At the end of 2015, the government delivered a financial blow to community pharmacy in the shape of funding cuts of £170m in 2016–2017, from £2.8bn to £2.63bn.
Warning that the cuts will “force pharmacies to reduce staffing levels and direct more people to GP or urgent care”, Sue Sharpe, chief executive of the Pharmaceutical Services Negotiating Committee, called it a “profoundly damaging move” that will “deliver a destructive blow to the support community pharmacies can offer to patients and the public”. At the same time, she praised the “many excellent business owners in the pharmacy sector who are incentivised to run their businesses as efficiently and effectively as possible”.
But just what kind of person does it take to run a successful pharmacy business that not only meets the needs of patients but also can deliver these massive savings to the NHS?
The ability to diversify is important. Even though his company has recently added an 11th outlet in the north of England to its portfolio, Steve Jeffers, chief executive of The Hub pharmacy, says entrepreneurs shouldn’t just focus on buying a shop. “There are so many more possibilities opening up where an entrepreneurial mindset can develop a business that is not necessarily a traditional community pharmacy — for example, via finance, marketing, healthcare consultancy, [human resources] and clinical routes,” he says.
You can’t just be in your little pharmacy bubble and plan your business from there — you need a breadth of understanding about the wider healthcare context.
Pharmacist Norman Niven understands this only too well. He pioneered the concept of tele-enabled monitored dosage systems at his company, Protomed, which he then sold to Quantum Pharmaceuticals, before setting up Protelhealth, a business that promotes health technologies to help more people live independently in their own homes.
His entrepreneurial life started when he set up his own pharmacy from scratch in 1985, and he says he built his businesses by “focusing on a need and filling that need, rather than creating a product and then finding a market for it”.
“Real entrepreneurs don’t chase the money, they chase the glory — they want to be the first and best at what they do,” he says. “They only think about money when they come to sell their business. They are also all obsessives, and don’t listen to anyone telling them they can’t or shouldn’t do something. In many cases their business plans look bad and they still go for it and, if they’re good, they turn things round.”
If knowledge is power, what degree of experience in the profession is required in order to be a successful entrepreneur?
Joanne Harris believes that a good commercial eye is necessary. Since 2012 she has been the health centre pharmacy owner and manager at Cross Hills Pharmacy in Keighley, West Yorkshire, and says: “I don’t believe you need experience in the profession to be a successful entrepreneur necessarily. The skills required are patience, vision, determination, good customer communication skills and an eye for detail. However, knowing your target market and competition is always a bonus so you can identify what your unique selling point will be, how you will capture your market and differ from the competition.”
Jeffers adds that age is no barrier, and suggests: “You’ve got to have an intellect in order to identify potential business opportunities and, crucially, you must be able to analyse what the potential and the risks might be.”
Beyond this, Niven adds it is not enough just to understand pharmacy. “You need an understanding of the wider healthcare scene — what GPs, nurses, social workers, and occupational therapists are up to. One thing you can guarantee in healthcare is that it’s going to change, so you can’t just be in your little pharmacy bubble and plan your business from there — you need a breadth of understanding about the wider healthcare context.
He says the vast majority of entrepreneurs have “an enormous amount of energy” although they are also “introspective, focused and can be obsessive”. He also warns that “most are poor delegators and poor managers” who can “destroy businesses that are up and running”.
“Once your business needs management you should get out — that’s when you need a good manager who focuses on detail, something that entrepreneurs don’t do.”
Sharing the vision
Successful entrepreneurs also know how to make the most of their staff, as Harris explains: “A good employee is steady, hardworking and good at carrying out instructions, whereas the entrepreneur has the vision, creativity and sets up how the service should be delivered. The staff need to be able to deliver the vision, but a good entrepreneur develops the staff and allows them to share visions on how the business can grow.”
Jeffers believes this chain of mentoring can help develop the entrepreneurs of the future. He says: “We ask all our pharmacy managers to act as local pharmacy entrepreneurs, identifying business opportunities to the company by linking in with the local healthcare environment. As the CEO I can’t possibly know what’s going in all our places all the time so I rely on our local pharmacy managers through the links they naturally create with local GPs, practice pharmacists, and nurse prescribers to identify business opportunities for us, and then we support them to develop those opportunities with our expertise and knowledge. That rubs off on them because they see how an idea is developed, planned and then delivered. Several people I’ve mentored over the years have gone on to set up their own businesses and I’m delighted about it.”
A step too far
Some people decide not to make the jump from employee to boss, and it is not necessarily through lack of ambition.
Jas is a community pharmacist at a large supermarket chain but says he is now looking for new opportunities away from the dispensary in either a hospital or primary care position. So what has put him off setting up on his own?
“I have been working in the same environment for a number of years and want to experience what other options are available for a pharmacist,” he says. “As well as this, I have recently become an independent prescriber but in order to use this qualification I need to move away from the community or retail environment because there are few opportunities to use it currently.”
He also cites what he calls the “ever growing demand to hit targets for advanced and enhanced services” as fuelling his desire for a change.
“This growing demand, alongside a reduction in the amount of support staff available, leads to an increased risk to patient care and the inappropriate administration of these services (e.g. medicines use reviews being conducted when they are not necessary in order to hit targets set by the company). This is an issue that many of my colleagues working for different companies also experience, although I must admit that my current employer seems to be nowhere near as demanding as many other multiples I hear about,” he explains.
Owning his own pharmacy was his aim when Jas was a student. “But the more time I have spent working in the community sector, the less attractive it has become,” he says. “The recent news about a 6% reduction in pharmacy funding, the continual reduction in category M payments, the failure of a number of 100-hour pharmacies, the high prices of pharmacies for sale, and those with relatively low or artificially high prescription numbers (i.e. through prescription channelling between pharmacies within the same business) have all put me off buying a pharmacy. It just doesn’t seem like an achievable aim to purchase and run a successful pharmacy business in the near future.”
For Jeffers, the “willingness to balance risk” is probably the biggest differential between and entrepreneur and someone happy to continue being an employee. And he adds that “risk taking isn’t just financial. You also need to have your family support network behind you because there will always be ups and downs and most people can’t get through it on their own inner drive alone. Time requirements can also put a strain if you have a young family so remember that work is not everything, even for entrepreneurs.”
Entrepreneurship is not for everyone but, for those who do manage to make it work, it can be life changing. Harris says she would “find it hard to be employed by someone else now because I like the freedom to create and develop as I see fit”.
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