Insight: better clinical consultations

Independent pharmacists regularly go above and beyond what is required of them, yet their stories often remain unheard. Laura Husband speaks to one such pharmacist and Avicenna member who is using her knowledge from a short prescribing course to intervene when patients’ lives could be at risk

Name: Bina Patel Job

Title: Independent pharmacist

Pharmacy: Kalsons Chemists, Essex

Initiative: A short non-medical prescribing course to help ease the burden on local A&E services, where appropriate, and liaise with medical professionals when there is cause for concern.


Bina Patel carried out a short course in consultation diagnostics, which included 30 hours in practice. She is using her new skills to examine patients where appropriate, and to build trust and links with the medical professionals in the local area.

Ms Patel says that her local surgeries feel confident sending their patients to her when there is a particular pharmacy-related clinical query because they know that she has helped them out in the past.

She explains it’s not just about having knowledge, it’s about using it to be proactive. For example, she once had a gentleman in his late seventies come into the pharmacy with a red and swollen ankle. She asked to have a look at it and the ankle was hot to touch. She asked him how long he had the problem and if he was diabetic. It turned out he was diabetic so she told him he needed to go to the doctor straightaway to avoid him needing surgery. ‘It was a Friday and if he had left it until Monday, it might have got worse. I phoned the doctor’s surgery and told them they needed to see this patient as a priority and the surgery agreed to see him that day,’ she says.

Ms Patel has built such a good reputation for herself in the area that if a patient comes in with a severe ailment, she can step in and ring the surgery for the patient to tell them that in her professional opinion the patient needs an appointment quickly.

She says: ‘It’s about talking with confidence and knowing what you are doing. If I don’t know the answer, I will ring the GP and let them know that I’ve got one of their patients and describe their symptoms. It’s about knowing how to take the person’s history and spot when something is not quite right.’

How has this experience benefited the pharmacy team?

A ‘I think that my team have benefited from watching the way that I interact with patients. If you have a relaxed manner with patients, your staff will develop that relaxed manner, too. I also believe in encouraging staff to continue with their training. For example, I ask my staff to do a 10- to 15-minute presentation on a topic each week to build their confidence. I also ask them to have a look in the shop at what we stock for a particular disease, what are the signs and symptoms, what can we recommend and why do we not recommend one thing or the other.’

Q What’s been your proudest moment?

A ‘I had a young couple come in who wanted to have children but were worried they wouldn’t be able to because the wife had just been diagnosed with fibroids. They were reluctant to go to a specialist, as they didn’t want to have a hysterectomy so I explained that fibroids could be treatable and they should listen to the doctor and see a specialist. She was treated and eventually came in with a baby. A few years later, I went to buy a new mattress and the salesman turned out to be the husband. He said I was the only person to help when they didn’t know what to do and he insisted on giving me 50 per cent off the mattress as a thank you.’

Q What have you learned about yourself in the process?

A ‘The course has given me the confidence to treat minor ailments in the pharmacy. When a customer asks if something is broken, I have a look at it and ask them if they can move or lift it. If they can, I advise them to take the weight off it and if it continues to swell, I advise them to go into A&E. This means I’m saving the patient from queuing in A&E and reducing the strain on the local health service because I’m advising them in the pharmacy instead.’

Q What dos and don’ts should pharmacists follow?

A‘You need to get to know your local doctors to ensure there won’t be any hostility if you need to contact them for clarification. For example, I’ve had to say to a patient that I don’t know if they gave the doctor the same information as they gave me. If they had, the doctor may have reconsidered their prescription. You also need to be careful about confidentiality, because once you start getting close to a patient, you have the risk of letting out something that you shouldn’t.’

What’s your advice for other pharmacists as a result?

‘If pharmacists utilise their staff better, it would free up time to do more in the pharmacy. All pharmacists can up-skill like I did when I went back to university after 20 years. We need to take on the challenges ourselves because if we don’t set a good example, how can we expect our staff to do it?’


Bina Patel is a member of Avicenna, the UK’s largest independent pharmacy support group


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