How to get your foot in the door with foot care

Peter Bettles studied at the University of Nottingham and registered as a pharmacist in 1984. Since qualifying, he has worked for Boots, Moss Chemists and Alliance Pharmacy before joining Pierremont Pharmacy in 2014. He started as pharmacy manager before assuming the additional responsibility of pharmacy superintendent after about a year. In 2016, he qualified as a pharmacist independent prescriber specialising in anticoagulation, which he uses to facilitate Pierremont Pharmacy’s international normalised ratio monitoring and prescribing service.

Why did you start a foot clinic in your community pharmacy?

The foot clinic was introduced to the pharmacy early in its history (we opened in 2007) and pre-dates my arrival here. The intention from the outset was for Pierremont Pharmacy to be a services-oriented pharmacy. We opened with two consulting rooms, and we have since added another. Foot care was a service we thought would be valuable because it fits well with the local demographics. It also enabled us to work with other (foot health) professionals, who were working on a self-employed basis but looking to set up a practice locally, many of whom historically offered house calls only.

One such professional actually made the decision to move further along this route and decided to open a clinic in addition to the days he did for us. It gives us satisfaction to be able to facilitate business growth in this way.

How does the foot clinic feed into your pharmacy business?

The clinic is run by a self-employed foot health practitioner. The arrangement in place is that the patient pays the pharmacy for the appointment and this is included as part of our daily cash takings. Subsequently, at the end of the month the practitioner invoices us for a set percentage of that month’s foot care appointment takings.

There are other benefits to the pharmacy from over-the-counter sales of items recommended to the patient by the practitioner on their visit and repeat purchases of the same. Also, over time, we have developed a reputation locally for having a degree of expertise in this area, which I believe encourages people to choose our pharmacy if they are experiencing a foot-related issue.

Over the years, the foot health professional running the clinic has changed but the same patients come back time and time again. There is trust between the pharmacy and the patient. Our patients know that, if they come to us, they will get a good and reliable service, and the satisfaction that they are being seen by a professional who knows what they are doing.

What business opportunities has the foot clinic created for your business?

Patients, when choosing which pharmacy to use locally, will consider what the pharmacy can do for them. We are fortunate in being able to offer a number of services — foot care is just one example. I believe this influences their decision-making. Our pharmacy is positioned on a busy main road and is fairly central in Broadstairs. However, there are no GP surgeries closer to us than to other pharmacies, so every one of our patients has travelled further than absolutely necessary to access our pharmacy services. Just up the road from us, there is another pharmacy (a multiple) that has a chiropodist who comes in from time to time, so we really need to offer top-level service to retain our clients. Hence, our reputation is important and people need to know that if they come to us they will get good service.

What are the most common foot complaints that your pharmacy comes across?

The most common complaints include athlete’s foot, corns, calluses, ingrown toenails and verrucae. As people get older, they are more likely to seek help because they encounter more problems and find it increasingly difficult to look after their feet without help (i.e. they encounter issues with dexterity and actually reaching the feet easily to take care of them).

How does your pharmacy take advantage of specialist foot care products to increase sales?

Following initial product recommendation by the foot health practitioner, our counter staff discuss the patient’s issues with a view to identify other products that may, in combination, help the patient with the condition. Frequently recommended products include fungal nail solutions, heel balms and callous/corn removal kits. A number of patients present with general aches from being on their feet for long periods and the gel insoles are popular. In summer, fungal conditions are more common and we will discuss good foot hygiene and make recommendations around treatment and prevention of conditions such as athlete’s foot. We look to offer products that will ensure good foot health between appointments.

Do you get referrals from other healthcare professionals because your pharmacy runs a foot clinic?

Sometimes, but not often. Local GP surgeries are aware that we offer this service, but some offer their own service or rent rooms out to foot health professionals. We receive referrals but we do not record them, so we do not have any statistics to identify how many we receive. Most of the appointments are with returning patients and the repeat nature of the business is an important plus-side to offering a foot health service. The advantage with us is that it is often easier to make an appointment here; because of the way we operate, with adequate time allowed for each appointment, we can guarantee the patient will be seen promptly at the allotted time. This, of course, is important for those who lead busy lives.

How do you ensure your staff are knowledgeable about foot care and the latest products on the market?

We have an experienced and knowledgeable team; the challenge really is to make sure they stay up to date as new products become available. To achieve this we make related training materials available to the staff and encourage them to develop and maintain a good level of product knowledge around the ranges we offer. Because we have a foot health professional here, it also means that staff can ask them questions, too, and increase their knowledge even further but, ultimately, it also enables our staff to signpost patients who come in with a foot query to our clinic to ensure they receive specialist advice.

What are the challenges in creating business opportunities around foot care?

When the pharmacy first opened, the biggest problem was building awareness among the local population on what we could offer them. By using the local press and our website, we were able to advertise the service and get the message out there. Another challenge was that we needed to make sure that we were competitive. It is all well and good to be offering a service but if you have someone else offering a similar service just up the road and they are a lot cheaper, then, of course, people will go there. By ensuring our rates are competitive, we have ensured that patients will keep coming back and that they receive great value for money.

We have been running the service for nearly 10 years now, and the pharmacy has built up a good reputation and, for many, it has become a first port of call for foot health issues.

What advice would you give to other pharmacists who are considering expanding their business into foot care?

Look at local demographics; consider how often you have been approached by patients in your area looking for this service; and ensure you have appropriate facilities, i.e. fully equipped consulting rooms to accommodate the clinics.

Work in partnership with foot health professionals. Do not be greedy but, likewise, do not sell yourself short either. Ask yourself:

• Is there a similar service close by?
• How much do they charge?
• What does their service offer?

In any business, you either open up where no one else is providing a service or you open up where several businesses offer the same thing (or similar). If you are near another business offering a similar service, being competitive is the key to getting it right because if you are not, customers will not come. You need to speculate to accumulate. In essence, better half of something than all of nothing.