During 2012/13, only 50 per cent of at-risk patients in England were vaccinated against flu. Two pharmacists involved in delivering innovative flu services discuss how pharmacies can help to boost this figure

 

Experts estimate that to minimise the impact of flu, at least 75 per cent of those at greatest risk need to be vaccinated before the season starts. Pharmacists are increasingly playing an important role in helping to meet these targets, providing both private and NHS-commissioned services for adults and children.

Children’s pilot

The phased introduction of flu vaccines for two to 17-year-olds began last winter with a pilot scheme for primary school aged children in Cumbria, Bury, Gateshead, Leicester and Rutland, Havering and Newham and South East Essex. Children were offered an intranasal vaccine. In most areas, school-based delivery was used, but in Cumbria, community pharmacies were involved. Across the county, 87 community pharmacies delivered 11,113 vaccinations. The service will continue this winter. Chris Stothard, pharmacy manager at Asda in Workington, was involved in the scheme last winter.

“We got all of our dispensing staff trained with the paperwork and background information on flu so they could answer questions from parents. The parents were made aware of the service through schools and we also got staff to mention it to customers in the shop. Parents came in after school with their children, or whenever it was convenient for them, and they could either book an appointment or just turn up,” explains Chris.

“The parents were all happy for us to do the vaccinations as they understood we’re qualified health professionals. Parents asked us if the service would be recommissioned as they wanted to use it again. I think it certainly helped to build public trust in us. We also made good use of our consultation room, which helped make customers aware of the other services we can offer too.”

Chris’s pharmacy gave flu vaccinations to 551 children last winter – the second highest number in the region. “It was quiet to start with,” says Chris, “but we had a peak in November and early December.” The scheme has been recommissioned this winter as it was so successful. “Our LPC is doing most of the promotional work,” says Chris, “sending out vouchers to parents and also letters through schools to parents. But we’re also mentioning the service in-store when patients collect prescriptions.” The pilot may be extended to include older children next year.

The London Pharmacy flu vaccination service

Last winter, Pharmacy London (a forum of 12 local pharmaceutical committees (LPCs) in London) developed a city-wide community pharmacy-based NHS flu vaccination service. The aim was to provide flu vaccines to over-65s and under-65s in at risk groups. Almost two-thirds of London’s 1,800 pharmacies provided the service, and a total of 76,000 vaccines were given.

“Patient survey results show clearly that people really valued the increased access and choice provided by pharmacies delivering flu vaccinations. The working population in particular value not having to take time off work,” says Rekha Shah, chief executive officer, Kensington, Chelsea & Westminster LPC. “The success of the service last year resulted in the NHSE commissioner in London being keen to recommission the service this year.”

In addition to the seasonal flu vaccine, pharmacies in London have also been commissioned to give the pneumococcal vaccine to patients this winter. Anar Tejani, proprietor pharmacist at Portmans Pharmacy, Pimlico, was involved in last winter’s London Pharmacy service. 

“We previously offered NHS commissioned flu vaccines, but on a smaller scale to Westminster residents only,” explains Anar. “The London-wide service we offered was extremely popular last winter and really appreciated by customers, especially under-65s who were working and not necessarily from the same borough but within London.

We were overwhelmed by just how many customers said they would want to access all kinds of vaccinations from us

“Many of them were really appreciative that they could access the service on their way to work or in their lunch hour or at the weekend, as ours is a walk-in service,” she says. “There were many who said they have previously left it until very late and waited until there was a scare or not bothered at all because it was so inconvenient having to book an appointment with their GP and take time off work.”

Anar believes that offering the same service throughout London was key to gaining public confidence. “Because it was the same service right across London, it got itself some branding and spread via word of mouth,” she says. “Pharmacies can reach those at risk so well because of the sheer footfall we have. We managed to vaccinate a large percentage of at risk under-65s – in particular pregnant women and frontline healthcare workers.”

Last winter, Anar vaccinated 325 patients, and the service as a whole was a huge success. “We were overwhelmed by just how many customers said they would want to access all kinds of vaccinations from us because they felt we were more involved and spent proper time counselling, providing them with much more information about how the flu vaccine helped them, how it worked, etc. We also had such a lot of requests for us to do travel vaccinations too that we’re going to provide this service, but on a private basis.”

 

Is it a cold or flu?

While a basic rule of thumb may be “If you can still get out of bed, it’s not flu – it’s just a cold”, it helps to be specific when finding out if your customer has a cold or flu.

Cold symptoms: Runny nose, sneezing, blocked nose, coughing, hoarse voice. Symptoms develop over one or two days and can last up to 14 days. Children may have a raised temperature.

Flu symptoms: Symptoms start suddenly and are severe. Alongside cold symptoms, additional signs include sudden fever, headache, tiredness, chills, aching muscles, joint or limb pain, diarrhoea, loss of appetite and insomnia. Symptoms peak after two or three days, but recovery can take up to 10 days. Patients can remain feeling tired for longer than this.

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