope with the funding cuts. The multiple has sold or closed around 200 branches in the past two years (you can see their locations here) and revealed to C+D in January 2018 that it had started charging certain patients for medicines deliveries.

Earlier this month, its parent company cited the funding cuts and “competitive pressures” in the UK as two reasons for a 72% drop in profits across its European business.

25 Comments
Question: 
What do you make of Lloydspharmacy's decison?

SP Ph, Community pharmacist

""receive a £5 voucher when they next spend £15""

Next time you want to buy anything from Loyds Pharmacy worth more than £15, get a Blood Pressure tested. At least you save £2. No fun getting a diabetes test done though. 

This comment it just for laughs :-))

Umer Bhuta, Community pharmacist

Multiples still to this day dish out free services. Like free weekly packs to anyone that wants them. They're still giving out vouchers! When will they learn? It's never too late to start charging for uncommissioned services. But why offer free services in the first place? These are hard lessons to learn from as we look to the future and not repeat the mistakes of the past not least before anyone utters the word free again.

Benie I, Locum pharmacist

All too little and much too late. When these multiples were all slitting eachothers throats thinking they were being novel and innovative I suppose they never stopped to think. Free ! Free ! Free ! and you think your customers will attach any sort of value to it ?! Suddenly you introduce a fee and you expect these same people to rejoice and clap out of loyalty.

Whaever you're drinking I'll have 2 pints.

Peter Smith, Student

They'll be on the Dom Perignon, you'll be lucky to get half a pint of tap water.

Leon The Apothecary, Student

Blood Pressure is an odd one, because I would simply go to my surgery, where there is almost always a machine available to be used freely as well as costing nothing in terms of consumables.

I think this move will increase the risk to patients, who I believe will opt to not use the service or simply go see their GP; increasing their workloads.

C A, Community pharmacist

"as costing nothing in terms of consumables"

If it is being done properly, the machine would need to be validated every six months, which would likely be outsourced to another company, resulting in a recurring cost to providing the service. 

Andy Burrells, Community pharmacist

I take it from this comment you've never worked in a pharmacy then?

Leon The Apothecary, Student

Respectfully; longer than you there. Historically when you start charging for something after providing it for free one should expect a sharp decline in the uptake or usage, with some loss to the competition who don't charge.

Latest example with your employer Andy? Delivery Charges.

However, Nigel is right in saying how they offer their service currently is definitely unsustainable and the voucher to encourage repeat customers and link selling is tactically a very savvy move.

C A, Community pharmacist

Leon, locally our GP surgeries have cut down on providing BP tests - they offer the option of an automatic machine at some of their sites, or visiting your pharmacy, who will do it for free. So we are seeing more people requesting blood pressure tests.

Adam Hall, Community pharmacist

I applaude the idea that pharmacies should start charging for services (in the absence of any commissioned service) - we cannot continue to do things for free. Lloyds have somewhat softened the blow by giving the customer a voucher against future purchases. I will be interested to see what impact introduction of charges has on uptake, and also if there are any changes to the demographic and would ask that C&D follow up on this in the future

Sanjay Mistry (Pharmacybox), Community pharmacist

I share your sentiments Adam, I think it is a great idea, unfortunate for patients who will suffer at the end. I am surprised that such services are still not funded in the community. Pharmacies and pharmacists should not be afraid to charge for valuable services that they offer - how many years went by where this service was free... 

Peter Smith, Student

That's the problem Sanjay, UK pharmacists have done everything for free for so long, that customers are loathe to spend anything there. They'll pay £3 for a movie on Amazon, £18 for a dominos pizza, and £10 for a packet of Lamberts, but £3 for a blood pressure check - no chance!

People attach zero value to goods or services provided for free, which is one of the reasons why community pharmacy is in such a pickle.

Leon The Apothecary, Student

To be fair, I also wouldn't value a BP check at £3. I'd buy a monitor for home use, a quick search shows an Omron for £7.

For the purposes of debate - when would I need to use a blood pressure service outside of seeing the GP?

Bob Dunkley, Locum pharmacist

People do not give a value to anything that is free as the Scots are now discovering with their mountains of pharmaceutical waste as a result of free prescriptions.

