Mobility aids are a huge, largely untapped market and pharmacists could become the first port of call for their provision in England if a fledgling scheme takes off, finds Francesca Robinson
A government scheme to make mobility and daily living aids available through pharmacies is set to open up an interesting and profitable new market.
The government is looking to pharmacies in England to provide these products because there have been growing problems with the way the service has traditionally been provided.
The equipment – ranging from simple aids for daily living such as eating and drinking utensils, grab rails and raised toilet seats to more complex equipment such as pressure care mattresses, hoists and lifts – helps millions of people to live independently in their own homes.
But currently only 40 per cent of people who are entitled to have the equipment provided by the state are receiving it.
There are long waits for assessment by occupational therapists and for subsequent delivery of the equipment from a loan store. The process is expensive for local authorities, which provide the products in most areas and have to pay for delivery and recycling of the equipment.
So the Department of Health (DH) has launched the Transforming Community Equipment Services (TCES) programme, which will see people entitled to state-funded mobility aids issued with prescriptions by occupational therapists. The prescriptions can be exchanged for products stocked by any accredited retailer – and the DH is targeting pharmacies to become such providers.
If they wish, users can top-up the prescription by paying extra for a more advanced or luxurious piece of equipment. Pharmacists will be reimbursed for TCES products at a price fixed by a national tariff.
Phil Stephens, the then DH TCES project lead who launched the scheme, says: “We wanted to create an open marketplace, not only for the people who receive prescriptions but also for those who want to buy the equipment themselves.
“Pharmacies are well trusted by their customers and are located in the communities where people live, so they tend to know the people who will be receiving the prescription and any other health needs they might have. It is an ideal fit.”
The scheme has already been piloted by councils in the north west and in the last year has gone live in several London boroughs. The DH hopes to have two-thirds of local authorities on board within three to five years.
How to get involved
The first thing a pharmacy will hear about the scheme is when a letter drops through their door from their local authority inviting them to a briefing event. This is the point at which they can register an interest.
Pharmacists who want to take part must be accredited by their local council. This involves going on a short training programme to ensure they and their staff are competent to advise on the suitability of products and demonstrate the safe and correct use of equipment. Some authorities are providing free training, while others are charging pharmacists cost price – anything up to £130.
Pharmacies will be expected to stock smaller items so that customers can pick them up in-store. Bulkier items will be sold from catalogues and pharmacies will negotiate with wholesalers to deliver the products on a daily basis. They will then have to either deliver and install the products themselves or pay a company to fulfil that part of the transaction.
The benefits for pharmacies
Around 60 per cent of people who need mobility aids are not getting them and Mr Stephens estimates the retail value of the market is potentially worth more than £1 billion.
“Pharmacists will make more profit from selling daily living aids than from selling shampoos and trying to compete on price with Asda. If people go to the pharmacy to buy a daily living aid, they will tend to buy more than one. There are good margins to be made on them,” he says.
“What we are trying to do is create an accessible marketplace for these products. At the moment, consumers don’t know there is a market out there.”
Hatul Shah – an independent contractor who is part of the pharmacy supplier Sigma, which has a mobility aid arm, Sigmobility – has been working with the DH to develop the programme and believes the scheme represents a significant business opportunity for pharmacists.
“Mobility products will give an instant profit margin and is a niche market, which will bring new customers into the shop. Also, it fits well with what we do in the pharmacy; it is all about providing care,” he comments.
Mr Shah says pharmacists can expect to make a profit of around 20 per cent on a TCES line and around 45 per cent on a product sold privately. This compares with around 5 per cent profit on selling disposable nappies.
He observes: “Pharmacists have been hesitant about this new area – they are reluctant to change. But slowly they are realising there is a market here and with the ageing population there is an increasing requirement for these products.
“There is potential for massive growth in this market which could generate a lot of revenue for pharmacists. When you have got the government pushing a scheme like this, you can’t ask for anything more.”
Case study 1: Boots
Earlier this year, Boots trialled the TCES scheme in “a number” of its stores across the UK.
