Bhanu Chohan is used to running a successful flu vaccination service but the 2018-19 flu season got off to a bumpy start due to supply issues

Bhanu Chohan with colleague

Bhanu Chohan is firmly embedded in her community in the East End of London and believes this is key to her success with the flu vaccination service. She has been providing the service for over a decade, and says it has gone from strength to strength in that time.

“We’ve always done quite well with the service,” she says, adding that pharmacy offers patients many advantages. To them, the convenience is excellent – “they can have their flu jab when they like”.

Florida Pharmacy, an Alphega member, has three pharmacists, all of whom are trained to provide flu vaccinations. This means that when patients come in and ask to be vaccinated there and then, capacity isn’t an issue – unlike GP surgeries, where an appointment is usually required.

Consistency

The consistency of her team is important. Bhanu says her patients feel comfortable because they know the team personally. “I don’t have a lot of change in my staff,” she says. One pharmacist has been with her for over 20 years, the other more than five years, and her pharmacy technician for over a decade.

“It is the continuity that people like. People get to know them. It is like when you go to your GP – you like to see the one you’ve seen regularly,” Bhanu says. “We have a relationship. We know their children, their grandchildren. They just walk in and are very comfortable to have their vaccination with us.”

Bhanu describes her relationship with the two local GP surgeries as “very good” and says there has been no disagreement over the provision of flu vaccines. “It is up to the patient. If they’ve made the appointment with the GP, of course they can have it there – but a lot of our customers have been with us a long time and prefer to have it here.

“There is no animosity [with the GPs]. We work together and help each other. In fact, one of my pharmacists works at the practice one day a week.”

Complicated

Setting up the flu vaccination service was pretty painless and it has run smoothly ever since – but things have been more complicated this year. Like many pharmacists and GPs in England, at the time of this interview (mid-September), Bhanu was struggling to source supplies of Fluad, the vaccine licensed by NHS England for the over-65s this flu season, despite having ordered it in early 2018.

While she welcomes the changes to this year’s service specification – delivering vaccines in patients’ homes is “not a problem”, she says, and the increased payment per vaccine is welcome – the supply issues have kept her hands tied.

Pressure was beginning to mount when we met. “Everyone’s walking in already for their jab. I’ve been doing flu vaccinations for more than a decade, so people just expect to be able to get them.

“They’ll come in and ask if it is time for their jab, and you have to say ‘we haven’t got it yet, try your surgery and see if they can do something for you’. I don’t know what sort of impact that will have on us.”

Supply headaches

Having worked as a pharmacist for over 40 years, Bhanu has a good vantage point from which to assess current changes in the profession, and says a lot that she is seeing is “not positive for pharmacists”.

Supply issues don’t end with Fluad, she says, as she gets “several pages” of orders listed ‘out of stock’ on her deliveries every day. This entails a lot of legwork, such as “apologising, asking the doctor if they can change the prescription to something similar, or offering to deliver to the patient’s home at night because the medicine wasn’t there when they came in”.

Online concern

Online pharmacies are another concern. Bhanu says she sees more and more patients signing up with them. “They’re not getting the service but I don’t think they realise it,” she says. It doesn’t allow them to have that crucial face-to-face interaction with a pharmacist – but people still come to her.

“People might have got their prescription somewhere else but they still know that at every pharmacy they can get free advice. They’ll call in and ask how they should take their medicine and we still give them the time – although we are not being paid for it.”

Significant costs

To try and compete, Bhanu offers a delivery service, but this comes with significant costs. As an independent, she feels the familiar relationship she enjoys with patients means that some things can be taken for granted.

“With the multiples, if a patient isn’t in when the delivery van arrives, the patient just has to wait – whereas with us, they’ll phone up and ask us to pop back later. This makes costs go up a lot.”

After working as a pharmacist for over 40 years, Bhanu says she still loves serving her local community but has concerns about young pharmacists entering the profession.

“I have a lot of loyal customers, but the younger generation have grown up with computers and seem quite comfortable buying online. I’m not sure how pharmacy and being a pharmacist is going to pan out in the future...”

Alliance comment on flu jab supply

Alliance Healthcare told PM: “We plan carefully for the flu season each year, calculating volumes in line with previous seasons’ flu vaccine demand and building in a growth element. However, despite this, we have seen unprecedented demand for the Fluad vaccine this year.”

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