Healthcare: Pharmacies on the front line

Last month a Which? investigation claimed pharmacies were failing the public, but a PR battle is being fought, finds Mark Johnson

Most people can't get through the winter without at least one visit to the chemist for a sore throat or a cough. Even with minor ailments, we rely on pharmacists' recommendations for a speedy recovery. When it comes to more serious illnesses, that advice becomes even more crucial. But what if the advice that pharmacists give us on treatment is wrong?

On 5 February, the Consumers' Association's Which? magazine published a damning report on the advice pharmacists give to consumers. Which? claimed that more than 40 per cent of pharmacies gave unsatisfactory advice and often failed to ask the right questions when 12 of its researchers went undercover last October to visit 84 pharmacies across England, Scotland and Wales. The story was widely reported in the media.

Such findings are never timely, but the timing of this report was particularly sensitive given the Government's plans to expand the role of pharmacists in front-line healthcare. Later this year, the Government is planning to allow some pharmacists to prescribe medicines and repeat prescriptions without involving a doctor. Some healthcare experts are now concerned that the Which? report might damage consumer confidence in community pharmacies.

At a corporate level, pharmacy chains themselves could also face a PR battle to restore consumer confidence. The report claimed that unsatisfactory advice was obtained in many parts of the country, and across the whole market, from the three big chains - Boots, Lloyds and Moss - to the smaller chains such as Superdrug, supermarket pharmacies and independents.

But despite the combination of a respected campaigning body, the media sensation following the damning findings, and the Which? results themselves, have done little to concern PR departments, according to most major high street pharmacies.

Measured response

Superdrug reacted immediately with the release of a prepared statement, as did many other high street chains such as Boots (see box) - not the behaviour of embattled brands.

Superdrug head of PR Wendy Campling says: 'Superdrug restated its commitment to training all pharmacists and reminded all of them about the report.' But she adds: 'There has been no change in our PR tactics.' Instead, an ongoing battle is being waged between the Consumers' Association and the professional and regulatory body for pharmacists, the Royal Pharmaceutical Society (RPS), that is itself something of a PR stalemate.

On the day the Which? story broke, RPS director of practice and quality improvement David Pruce appeared on GMTV, the BBC's Breakfast and lunchtime news shows, and a range of other radio and TV interviews, admitting disappointment in the findings but defending the majority of pharmacies.

'We tried to put it into perspective and put over the amount of training pharmacists have and the amount of (extra) training they will be required to have if the Government gets its way,' says Pruce. The RPS also put forward president Dr Gill Hawksworth who gave nine live interviews for local and regional BBC radio. Since then, the RPS claims it has requested details of the findings so that it may fulfil its regulatory role and take appropriate action.

'We said we intended to investigate the findings,' says Pruce. 'We've asked Which? to share the results but it is so far not doing that (at the time of PRWeek going to press).'

In what amounts to a stand-off between the two bodies, Which? responds by saying that the RPS was shown the findings prior to publication. 'After the meeting they said they were happy with our approach but concerned about our findings. They communicated to us that they thought we'd done a thorough piece of work,' says Which?

magazine senior researcher Nikki Ratcliff.

'We want to enter dialogue with RPS to reveal all our findings. We are willing to share them. But we are not willing to identify the 35 pharmacies (that received bad results in the report) who may be scapegoated,' she adds.

Criticism of the Which? report does not stop there, either. The National Pharmaceutical Association (NPA), the trade body for pharmacies, criticises the methodology of the research.

NPA head of PR Judy Viitanen says: 'The NPA is understandably disappointed with the findings of this research. But great caution is needed in extrapolating the results of such a small-sample study.' On that point too, Which? defends its work. 'We are confident we were thorough and our findings were robust,' says Ratcliff.

Outside the ongoing war of words, people seem to rely upon the advice of their high-street pharmacist as much as they did before the report.

The Government also appears just as determined to involve pharmacists more in health promotion, advising on issues such as sexual health and encouraging better self-care in areas such as weight loss and quitting smoking.

This despite the fact that the report also highlighted missed opportunities for pharmacists to advise on sexually transmitted infections when researchers asked about emergency contraception.

The NPA says the reason the survey has failed to cause as much concern as the Consumers' Association perhaps expected, apart from the reasons mentioned before, are that the findings fly in the face of existing research.

NPA chief executive John D'Arcy says: 'A core reason why the Government is pushing forward plans for this extended healthcare role for community pharmacy is that it has recognised the good, valuable work that pharmacists are already doing - and has seen evidence and reports to that effect.

This evidence is based on robust surveys, rather than small-scale studies.'

In the long term, the question of whether consumers will remain as trusting of pharmacists' advice as they traditionally have been seems almost settled.

The NPA is unequivocal in its views. Viitanen says: 'The public will weigh the results of this small-scale study against their real-life, personal experience of receiving solid, expert advice and healthcare services from their local pharmacist. We know there is a high level of satisfaction among consumers about the services they receive from their local pharmacist.'

Chemist & Druggist magazine, the weekly publication for community pharmacists, feels similarly that the report goes against the experiences of the vast majority of customers.

Escaping unscathed?

'High street chemists, because they have such a good rapport with customers, have managed not to be damaged by the Which? report,' says Chemist & Druggist editor Charles Gladwin. 'The message that has come across throughout this is that there is a lot of good pharmacy practice,' he adds.

Whether the report's findings are justified or the research is flawed, pharmacists and the Consumers' Association have ensured their arguments have been heard. The key element determining the fallout will be whether consumers increasingly turn to their pharmacies for advice.

BOOTS'S REACTION

Oonagh Turnbull, Boots head of PR Q What was the immediate reaction to the Which? report?

A We defended the role of pharmacists and pharmacies. We are confident and passionate about their role in helping people to take responsibility for their health. We went out to restore confidence by putting forward Boots pharmacist Janis Churton early to broadcasters. On the day she appeared on Radio 1, IRN, Saga Radio and lots of local stations. We targeted radio because at that time of day it was a radio rather than a TV story.

Q Has it caused you to change your PR tactics?

A It hasn't because we are already active in promoting our health and wellbeing offer. We have a team dedicated to healthcare and pharmacy in particular. With the expanding role of the pharmacist in the news at the time the Which? report was released, we already had the story on our agenda.

Q Do you have any independent research to refute the claims made by Which?

A We have, since 1980, used mystery shoppers once a month who visit our stores and look at all of our services, and that is handled by an independent company. It is conducted through every one of our pharmacies with an NHS contract. We use the findings to support any training needs we might have.

Q What kind of feedback have you had from customers since the Which? report?

A We know our customers trust our pharmacists and the advice they get.

We have a big customer service centre and have had no negative comments or feedback. We were concerned about the potential short and long-term impact of the report. On the day, we spoke to our pharmacists and sent out briefings to our 1,400 stores so our pharmacists were informed and could respond to customer enquiries.

Q What is your next move in terms of PR now that the inital story has died down?

A We wanted to ensure that our customers heard a balanced view on the Which? report, so we will continue to support and promote the role of the pharmacist.

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