When the NHS Business Services Authority (NHS BSA) published its April data for dispensing contractors in late July, it revealed that England’s community pharmacies have been largely struggling with Pharmacy First - averaging 17 clinical pathway consultations per pharmacy that month.

The data also showed which pharmacy had found the most success with the service: Optipharm Pharmacy in Wembley completed 3,292 Pharmacy First minor illness referral consultations in April alone.

The pharmacy is open six days a week for a total of 72 hours a week - or 312 hours in April - according to NHS data. This means that Optipharm would be completing more than ten minor illness referral consultations an hour on average.

Read more: UPDATED: August Pharmacy First consultation threshold dropped to 15

But a spokesperson for Optipharm yesterday (August 7) told C+D that its mammoth April haul is “well under the pharmacy's capacity”.

It comes as the minimum number of Pharmacy First consultations pharmacies must complete in August to qualify for a monthly payment has been reduced from 20 to 15, amid ongoing concerns about the achievability of the target.

 

13 pharmacists

 

Sole director and shareholder of Wembley Park Pharmacie – which bought Optipharm in January 2023 - Rafik Hammouda told C+D that the way it operates is “quite different from running a traditional retail pharmacy”.

It employs “up to 13 pharmacists at any one time” and each “generally conducts six remote consultations per hour”, he said.

While Optipharm’s “retail” pharmacy is open to the public, the pharmacists sit behind “dual screens” with “telephony headsets” in “the rear of the premises”, which hosts “consultation rooms and facilities” that can accommodate all 13 pharmacists, he added.

Read more: GPs need to ‘feel confident’ about Pharmacy First referrals, says BMA

These pharmacists are overseen by a “strong professional administration team” that organises rotas “in line with demand”, Hammouda told C+D.

NHS BSA data shows that Optipharm’s business in the traditional realms of pharmacies is modest, as it dispensed just 5,083 items in April. 

It did not do any other Pharmacy First consultations under the seven clinical pathways or urgent supply, according to the data.

 

“Many GPs unhappy with pharmacies”

 

But Optipharm has clearly carved out a niche in minor illness referrals - it receives referrals from “over 50 GP practices”, according to Hammouda.

He said that Optipharm had developed the “vast majority” of its relationships with GP practices before the launch of Pharmacy First.

He added that once a GP practice has made referrals to Optipharm, it “tends to continue and increase the volume due to patient choice and preference”.

Read more: Fifth of pharmacies warn May Pharmacy First threshold increase ‘unachievable’

“The sole incentive of the referral system for the GP practice is to achieve the [Pharmacy First] scheme's purpose of reducing the burden on the GPs and dealing with minor conditions that can be carried out quickly and effectively at a much-reduced cost and saving in time,” Hammouda said.

He told C+D that “many GPs are very unhappy with the service offered by many pharmacies”, adding that GP practices make their “own choice based on performance”.

Read more: GPs switch off update patient record function in new Pharmacy First IT twist

“In contrast to other pharmacies that are more traditional”, Optipharm has “built a professional service” that addresses patient needs, he said.

“Invariably, given patients' past experiences with pharmacists, patients opt for high-quality professional pharmacy services,” he added.

 

“Best in class”

 

Hammouda told C+D that Optipharm has “concentrated [on] and heavily invested in providing a professional service”.

This investment bought it the services of its 13 “top-of-their-profession” prescribing pharmacists, “administrative support”, its technology and a “comms system so that our pharmacists can be directly contacted through each GP's phone line”, he said.

Hammouda clarified that Optipharm does not dispense any of the prescriptions from this service, but it does continue to dispense other medications as a community pharmacy.

Read more: Pharmacies set to receive just £180m of £645m ‘promised’ Pharmacy First funding

“We are proud to consider ourselves ‘best in class’ and always strive to maintain and improve our level of service,” he added.

He added that the pharmacy is planning to “widen [its] offering” and “undertake the investment and training needed to provide the broader [Pharmacy First] service”.

He told C+D that Optipharm is “always happy” to share its experience and “advise on how to put in place a different type of pharmacy service”.

 

Sister pharmacies

 

But Optipharm is not alone in securing thousands of minor illness referrals under Pharmacy First.

Two other North West London pharmacies owned by Hammouda are in the top three pharmacies for Pharmacy First consultations.

Meacher, Higgins & Thomas in Marylebone performed 2,626 minor illness referral consultations in April, and Overton & Pickup in Harrow completed 2,275. 

Read more: Pharmacies with extra ‘capacity’ to pick up digital Pharmacy First consultations

Both are small pharmacies in terms of items dispensed, with Meacher dispensing 1,012 items and Overton 1,822 items in April.

The three pharmacies completed 6.5% of all minor illness referrals in England under Pharmacy First in April, according to NHS BSA data.

Hammouda told C+D that he is “sole shareholder and director” of Wembley Park Pharmacie and 7Day Chemiist, having bought both on June 14 2024. 

He said that Wembley Park bought Optipharm in January 2023 and Overton in June 2023, while 7Day Chemiist acquired Meacher in December 2023.

Read more: BREAKING: Pharmacists able to update GP records from today

While Companies House lists different people as the directors and people with significant control for Optipharm, Meacher and Overton, Hammouda said that he has faced a “delay in registering” because he is “awaiting the NHS contract counter signature” amid “a significant backlog”.

From October, pharmacies face a threshold of 30 Pharmacy First consultations per month to qualify for the £1,000 fixed payment.