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Fee for service, not free for service

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Fee for service, not free for service

It may be time to think about charging for some of the services that community pharmacy has been offering our customers for free, says Noel Wicks

These days everything seems to be about “no frills”, and while some businesses have always had this as a core value, others have had to introduce it simply to compete.

One example of this that really sticks out for me is British Airways. This is a company that has, for many years, offered me a comprehensive service in a single inclusive ticket. But now, the advent of competitor low-cost airlines, with their basic ticket prices and premium add-on choices, has forced BA to change its pricing model. The pressures on basic ticket prices in the market mean that BA, too, now offers a standard ticket, but with additional costs for baggage and seat allocation.

BA isn’t the only example. Think about how many other businesses and services now work from a basic, free or low-cost model with the option for customers to pay for additional and add-on services. There has always been the option to pay extra for premium goods and services, such as private healthcare or business class travel, but what’s happening now is different. In my mind, it is more akin to stripping out all the nice things that generally used to come included and then repackaging and selling them back to you at a premium.

It’s a sign of the times that this is one strategy that community pharmacy may also need to at least consider, if not indeed embrace. If Newton was right, every action has an equal and opposite reaction. And it seems inevitable that cuts to pharmacy funding will lead to a reduced service offering.

When you think about what community pharmacy is actually remunerated for, then you understand the scope of the many additional “frills” that we provide free of charge. But perhaps, rather than cut services, we should look at “repackaging” them. In this way, we provide the basic service as funded by the government, while allowing people the choice of which non-funded services they wish to purchase.

What would this look like? Let’s assume that internet pharmacy is the benchmark for a “basic” service. Brick and mortar pharmacies would then have the option of offering additional upgrades. Unlike internet pharmacies, we could offer speedy boarding (faster access to your prescription), an upgrade to business class (MDS trays) or even an all-inclusive package (unlimited same-day home deliveries).

All of this could be charged ad hoc or via a simple monthly subscription, and of course we could also introduce you to our carefully selected partners who can offer well-priced insurance, mobility aids, hearing tests and so on.

This idea of fee for service, not free for service, is not a new one, but I suspect that community pharmacy has avoided up to now it due to the enormity of risking damaging peoples’ perceptions about our business model.

However, as I stood in a long queue to board my BA flight to London today, I was reminded that, while making this change may turn out to be an enormous task to get right, it is certainly not an impossible one.

Perhaps, like low-cost airlines, rather than cut services, we should look at “repackaging” them

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