The Pharmacy Planet Podcast: Pharmacy Leadership & the Future of Community Pharmacy: The Expert Opinion with Mandeep Mudhar

Boo Dhaliwal: Yeah. 

Mandeep Mudhar: I'm a big fan of it. Yes. I'm, uh, long, gosh, it shows how 

Mandeep's Journey: From Kenya to UK Pharmacy
Mandeep Mudhar: old I am.

I. I came to this country, uh, almost 40 years ago. I'm an East African Asian. 

Boo Dhaliwal: Okay. Okay. 

Mandeep Mudhar: Uh, from Kenya to do my pharmacy in Bradford University. Uh, of all places you imagine from the tropical climates of East Africa, straight, straight to Bradford. Yeah. 

Boo Dhaliwal: Lovely. 

Mandeep Mudhar: I know, and I was. The last of the three year courses there before they moved onto the sandwich course.

Yeah. Permanently. Which then, you know, a lot of universities did, finished there and then did my pre-reg for an independent pharmacy down in, uh, Kingston. Okay. Um, and, you know, learned so much about, you know, running, managing a, a pharmacy there because you're hands on in an independent pharmacy. 

Boo Dhaliwal: Yeah. 

Mandeep Mudhar: And then a lot of my friends from uni were all.

In the East Midlands, they were all working there. Um, so it felt like a good idea to sort of head to towards the Midlands. And I became manager of a Moss pharmacy there. 

Boo Dhaliwal: Okay. 

Mandeep Mudhar: Um, those days Moss had about 90 [00:02:00] pharmacies and they just started opening, uh, pharmacies in, uh, Asda stores. 

Boo Dhaliwal: Okay. 

Mandeep Mudhar: Um, so I was managing one of their pharmacies, which was actually one of their busiest pharmacies in, in Derby.

Um. Did that for about two and a half years. But there was something there, boo that said I need to, you know, use my brain a little bit further because I'd had a good degree from university and I just felt that I needed to do something. And you 

weren't 

Boo Dhaliwal: using 

Mandeep Mudhar: it at most, right? I didn't feel I was, I was exercising 

Academic Career at Aston University & PhD Journey
Mandeep Mudhar: everything I had.

And a job came up at Aston University and they were looking for lectures in pharmacy practice. Yeah. Not, not paying you anything near a salary for lecture, but an opportunity to do a PhD as well. 

Boo Dhaliwal: Yeah. 

Mandeep Mudhar: So, uh, opted, took a huge pay drop and moved to Birmingham, had Aston University where, uh, I think, uh, uh, you know, our parts, uh, crossed many, many years ago.

Boo Dhaliwal: Yeah. 

Mandeep Mudhar: And, uh, so I was there for seven years, uh, teaching pharmacy practice, teaching a bit of clinical pharmacy. Uh, I think there's been over a thousand students who've [00:03:00] passed through my sort of, you know, the life there. 

Boo Dhaliwal: Yeah. 

Mandeep Mudhar: Uh, and I finally got my PhD, uh, which took a doctorate. Yeah. Seven good years to, to get, and literally as soon as I did at that time, Aston, you know, a lot of universities were really.

Be sorted by you having to stay there to do research Yeah. And get research funding. And, and I, I just thought, you know, if I'm gonna buy a house, have a mortgage, live a sense of a life, academia's not gonna be foreign. It, 

Boo Dhaliwal: it's not gonna work. 

Mandeep Mudhar: Yeah. And, um, a h at that time were advertising for a professional services 

Breaking into Pharmaceutical Services at AAH
Mandeep Mudhar: pharmacist.

Um, the MD at the time, he was really farsighted. He could see even then. That they, the pharmacy, the future pharmacy would be services. 

Boo Dhaliwal: Yeah. 

Mandeep Mudhar: And so he, he was literally taking a punt in, employing a pharmacist to try and define what that looked like. There was no funding, there was no NHS funding. There was no recognition of services in p 

Creating the First Pharmacy Service Suite
Mandeep Mudhar: nothing.