Peter Smith, Student

When I was recently qualified, I can remember that a lady in her 80's had died locally and the relatives brought the medication from her house to my branch for disposal. She had been on a lot of medications, some were quite expensive ones as well, for decades. There were 4 large black bin liners jam packed with medication, we counted almost £4000 worth of medications from one bag alone but gave up counting because it took too long. All tax payer's money, straight down the drain. When questioned why there was so much, her daughter told me "she hated taking pills, but kept getting the prescriptions because she didn't want her GP to know that she wasn't taking them". If she had been paying a small charge of 50p or £1 a script, that waste could have been prevented because she presumably would have had the courage to tell her GP that she didn't want them, or at least she would not have collected them and the doctor would have known that she was not taking them.

Richard Grahame, Community pharmacist

What an odd comment.  Do you care to substantiate?  Doctors are so strict with prescribing its impossible to stockpile.  You order your repeat Rx 2 days too early in the eyes of the gustappo receptionists and you simply get no prescription.  Rxs may be free but doctors protect their budgets with aplomb. 

Peter Smith, Student

She was an elderly patient on many medications. She had not been taking them for years, but had been assuring the GP that she was taking them for fear of further interrogation, hence the massive stockpile found in her house after her death. I can only assume that she was ordering at the correct times, collecting the meds, then chucking them in her spare room after she got back home. It's not that hard to get your head around - I've seen this many times in my years as a pharmacist but just not to this extent.

Richard Grahame, Community pharmacist

My comment was directed to Bob!

Peter Smith, Student

Bob is saying the same as me - free anything results in massive waste. A very small charge can dramatically reduce wastage, as has been seen with the supermarket plastic bag charge. 

Free stuff = wastage, it's very, very simple.

If McDonalds started handing out free french fries, it would probably be 24 hours before most cities' drains would be overloaded with pieces of fried potatoes. The small price which McDonalds charge largely prevents this, because people want to eat them instead of throwing them at each other, or seeing how many it will take to block a pipe of some description.

Walk around London on a Sunday morning and look at the nightclub flyers on the ground. Do you really think that there would be that much garbage to collect if people had to pay 50p for them?

Free things are not treated with respect, and as a result, are often wasted. I suspect that trillions of pounds have been wasted by free prescriptions since their inception. Prescriptions should never have been free, there should have been two tariffs, the full tariff and a 90% reduction.

People respect their possessions infinitely more if they've had to pay for them with their hard-earned cash, whatever the cost may be.

Richard Grahame, Community pharmacist

Bob talks about mountains of pharmaceutical waste in Scotland  as a direct consequence of free prescriptions.  I asked him to substantiate that claim.  While I actually agree to a small charge that gets reinvested ito the NHS for some I disagree that it has caused presciption wastsage.  I have shops in Scotland.  We certainly didn't see a huge rise in prescription numbers when they went free in 2011. Why because doctors won't allow it.  

 

Peter Smith, Student

You're right to question him, however I think that his statement is using common sense to link the two, so it is unlikely that he will be able to provide you with a pdf document to prove as such.

Richard Grahame, Community pharmacist

Is the problem worse in Scotland than it is in England?  This is the first I've heard of waste being a big problem in Scotland compared to anywhere else.  Rather than use common sense my daily working in several sites points to this not being the case.

 

Leon The Apothecary, Student

My daily working in roughly 80-100 branches over the course of the last two years points across a number of CCGs to waste being a substantial problem and can be attributed in my opinion to adherence; fear of losing access to medicine, stemming from access to seeing a GP, stemming from cuts across the NHS as a whole; a slow uptake of Repeat Dispensing; and a slow uptake of Prescriptionist Roles within surgeries such a GP Pharmacists and Technicians.

Respectfully; it sounds like your local area seems to be quite on the ball when it comes to prescription management.                                        

Peter Smith, Student

Your several sites may not be a statistically significant sample of the population as a whole.

C A, Community pharmacist

100 sites out of 11674 sites is enough to be significant. You'll have a fairly large 95% confidence interval though +/- 9.5%. For example 20% +/- 9.5% wastage. 400 pharmacies sampled would roughly half the CI margin.

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