In May last year, P3pharmacy teamed up with Pharmacy Complete to follow five independent pharmacy owners through its Planning for Growth structured business framework and development programme, which lays out all the key elements for building an effective business plan.
Following an initial analysis of their businesses to enable them to determine where they should prioritise and invest for growth, our pharmacy owners were encouraged to detail their purpose and consider what critical success factors would help them achieve their goals.
Over the course of the year, Mike Holden, Pharmacy Complete’s associate director, and Deborah Evans, managing director, supported and coached them via group sessions, face-to-face meetings and regular phone calls. However, with the ever present challenges facing community pharmacy, not all the participants were able to follow their plans at the same pace, and as our coverage of their stories draws to a close, there were some who made changes, and others who are still to implement their ideas.
“We wrote Planning for Growth to equip independents with the tools and techniques to think more strategically about their business and to make decisions around investment in which services to deliver (NHS and private), buying new equipment, developing new services and training themselves and their team to improve capacity and capability,” says Deborah.
“With all the current challenges around funding and money coming out of dispensing, independent contractors know they need to move to a more service-led business model, but many are finding it hard to find the time to plan how they are going to do that, or work out where to start. We frequently see contractors making decisions based on what they see others doing, what they’ve seen at trade events, and what they think they should be doing, but we wanted to encourage them to be making evidence based decisions for their business in their local context. So, ‘if I do x I won’t be able to do y’ or ‘z will give me a better return’.”
The programme is structured to take pharmacy owners and managers through a number of practical tools to make decisions and then create a specific action plan.
“The key steps start with doing a situational analysis to find out where you are with your business right now, so you can make decisions based on the numbers rather than gut feel”, says Deborah. “This involves looking at data like prescription volume over time, split of NHS and retail business, local demographics and health inequalities, what commissioners want, and what your customers’ needs really are. These are all important because the actual numbers can tell a story of trends that you may not notice over time. This can lead to businessspecific statements such as ‘we are well connected in the community, but not using that insight to deliver what commissioners or customers want’ or ‘we have a loyal and committed team, but haven’t developed new skills required for service delivery’.”
The next stage involved the participants focusing on where they wanted to get to in five years (for example, did they want to own more pharmacies, retire, create a wellness hub, change their split of NHS/ non-NHS revenue, etc?) and planning their strategy for growth by working out what would be critical to success. For example, could they do more to make the most of what they’ve already got, did they need to upgrade their digital presence, offer new products and services, find new customers, or offer new services such as a travel vaccination clinic?
The final stage is about focusing on specific actions. Here, Deborah and Mike coach participants on a one-to-one basis so they get guidance working through the process, are accountable for delivering and know how to measure the progress and impact of their new activities.
We have been able to cope better during very difficult and uncertain times - Tajinder Singh Totley Pharmacy
Mike coached Tajinder Singh from Totley Pharmacy in Sheffield, who already had a business plan in place, but said from the start that he wanted to refine it to achieve his goals. He also knew he wanted to further empower his pharmacy team to own specific parts of the plan, and for them to achieve the targets.
Over the course of the programme, this focus saw Tajinder reduce his percentage of turnover from NHS dispensing from 87 per cent in 2018 to 84 per cent in 2019. He also grew his turnover from private services from 0.4 per cent to 2.4 per cent, with net profitability before tax as a percentage of turnover up 2 per cent in 2019 compared with 2018.
“This data illustrates that his focus on doing the right things is already paying some benefits, with a shift away from NHS to non-NHS revenue and an already positive impact on the bottom line,” says Mike. Tajinder acknowledges the impact the Planning for Growth programme has had on his business. “We have done a lot more flu vaccines this year on the NHS, but also over 200 private flu vaccinations, and we have started a travel vaccine service, which is taking off nicely. We are also focusing heavily on NMS and are averaging 55 per month at the moment, which is helping to compensate for loss of MUR funding”, he says. “The guidance given at the original meeting and the plan that we formulated following this have helped us to work with a clear idea and confidence. We have been able to cope better during very difficult and uncertain times.”
At the start of the programme, Lindsey Fairbrother from Goodlife Pharmacy in Hatton, Derbyshire, said her priorities were about “driving the services business to reduce reliance on NHS”.
Now, on the other side of the process, she says of her involvement: “It pushed me to do things that maybe I was wondering if I wanted to. I already put a lot into the business, but having the focus of the programme and coaching from Deborah made me move faster on things I was maybe procrastinating about.”