And so, uh, so joined there in a marketing department bizarrely, and we created. The first, I think ever, um, suite of [00:04:00] services and there were literally diagnostic tests, uh, that we encouraged, um, customers of a h to, to sign up to. Uh, we first started it, uh, by calling Advantage Community Health Services. Uh, we trained the pharmacies.

These were big clunky diagnostic kits, you know, that you, you, you, you sort of try to get and patients had to pay for them. You know, now it private sort of services are pretty common in those days, are unheard of. We then moved on to something called Vantage Health Watch, and that's where we started developing the whole idea 

The Vision: From Dispensing to Services
Mandeep Mudhar: of services.

And even back then, I still remember this slide I put together to try and convince pharmacists that the future is all about services. And it was a C source slide. And it basically said today, you know, 90% of your income is on dispensing. 

Boo Dhaliwal: Yeah. 

Mandeep Mudhar: And the rest is sort of OTC. In 10 years time, 15 years time, 90% of your income will be on services.

Yeah. You know, I was trying to sell this sort of vision to them and some of them bought it. Some of them did. And look where we are today. [00:05:00] 

Boo Dhaliwal: You've, you just, you've just packed in a lot of years in the last couple of minutes. Yeah. Let me just take you back to what you just first said. The academia side, like, I dunno whether a lot of people know this, but me and the two directors who own Touchwood Pharmacy and Pharmacy 

Life as a Pharmacy Lecturer
Boo Dhaliwal: Planet.

We were your students. Yeah. Right. We actually studied under Mr. Mud, so Mr. Mudda was, was our lecturer at the time. It's even, it's, it's so weird because even now when we see you at various meetings, we have an automatic urge to just sit up a little bit and pay attention because it's, it's weird. 'cause you are as a 19, 20-year-old, like now I see you now and then 30 odd years ago.

Oh, what is it? 25 odd years ago? Whatever it was, longer 

Mandeep Mudhar: than 

Boo Dhaliwal: that. Yeah. Whatever it was to see. And, uh, to see you now, it's just, it's shocking. So you must see loads of your ex-students right now? All the time. 

Mandeep Mudhar: I do. And thankfully I remember most of them visually. Yeah. Even if the name sometimes escapes me and I do.

And I, I promise you, it gives me [00:06:00] so much pleasure when I see how well you guys have done. Or someone says to me, you know, I, I did this and then I moved on to this. In my career, I've met Pharmac who are now in academia who are. Leading in pharma industry like yourselves who own, you know, so many really good pharmacies, you know, people who formed those friendships at uni.

Honestly, it is, it is an amazing, you know, thing that I, I went through, well, 

Boo Dhaliwal: I don't know, so. My whole working life has been about either, either entrepreneurship and pharm and pharmacy, right? So it's been about retail, contractor, pharmacy. I don't know nothing about academia, but I've always thought these academics, these lecturers, they live a charmed 

Academia vs Retail: Stress & Challenges
Boo Dhaliwal: life.

Is it all relaxing and chilling a couple of lectures a week and spend the rest of the time at the pub? 

Mandeep Mudhar: I'll tell you what it I, it probably wasn't as stressful as running a pharmacy in a pharmacy. The stress bizarrely enough, was the fact that universities at that time would. Sorted by you bringing in research income.

Boo Dhaliwal: Alright. Okay. 

Mandeep Mudhar: And in pharmacy practice, [00:07:00] that's, that's how they 

Boo Dhaliwal: get paid, 

Mandeep Mudhar: right? Yeah, exactly. That's what drives the income. That sort of, and in those days, things like pharmacy practice, the things that I I was teaching didn't really have any research income. 

Boo Dhaliwal: Right. 

Mandeep Mudhar: So you are constantly being challenged, where's their research income?

