Pharmacy travel clinics: ready for take-off?

Reasons for starting

There are a variety of reasons that prompt pharmacies to offer a travel health service. Michelle Claridge, pharmacist contractor at Aqua Pharmacy in Ipswich, set up a travel clinic more than nine years ago, shortly after starting her business. It was all about having “an additional string to the business bow,” she says. 

“At that time the Government had started to implement funding cuts and the revenue from the prescription side of the business was slow. Running a travel clinic looked like a good business opportunity – which it has proved to be.”

James Tibbs saw setting up a travel clinic 10 years ago as part of his “personal development”. “It was also a great way to interact with patients and to get to know them a bit more. We were getting requests for travel vaccinations and I didn’t want customers to go elsewhere,” he says.

Shaheen Bhatia, superintendent pharmacist at P&S Chemist in Ilford, was prompted to offer travel healthcare 15 years ago to meet the needs of a diverse patient community. “Customers travelling on pilgrimage to Mecca were asking
me to set up a travel clinic to give the meningitis ACWY vaccination,” she recalls.

Confidence gained from providing flu vaccinations inspired Ade Williams to set up his travel health service in 2018. “It seemed like a very good fit for us,” he says.

Do your research

Any pharmacist seriously considering starting a travel health clinic needs to do some research, advises Michelle Claridge. “It is about reputation and credibility – if you’re going to do it, do it properly. Think about what you’re going to deliver and how you’re going to deliver it.” 

As part of that research, visiting other pharmacy-run travel health clinics can be an opportunity to learn from their experience – “their knowledge and expertise is useful”, she says.

A risk assessment is advisable before starting a travel health clinic, says Ade Williams. “I looked at the additional risks this service would bring to the pharmacy and what was needed to mitigate those risks, such as what the skills gaps were and what training was needed to fill them.”

When conducting a risk assessment, it is important pharmacists consider the kind of travel health service they want to offer. “Ask yourself: do you want to offer some or all of the travel vaccinations available? Do you want to do more extended travel health services? Whatever service you decide to provide needs to be safe and you will need to have the appropriate level of competence and experience,” Ade says.  

Another initial step to establishing a clinic is to partner with a specialist provider of patient group directions “that will do all the risk assessments and keep you up to date with the latest legal requirements”, explains James Tibbs.  

Training

Training on how to deliver a travel health service is crucial. Typically it includes evaluating the risks of diseases people could contract overseas, the specific vaccinations they will need, talking them through potential side-effects, and the importance of doing a risk assessment before giving vaccines, such as asking patients about their allergies and if they have had any previous allergic reactions to vaccinations. 

James says there are lots of organisations who offer training at a competitive price. Training is usually online, he says, can take about two weeks and is often completed with a face-to-face assessment by a travel clinic nurse, which involves the pharmacist demonstrating core competencies.

Pharmacy can deliver a wide variety of vaccinations including typhoid, meningitis B, cholera, hepatitis, rabies and Japanese encephalitis. Yellow fever needs specific training. Vaccinations is an area “most pharmacists have in their armoury now because they do flu and Covid vaccinations – and the principles with the act of vaccinating are essentially the same,” points out Michelle Claridge.

Travel health training is vital not only for pharmacists but also their team. “It is your team that sells the service for you and they need to know almost as much as you – so the more time you invest in their training, the happier they will feel about promoting the service,” says Shaheen Bhatia.

James recommends holding team training sessions – including role play – looking at what is realistic for the team to deliver and the challenges they might face. “This approach works well and allows people to really get involved with new services,” he says.

Time factor

Recruiting additional staff is also a consideration as pharmacists may need more help managing day-to-day services in the pharmacy, advises Michelle Claridge. Pharmacists need to factor in the amount of time that is involved in delivering a travel health service on top of managing a busy pharmacy.

“Giving a travel jab is a much longer interaction than doing a flu vaccination, so consultations can take quite a bit longer – maybe at least an hour,” she says. As it is a private service, people may also expect a more personal approach compared to a general practice travel appointment, she suggests.

Offering a travel health service is “very much about individualised care”, she adds. “To make your service desirable, good value, reputable and credible, you need to think about individual needs – such as if someone is going to be travelling ‘off grid’ for some time. It is not just about saying ‘you need this vaccination if you are going to this place’.” 

Key to providing a travel health service is the consultation room. “Your room needs to be fit for purpose and a calming environment – some people are nervous about vaccinations,” advises James Tibbs. He recommends investing in a bed if there is space – “it helps people to relax more” – or at least having a couple of chairs in the room.

Pharmacists also need to invest in a vaccine fridge – “don’t underestimate how much space vaccines use up”, says James Tibbs. And the need to keep expensive vaccines in cold storage means it is important to have the right insurance that covers travel health services. “All it takes is for someone to accidentally pull out the fridge plug,” warns Ade Williams.

Promoting the service

Travel health services need to be promoted through a variety of means – ranging from window display screens and posters to pharmacy websites and social media. “Promoting travel health services is very important and should be done wherever possible – including Instagram, Twitter and Facebook,” says Shaheen Bhatia.

Pharmacy teams should be encouraged to promote travel health services, says James Tibbs, while travel health clinics offer an opportunity for the pharmacy to link sell useful OTC travel products such as sun creams, mosquito repellents and nets, first aid kits, painkillers and antidiarrhoeals.

Customer satisfaction with a travel health clinic can lead to pharmacists engaging with them on other health issues or offering them additional services such as blood pressure checks. “I’ve had quite a few customers say they would like to bring their prescription here because of the advice I’ve given them and the time I’ve spent with them,” says Shaheen Bhatia. 

Having a clinic with a strong reputation helps retain customers and encourage new ones through word of mouth. Pharmacies can also ‘spread the word’ about their clinics to their GP colleagues and help ease the pressures in general practice. “We’ve built relationships with our local GP surgeries, who recommend us to patients wanting travel health services, including last minute travellers who aren’t able to get an appointment,” says Ade Williams.

Of course, setting up a travel clinic may not be all plain sailing and running a clinic can be time-consuming. “Don’t underestimate how long it can take to get the hang of things,” warns James Tibbs. 

It is also a high cost operation. “I have thousands of pounds worth of vaccines in my vaccine fridge at any point in time but you don’t bring the revenue in without having vaccines in place to meet a whole variety of needs,” says Michelle Claridge, who recommends starting a travel clinic gradually. “You might want to start with hepatitis B vaccinations to keep your financial input limited in terms of the range of vaccines you need to keep.”

Running a travel health clinic is “immensely rewarding”, she says. “It is a different level of interaction from a lot of what community pharmacy does, which is dealing with the ‘ill health’ side of life. Travel health is a preventative intervention, it is about engaging in scenarios that are usually joyful and exciting. And now holidays are back, we are vaccinating some very happy people."

Resources and further reading

• National Pharmacy Association: Travel Health
• National Pharmacy Association: Vaccination FAQs
• Pharmacy Magazine: Travel Health