The multiple is interested in supplying independent living aids because it fits with its ethos of offering a wide choice of products and services to meet the requirements of its customers, a spokesperson says.
Boots is no longer dispensing the equipment in-store, because the trial found local variations in requirements, expectations and market conditions made it difficult for the multiple to operate the service consistently across its national chain. “For a national retailer, meeting the different requirements that each local authority naturally has brings operational complexity,” a spokesperson says.
The company also found some logistical challenges in delivering the in-store service. A spokesperson explains: “Unlike independent mobility retailers, pharmacies do not normally have space to store or display the tariff products, so order them when a prescription is received. The customer then comes to the store to collect the product once it has been delivered.
“This can be a disadvantage, particularly when the customer wants a product urgently.”
But Boots is still providing the independent living aids online. Over 600 daily living and mobility aids are stocked at www.boots.com – customers can order online or in any store, and orders are delivered direct to their home addresses.
Case study 2: Holborn Pharmacy, Camden, London
Pradip Patel became involved in the scheme, partly because he viewed supplying mobility aids as part of his caring role – and also because he felt his business could make money on the products.
“We are currently dispensing about two or three items a week,” Mr Patel says. “The most popular items have been bath boards, perching stools and bath stools and raised toilet seats. So far only a few people have topped up their prescriptions.
“We are now stocking around 30 of the lines we know will sell. We always keep a selection of walking sticks and crutches and we will start displaying these items as well, so people might see them and buy more.
“Delivering mobility aids can be difficult as we are in central London and a lot of people live in flats. It can also be time consuming – for example, it can take 10 to 15 minutes to put up a perching chair.”
Mr Patel has two members of staff accredited to dispense mobility aids and says the two-hour training provided free by Camden Council was good.
“I see the scheme as an add-on to what we are doing at present, but it is still early days. When there are bigger volumes, it will be worth keeping more items in stock,” he says.
Case study 3: Southwark Council
The scheme went live in Southwark in February with 14 accredited retailers, 10 of which are pharmacies, and the council’s TCES project manager Taylor Jakks says it is now “mainstreamed – part of our day-to-day business”.
The number of monthly prescriptions is increasing and the council has now redeemed almost 400. Retailers have also reported that customers have been topping up their products and self-funding additional items, Mr Jakks says.
The most frequently prescribed items are: plastic grab rails, pick-up and reaching aids, perching stools, bath steps, commodes, general furniture raisers, raised toilet seats, bed lever and trolleys.
To join the scheme, pharmacies paid £130 per person for accreditation training, which involves a four-hour e-learning course, plus a further three hours face to face, familiarising retailers with the equipment and related issues, so that they become experts and can give good information and advice. “We expect the price of the training will fall as the market for assessor training grows,” Mr Jakks says.
Pharmacists redeem the prescriptions through the council’s online ordering portal and are on immediate payment terms to receive reimbursement within a week.
One issue has been the size of pharmacists’ shops and their ability to keep large amounts of stock. “We have three pharmacies that are a good size and can keep stock and exchange products immediately for prescriptions. We encourage the smaller shops to keep four or five different catalogues so they can offer people a choice of products so that they don’t have to hold vast amounts of stock,” says Mr Jakks.
Pharmacists make a profit of around 22 per cent on TCES items. “But what my retailers have realised is that it’s the top-up and additional sales on which they can make higher margins,” says Mr Jakks. “Getting a retailer to hold stock and become a source of information and advice encourages people to buy more items earlier privately for themselves. This might prevent accidents, while encouraging people to become more independent and less reliant on the state.”
Tips for your CPD entry on mobility aids
Reflect: Would my patients benefit from an independent living aids service?
Plan: Consider whether my pharmacy could get involved in the TCES scheme or otherwise provide mobility equipment.
Act: Join the TCES scheme where possible, or introduce independent living aids to pharmacy if appropriate.
Evaluate: Do my patients benefit from my independent living aids service?