Because in, in the scientific sort of projects, you know, pharmacology, chemistry, yeah. You know, they pay a lot of research funding because they want to find out a cure for cancer or whatever it is. Yeah, yeah. In pharmacy practice, you know, it was just the practice of pharmacy. There wasn't really any funding there, so that's what made it really, because Aston at that time really wanted to be the leader of research, you know, because they, they, they had found a drug for throat cancer, I believe, at the time, and the university was really famous for, for the, the, the, the sort of, you know, the, the research that it was churning.

But for guys like myself who couldn't really attract. That funding. Yeah. That was where the pressure was. But yeah, in terms of, you know, the workload and stuff, it wasn't anywhere as stressful as running a pharmacy or working in a, in a busy CPRIT environment. 

Boo Dhaliwal: Seven years for a pH seven [00:08:00] years is quite a big chunk of your life at that time as well.

Right? It was. It was. So you've gotta really love academia to even get through that. 

Mandeep Mudhar: Right. Right. You know. Yes and no. Part of part of it was I so far gone into the PhD at thought five, can't come back now Exactly. If I don't finish this thing now. And because it was part-time, I could only do hours in, in, on the weekends or whatever.

And so I got to that point where I just had to try and finish it one way or the other. And thankfully, um, the university let me, uh, just get away for the last year to write up my thesis. Did they, weren't you gone as well? They wanted, wanted me to finish it, get my PhD. Uh, that was a relief that, that I did.

So, uh, so that, so that, that's how I got across the line. 

Boo Dhaliwal: Then you moved on to a h now. Lemme get this right. They created a whole new role just for you. Yeah. You must have, you must have, you must have impressed somewhere or they had money to burn. 

Mandeep Mudhar: I think both. I think. I think the MD still to this day, he says, the reason I got you.

Because I thought this [00:09:00] guy's got a, a PhD, a doctorate. Yeah. He must be able to present well. 

Boo Dhaliwal: Right. 

Mandeep Mudhar: Okay. And at that time, being in a marketing department, it was all about presenting yourself well to customers and selling the idea. 

Boo Dhaliwal: Is this still the same now? Right. It's not really 

Mandeep Mudhar: changed 

Boo Dhaliwal: that much has it?

Mandeep Mudhar: Yeah. You still have to, you know, get your message across. Yeah. You still have to, you know, work with your customers to do that. Okay. But he was, he, he was ahead of his time. I mean, you know, to, to think about the fact that services were, was going to be the future before there was even a penny being, you know, given to pharmacy.

I 

Boo Dhaliwal: remember 

Mandeep Mudhar: it was quite, quite a thing. 

Boo Dhaliwal: So what kind of services could you possibly have started? Do you think I'm gonna take this role and fall flat on my face? 'cause I know for a fact when it was dispensing heavy pharmacies Yeah. There was no need to look at services because there was such a small fraction of your income.

It's the sort of thing where somebody started selling me to try a service, private service, or whatever it was. I wouldn't have even thought about it back in the day. Yeah. So what, what did you even start with? 

Mandeep Mudhar: I, I think, and that's where the, the, the marking was, [00:10:00] was very clever, which was let's just try and create some of these health.

Concerns, messages for the public to be able to become more aware. So for example, could I be at risk of having osteoporosis later in my life? Okay. Could I be at risk of perhaps, you know, uh, checking my diabetes or my blood sugar, for example? Okay. You know, those very early diagnostic testing. Can I check my blood pressure?

Okay. For example. So it was just things that, and the marketing was very much about, you know, checking your numbers, you know, the sort of things that you see even now, you know, and not, not a lot of that has changed. You're absolutely right. I think, to be fair, at that time, we attracted pharmacists who I suppose were running really good pharmacies, but they, they had a bit of a vision about wanting to do something else Oh, okay.

To exercise their clinical knowledge, their professional knowledge. So it wasn't for everyone. But it was for those who just wanted to, you know, do something a little bit different, um, in, in their pharmacies as 

Boo Dhaliwal: well. Okay. So you were there for four years. Did you grow the team or was it just you just tried the services thing, or did, did, did it [00:11:00] move from there 

Mandeep Mudhar: and there?

