Moving from a flu to a travel vaccination service

With the last flu vaccination campaign now over, as a community pharmacist you will no doubt be thinking ahead to next season…reflecting on how well you did and what you might do differently for the next campaign.

Whilst stepping up your professional development to learn a new invasive technique may have seemed daunting at the time, most pharmacists will agree that administering vaccines is just part-and-parcel of what a community pharmacist does. It is also professionally very rewarding… making better use of your clinical skills at the same time as contributing to an uptake in NHS flu vaccination numbers[1].

So…what’s next in your professional development?

The basic skills you will have perfected to administer a flu vaccination are essentially the same skills you would need to administer travel vaccinations. And with the recent NHS proposals[2] to remove travel vaccinations from the NHS, providing a travel vaccination service to your customers and patients may also make commercial sense. This may already be something you have been thinking about but haven’t had the opportunity to fully consider what it involves.

Things to consider when moving from a flu to travel vaccination service

Practical skills

·         The main additional skill you will need to use is how to reconstitute a travel vaccine that is not presented as a prefilled syringe. Essentially this is the same as reconstituting any powder/solvent preparation during dispensing, except that solutions are transferred using a sterile needle

·         Reconstitution is covered by ECG as part of your vaccination training so it’s really about putting what you have learned into practice

Legal framework

·         Whilst you will be familiar with using PGDs to authorise the supply of prescription-only medicines such as vaccines, you may also wish to consider using some of the alternative formats such as PSDs (Patient Specific Directions) or Online Doctor prescriptions. The differences between each of these is too big a topic to cover here but is certainly something you may want to look into[3] if you’re nervous about taking clinical ‘prescribing’ decisions yourself

·         If you are considering offering travel vaccinations to children, depending on their age, you should ensure this is covered by the scope of the PGD/PSD. You may also need additional mandatory training in basic life support, which ECG is able to include within your training

·         Ensure you have the necessary Standard Operating Procedures in place to support the service

Insurance

·         The insurance you have in place for your professional services may already cover a travel vaccination service but you should confirm this with your insurer

Operational constraints

·         When planning a travel service, do think very strongly about the practicalities of how you can deliver the service alongside your existing services. A good travel consultation will take at least 30 minutes…probably very much longer. The consultation room will be unavailable for other services during this time. You may have walk-in customers with prescriptions or just wanting your advice. You may want to introduce an appointment system for when you know you will be quieter

Clinical knowledge

·         The provider of your PGD/PSD will stipulate the training required to supply & administer travel vaccines &/or antimalarials. You should have an understanding of each of the vaccines, but also a wider understanding of travel health such as bite avoidance, sun protection and food & water hygiene. Ask your pharmaceutical rep if they have any training to support travel health, but also look into workshops such as those provided by the Royal Pharmaceutical Society

Reference sources

·         Staying up to date with the latest advice and recommendations is essential to offering a travel vaccination service. Avoid using printed information which can become out-of-date before printed updates are made available. The best sources of information would be the NHS Fit For Travel[4] website and the Department of Health’s online Green Book – Immunisation against infectious disease[5]

Supply & storage

·         Check with your supplier that they are able to supply all the vaccines you would need. Which brands are available and at what cost price / is supply restricted from certain wholesalers or direct from the manufacturer / is there a minimum order quantity / what is the lead time for delivery?

·         You will also need to think about your current storage capacity….do you have space to store the travel vaccines or is it time to invest in an additional or larger dispensary fridge?

Commercial opportunities

·         Think about your existing retail offering. When advising your customers about general travel health, you will be advising them in areas such as bite avoidance, sun protection, food & water hygiene, etc. Instead of sending them elsewhere to buy these items make sure you stock them yourself…your customer is much more likely to purchase based on your personal recommendations

Marketing opportunities

·         Think about how you are going to market the service, whether this is in-store point-of-sale of striking up a relationship with your local travel agent and asking them to refer or to display your service leaflets

 

  1. http://psnc.org.uk/our-news/over-221k-more-flu-vaccinations-administered-by-community-pharmacists-during-201617/
  2. http://www.dailymail.co.uk/health/article-4354724/Blueprint-save-NHS-Dramatic-drive-cut-costs.html
  3. https://www.rcn.org.uk/clinical-topics/medicines-optimisation/specialist-areas/patient-specific-directions-and-patient-group-directions
  4. http://www.fitfortravel.nhs.uk/destinations.aspx
  5. https://www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book

Written by Nitin Makadia (Consultant Pharmacist) 5th May 2017