Lindsey’s concentration on driving services saw Goodlife Pharmacy deliver more flu vaccinations this winter than any other shop in the local area – and with it came some unexpected outcomes. “This was a great result,” says Lindsey, “but of course every one of those 350 jabs had to be given by me personally. Debs suggested training up my locum to do them instead, so I bit the bullet and paid for her to do this because it was worth it to relieve the pressure on me.
“Having built on that, I got the ENT extended care service and went through the training, which then inspired my locum to get trained for that too. She’s been working for me for two days a week for the past nine years, and my hope is that this upskilling has made her even more proud of the work she’s doing now.”
Having the focus of the programme ... made me move faster on things I was maybe procrastinating about - Lindsey Fairbrother Goodlife Pharmacy
Aside from the huge challenges that coronavirus is placing on individuals and businesses, Lindsey is also facing a squeeze on staff numbers in another way. “I’ve had a pre-reg for the last three years, which has been one of the best things I’ve ever done”, she says, “but since the NHS Oriel national recruiting platform came in, there seems to be barely any pre-regs placing in community pharmacy, with most going to hospital or GP practice. It looks like this year coming, from July, I won’t have a pre-reg, and I know I’m going to really feel that from a work and a mental perspective because the whole burden falls back on me.”
Admitting that she was already conscious before the programme that she doesn’t give up on things, Lindsey says she had to be mindful not to be overwhelmed by the number of ideas the programme was helping her to generate. “A big problem in running your own business is that you think about it all the time, and I certainly don’t give myself a lot of rest,” she admits.
However, she says the ongoing coaching support from Deborah was a big plus: “You are pretty isolated in pharmacy and I don’t want to ring another pharmacist and have a moan, so having someone else I can talk to who is non-judgemental to coax me down the road to have a go has been good.”
Her advice to others considering taking up this kind of external business development challenge is clear: “You have to be aware of what you are getting into if you are doing something like this, because if you really want to commit to it, you’ll push yourself to do it. If you end up with more ideas than you can actually carry through, you can get a bit stressed. Having said that, taking part in this solidified what I was going to do anyway, so I found it positive.”
Lindsey is not the only one who has got something from the process. Deborah has found it a positive experience too. “I’ve done a lot of coaching over the years, so I believe in the principle that I’m not there to tell people what to do, but rather to give them the space and time to come up with the answers that they already have inside them,” she says. “This is certainly how things have played out with Lindsey, and it was great working with her as our calls were always very productive.
“Lindsey was fantastic. She was open to the coaching process and developed great insights because she created the space to think them through. Being able to be ‘on’ your business instead of ‘in’ your business is a very important thing to do, and not everyone can, but Lindsey showed that she absolutely had the answers. She was fully accountable and committed to our scheduled one-to-one sessions.”
Looking back at the past year, Deborah says that she and Mike have also pinpointed some ways to hone the programme. “Many in the community pharmacy sector find it difficult to find the time to look at their business strategically and take stock, especially with the cuts in funding and increasing demand,” says Deborah. “We need to find out how to best engage business owners in undertaking this thinking as it can really make a difference.
“This programme requires investment in thinking and time, so participants have really got to want to do it, to understand that it will give them important insights into their business, and that they will need to be disciplined and prepared to go with the process. It involves asking important and sometimes uncomfortable questions, engaging the team, interrogating the numbers in the business, and then being disciplined to complete.
“The workshop followed by one-to-one coaching format is new for us and, as in all our courses, we are constantly reviewing what we can change to make this more accessible. We’ve also seen how difficult it is for people to create that space, so we are mindful that we have to make the impact of the programme really obvious. Over time, we’ll be able to aggregate evidence of the successes so that more people can see the results.” With the world now facing an unprecedented health crisis, and our NHS at breaking point, business planning may seem like an insurmountable task right now. However, as Mike says: “It is always challenging for busy pharmacy owners to step back and look at their business, but now is a critical time to do it.” We will come out the other side of this, and when we do, a good business plan that develops the team, premises and local engagement to optimise NHS funding, explore opportunities, both commissioned and private, and creates a sustainable future, will be all the more important.
Narinder Chahal of N&J’s Chemist, Burntwood, Staffordshire; Akshay Patel of Regent Pharmacy, Northampton, and Samina Khan of Pateley Bridge Pharmacy, North Yorkshire, attended the original event, but were unable to pursue the programme at this time.