Yeah, so, so I was, I was fortunate whether it was, uh, you know, because of what, what I did, I, my role progressed quite sort of, uh, in, in the time I was there. Uh, and then I, I eventually, I ended up becoming director of marketing, so I was looking after the whole. Marketing function within. Ahh. And that included if at the time you remember Vantage Yeah.

Which was a sort of franchise support team. Are they not 

Boo Dhaliwal: around 

Mandeep Mudhar: anymore? Unfortunately, no. Unfortunately. You're 

Boo Dhaliwal: probably glad 

Mandeep Mudhar: now without figure 

Boo Dhaliwal: that they're not 

Mandeep Mudhar: around, they would've been a sort of competitor. Um, I was looking after marketing of the categories, you know, uh, PIs, generics, you know, branded.

I was looking after marketing of manufacturer services, so quite a broad remit. But, but I had also. Brought in a pharmacist to continue driving the, the services sort of message. Okay. And, uh, yeah, so we created something that was very exciting at that time. Um, but like with all things, you know, then we have to move 

Consulting & Freelance Pharmacy Work
Mandeep Mudhar: on.

Boo Dhaliwal: Okay. And then how come you left there then? 

Mandeep Mudhar: So what happened was, I think, I just felt that, you know, it at sort of worked big pharma, it was time to just, you [00:12:00] know, perhaps just. Have a bit of a break, do my own thing. And actually for about a year and a bit, I did a bit of consultancy, bit of locuming. Yeah.

Um, just wanted a bit of a change because seven years, you know, in, in a fairly intense sort of environment, corporate environment where there were a lot of changes also happening. Just felt like a, having, wanting a bit of a break. And actually I really enjoyed that time because. I went back to doing a bit of ing, but also I then did a lot of consultancy for like some pharma companies and mm-hmm.

I dunno if you remember, AstraZeneca launched a scheme called Making the Most of Your Medicines, and they were helping pharmacists, again, drive a message around compliance, around using their inhalers, uh, at the time. 

Boo Dhaliwal: Okay. 

Mandeep Mudhar: I helped design some of that, um, service as well, so, you know, there was work. Going on.

And the farmer were quite interested in driving the pharmacy sort of services agenda as well. So I did some fairly interesting projects during that time as well. 

Boo Dhaliwal: Oh, so that's, that's moving back quite a bit. Yeah. So you jumped so with, from manufacturers then you went straight, you went back into [00:13:00] uh, uh, 

Alliance Healthcare & Newmark Experience
Boo Dhaliwal: another wholesale group.

Right. 

Mandeep Mudhar: Good old alliance my first time around there. There, right, right. Okay. So yeah, so at that time, um, you know, the, uh, because I think Alliance were, um, aware of me having been that sort of a h and the things I did. They were looking for someone to, to fairly broad role to, to look after the categories, um, generics branded, uh, products, uh, PIs, uh, brand equalization, marketing.

It's a bit of everything. Services a bit of everything. 

Boo Dhaliwal: Yeah. 

Mandeep Mudhar: Uh, and, and, and that's what happens in, in, you know, in, in the sort of corporate world where you, you, you have a wide responsibility. Um, part of it helps because you're a pharmacist, so you understand the needs of, of the customer. So, yeah, so I was at Alliance for, for just under four years the first time around.

Uh, 

Boo Dhaliwal: okay. And you worked for Newmark as well, so, so yeah. Yeah, I was so Phoenix. So you worked for Newmark as well? Yeah. Yeah. You see now with Alphega as well. And Newmark and Alphega are basically, uh, competitors you would say, right? Yeah. So in the similar sort of field for pharmacy services. Yeah. So, uh. You must have picked up a lot of [00:14:00] Newmark as well, right?

