Penny Beck was appointed superintendent pharmacist at Tesco Stores Plc in 1998. Jonathan Buisson visited Welwyn Garden City recently to discuss the effect of supermarket pharmacy on the profession and what the future might hold through e-commerce
Providing a quality service to customers is what Penny Beck thinks that pharmacy at Tesco supermarkets is all about. She repeatedly told me that she felt that Tesco pharmacists delivered an excellent service to their customers. She added that pharmacy had to prove to the Government and other health care professions that it could do more than deliver a supply function.
Did she think that the development of pharmacies within supermarkets been good for the profession as a whole?
Yes, she did: "We give what I think is an excellent service to our customers. I think it complements the offers you get on the high streets. We are committed to quality of service and value. Other pharmacies are as well. If we can raise the overall standard in the profession then that is good."
The issue of non-contract pharmacies within supermarkets has been a controversial one. Tesco has been aggresive in applying for contracts for its stores and seeking judicial reviews when decisions had gone against the company, but Penny Beck says that she still believes that customers want dispensing contracts in supermarket pharmacies. The stores are "destinations" for them and they want to achieve as many things as possible when they get there, including having their prescriptions dispensed.
She also defends the non-contract pharmacies which the company has already opened, dismissing accusations that they are not professionally fulfilling for the pharmacists who work in them.
"We have some excellent non-dispensing pharmacies and we have some excellent pharmacists that actually work in them who provide a brilliant service for our customers. The customers do like the offer. I cannot speak for the pharmacists who work there and say that it is 'professionally unfulfilling'. It is really their decision as to why they take the job. If they are going to sit around doing nothing then that is down to them. Our customers like the pharmacies."
She adds that if the pharmacists provide the customers with the service that they want to receive then the non-contract pharmacies can be financially viable, even at pharmacies situated within some of the company's smaller stores.
"They are not providing the dispensing service, but that means that the pharmacist is out on the counter, customer facing, all the time. The customers like that and they will come back and reuse the service. They are open long hours so if customers do want distress sales then they can provide that pharmacy-only medicine service."
Penny Beck is quick to dismiss one of the other "horror stories" about working in supermarket pharmacies, that of pharmacists being challenged or overruled on professional issues by non-pharmacy store managers.
"I know there are a few horror stories. It is a very challenging environment, but our pharmacists are professional people who will make those decisions and, as within any organisation, you have to be able to defend a professional decision. There is a reputation that store managers try to walk all over pharmacy but it is not the case. We would not have people who work for us and who are very loyal to us and have worked for us for a long, long time if that was the case."
She adds that she has not had to deal with such a case in the two years that she has been superintendent pharmacist.
Even with the fallow year approaching, Tesco expects to be running a preregistration training course in the coming year. She says that the company's strong recruitment campaign, which has won a number of marketing awards, has resulted in an increased number of applicants for its pharmacy positions. "We have got teacher-practitioners at five universities and they will be key to marketing our pharmacy services in the future and trying to attract people to come and work for us."
She emphasises that working for Tesco gives pharmacists such opportunities as part-time work which allows them to pursue other projects, including providing prescribing advice or studying for clinical diplomas.
What did she think about the new pharmacy graduates? Were they being prepared for community clinical roles that did not actually exist yet?
"I think they come out of university with some very clear ideas about what they think they are going to do and maybe the reality is not the same as the theory. I think the universities have got an awful lot of work still to do on developing pharmacists who will enjoy working within their future chosen careers.
"There is absolutely no reason why the clinical pharmacy role cannot be delivered from community pharmacy. That role should be delivered at that level to the patient. It does not have to be a specialised role. We can extend the pharmacist's role by liaising with general medical practitioners and getting involved with decision making. But, an awful lot of the time, pharmacists want it done for them, rather than being proactive and doing it themselves."
Were new pharmacists are being trained for pharmacy's "new age", which has not arrived yet?
Probably: "Their expectations are very high and we have got to manage that when they get out there."
It would be nice to see the Government's long awaited strategy for community pharmacy in the not too distant future, Penny Beck says, but she is worried that it will turn out to be something of a damp squib when it arrives.
"One wonders if they are delaying it because it has got something so controversial in it that they are wondering how we are going to deliver it, or if it is so mind-numbingly boring that it will not deliver pharmacists expectations."