Mandeep Mudhar: Yeah. Uh, and, and you know, Newmark was at, at a time. Fantastic. Um, the organization that I worked in at a time when we were growing membership numbers significantly, when I joined, we were just under 2000, uh, members. And when I left, I think we were just at around 4,000 members because obviously, you know, they, they were 

Supporting Independent Pharmacies
Mandeep Mudhar: driving.

Um, sign up membership. But yeah, again, it was about looking after services, looking after marketing and supporting independent pharmacy. So the constant theme in my career has been independent pharmacies and, and supporting them, you know, whether it's at Newmark or whether it's at Vego, whether it was 

Current Pharmacy Challenges & Future Direction
Mandeep Mudhar: Advantage Yeah.

Is all about supporting independence. 

Boo Dhaliwal: Okay. Now pharmacy's going through a lot of change right now. Yeah, so it's, it's topsy-turvy. If I was now trying to advise pharmacists of the future, I actually wouldn't know which direction. And we all know it's kind of service led, clinically led, but it's very wishy-washy because you can be a little bit, uh, too ahead of the time, I would say, as in, [00:15:00] for example, you mentioned how the person at a h when you start to introduce services and people weren't really ready.

I I can imagine right now that you, if you go hell for leather. For various services, there's probably not as much demand yet. Mm-hmm. In the population. Yeah. And they don't realize that you can go to the pharmacy. Mm-hmm. Um, so what, where do you see, where do you see pharmacy? How do you see it now? What are the challenges we are face?

What do you as an ger. Director see the challenges for independent pharmacies. 

Mandeep Mudhar: Okay. So I think first and foremost, you know, when, and especially in the last couple of years with all the, the pharmacies that, you know, uh, people have acquired, you know, and starting from scratch is a, 

Boo Dhaliwal: yeah. 

Mandeep Mudhar: First and foremost you've got to get your operational efficiencies of doing the, the day 

Operational Efficiency: Getting Dispensing Right
Mandeep Mudhar: job.

Yeah, yeah. That is still very much around the volume of dispensing prescriptions. Yeah. As efficiently as possible. Um, there whilst, you know, we know funding has, has. Has decreased in that area, but it is still such a big chunk of your, your workload and, and your income 

Boo Dhaliwal: and [00:16:00] your cost. 

Mandeep Mudhar: Your cost base. Right.

Your cost of course. Yeah. All the, all the, the staff and, and the, you know, cost of, uh, you know, the drugs and everything else in there. You've gotta get that right. And, and so when we go and I go and see new owners, it is, have you maxed out the efficiencies of your dispensing process? Have you improved that as much as you have?

Do you 

Boo Dhaliwal: guys help with that? 

Mandeep Mudhar: Of course Vega. Yes, we do. Do you? So we, we have, uh, business mentors, um, you know, who are, they're not sales, uh, people. They literally, they deal with any issue that you have. So, for example, you've just bought a pharmacy. A business mentor will say, look, I'll spend the best part of a day with you and I look at how 

Alphega Business Mentors: How They Help
Mandeep Mudhar: we can help you.

Improve your dispensing operation, for example, that could be as little as where is your stock in the dispensary? Yeah. How are you, you know, doing the process of dispensing. When are you doing your checks? When are you, you know, handing the, the, the, the prescription off to a checking technician if you have one?

So they'll literally do that and, and they're very experienced business mentors, you know. Oh, 

Boo Dhaliwal: how, how do you choose a business? How do [00:17:00] you become. Become, I look, can I become a 

Mandeep Mudhar: business worker? Yeah. We have, we have pharmacists in the team. There's another side 

Boo Dhaliwal: hustle. 

Mandeep Mudhar: Yeah. Uh, we have a pharmacist in the team.

We have, um, the, the team are people who have worked either in and supported independent pharmacy for years. 

Boo Dhaliwal: Yeah. 

Mandeep Mudhar: Um, I have some of the, the team who worked with me in previous organizations, you know, wanted to, wanted a change. People like myself, I'll go in and sit with a member and I'll spend two or three hours there because, you know, I've, I've got a, you know, that's what I've, I've, I've sort of done in, in the past and it's just experience years and years and years of experience.