What she would like to see in it are some realistic strategies which would allow a clinical pharmacy service to be delivered to patients at a community pharmacy level.
"We are not able to deliver, within the restraints of the current remuneration system, that kind of quality service to those particular customers. I am not saying that we are not delivering a quality service in what we do at present, but there is so much that we could do to have a more integrated primary health care team."
Turning to primary care groups and their equivalents, and the forthcoming primary care trusts, what could supermarket pharmacy offer to them?
"Same as any other community pharmacy, to be honest. It is fair to say that we are keeping an eye open and trying to work where we can locally, but it is really early days. I don't think that PCGs know yet what they want from pharmacy.
"There is a fundamental issue that we are not seen as part of the primary health care team, because we are not directly remunerated in totality by the National Health Service. It is an issue, but not one that we can't overcome.
"We have got to prove that we can add value to the way PCGs work at a strategic level, so that we are seen as someone who not only has a supply function, but who actually delivers a quality service so that people will start taking note of what we do.
"Supermarket pharmacy's strength is that it has access to a vast number of people who are not coming into the pharmacy as a primary reason but they will use it when they are there. Supermarkets have a tremendous footfall of the 'walking well' or people who do not actually realise that they have something wrong with them. So it is all about the provision of advice and being the first port of call."
She cites some of the public health campaigns which Tesco has run recently. A campaign which involved giving out glucose testing strips and information about diabetes led to nearly 1,000 new applications for membership of the British Diabetic Association. A new information pack on asthma has had to be reprinted after three months owing to demand.
Tesco has been expanding its e-commerce operations recently, announcing a trebling of the number of its stores which which will offer a home shopping service via the internet. Some general sale list medicines are available through this service, although analgesics are excluded. Penny Beck says that the pharmacy team is watching developments in this area although she says that it is not one of the team's top priorities.
"Within internet pharmacy you have got an auditable trail if you have asked questions with regard to pharmacy medicine sales. You have that dialogue, although you don't know who you are having that dialogue with at the other end, but there are problems about the delivery - having somebody there at the other end to collect the medicines."
She accepts that many of the main users of pharmacies are the elderly and mothers with young children who are not currently high users of the internet as they lack either the technology or the time to do so. These people could easily become isolated from the communities they live in.
"People like to go out and meet other people as part of the shopping, or prescription collection, experience. We like to think of our Tesco stores as part of a community, as is the pharmacy infrastructure anyway. Pharmacies are sited where there is a community and pharmacy is an integral part of that community. If you are providing a face-to-face service then you create a strong environment from which to provide the pharmacy service."
Looking ahead five years, Penny Beck says that she hopes that pharmacy will still be around, but it will need to be providing an excellent quality pharmacy service in order to do so.
"There might be electronic transmission of prescriptions, electronic payment of prescriptions, but in the current economic NHS climate I do not know whether five years is long enough to actually see that. I would hope that there are increased roles for the pharmacist, be that increased prescribing powers or the extended role, as an integrated part of the health team. In five years time we will have all our technicians either trained or training, which hopefully should release the pharmacist to provide these additional roles."
However, if pharmacy is to go forward, it will have to speak with one voice more often than it does, she believes.
"We have got the Society, the National Pharmaceutical Association, the Pharmaceutical Services Negotiating Committee, the Company Chemists Association, etc. When you actually work together you create a really strong voice. That has actually been proved with a PCG task group where we have seen positive moves forward and the Government is actually listening to what the voice of pharmacy, which is of one voice at this particular time, is saying. That is certainly one of the ways forward - to talk to each other. I appreciate that everyone has their own niches and roles, but rather than having sideswipes at people all the time we can go forward with one voice. We can find common areas and really make those areas strong for the profession."
Finally, had she considered standing for the Society's Council: "People keep asking me that question. Not this year."
Moving into supermarkets
Penny Beck studied at the Bradford school of pharmacy from 1977 to 1981, undertaking the four-year sandwich course, with placements in hospital pharmacy at Oxford and community pharmacy at Bradford. After qualification she continued working in hospital pharmacy at Oxford, then moved into community pharmacy in 1983.
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Jonathan Buisson in on the staff of The Pharmaceutical Journal