Yeah. And, and, and so, you know, it's very difficult to, to bring someone new into the industry and ask them to do that. So we tend to bring, uh, mentors who, who. Got that knowledge and insight of pharmacy. They may have had operational roles with some of the big multiples, for example. Yeah. Um, so yeah, so we'll do that and, and if, if, for example, the, the, the new owner of the pharmacy says right now I've, I've sorted out my, my biggest challenge now is how am I going to drive?

People coming into my [00:18:00] pharmacy. Mm-hmm. Or how am I gonna drive services? Then we'll start focusing on that. So to your question, I think first, let's get your efficiencies right? Mm-hmm. Let's get, is your staff in the right place, right numbers, right Staff? Have you got the right mix of trained staff? Once we get that, then we'll look at.

What can we do in terms of your retail environment? You know, as your, have you got the best range, best product, best planogramming, because you still have to drive your OTC business, you know, it's still a, a, a significant chunk of, of your, of your turnover. And then we can look at, you know, right now you've got some services that are being commissioned by the NHS.

That's great. Do you want to drive, for example, private services? So we'll work on one thing at a time because we can't just, you know, start doing everything tomorrow, so, you 

Boo Dhaliwal: know. Okay. Yeah, it is, it's a good job. You mentioned OTC. What we've done originally when we first started in our pharmacies, um, OTCs, well, it, it's still a relatively small part of our business, but it was a small part of our 

OTC Sales Challenges in Community Pharmacy
Boo Dhaliwal: business.

It was the sort that even if you increased it by 10, 20, 30, 40, 50%. [00:19:00] It would've made very little difference to the overall pie. Yeah. So we found that concentrating on our OTC was didn't really move the dial. 

Mandeep Mudhar: Mm-hmm. 

Boo Dhaliwal: Times have changed where dispensing is just so poorly renumerated like we have no choice but to look at other avenues.

Yeah. So private services is one of them. We'll get to that as well. But OTCs now, we've pretty much ignored them, but we've got a problem. Mm-hmm. We've got a problem. I'll tell you what my problem is. Right. We don't have enough OTC sales right now. Um. We need them to improve. Yeah. So it is quite low. 

Mandeep Mudhar: Yeah.

Boo Dhaliwal: Now, anytime that I need to try and do anything, whether that's a planogram or whether that's some sort of ordering stock in and trialing something, or whether even it's just facing forward and getting the right stock levels in, I find that the cost. Of staffing outweighs any margin I'm making on the increase of sales.

Mm-hmm. Mm-hmm. So on our branches, or a lot of pharmacies, you will find they have very little stock on the shelves, if any, and they might keep it bare. Mm-hmm. Because [00:20:00] it costs more to maintain it, order the right things, get the right planogram, and you might increase your sales by even 50%, even a hundred percent.

It doesn't pay for a single staff member. Mm-hmm. So how, how do we, how do you, how do we. What do we do? 

Mandeep Mudhar: Yeah, really good question, and I wish I had a, but I think first and foremost, we, we are, we are lucky in pharmacy in that we have got a core category called medicines. Peds gsl. Yeah. Which is, which is. Our, which is, should be our dominant category 

Core Categories: Medicine & Healthcare Focus
Mandeep Mudhar: in, in pharmacy.

We shouldn't be letting that, those categories go anywhere else. You know, people should be coming for those medicines to us because with it, we have the advice with it, we have the service with it, we have the knowledge. It's what we do. 

Right? 

Mandeep Mudhar: That's what we do. Exactly. And I think sometimes we lose sight of the fact that that is where core.

Of the pharmacy sort of offer sits, and sometimes we start spreading ourselves too thinly into perhaps other areas of retail that perhaps Exactly to your point, either may not have the return. [00:21:00] Yeah. Or might have too big an investment that you need to put in the stock. So again, it's about just going back to basically and saying.

Have you got your core ranging right? Yeah. And the core ranging is have you got the right meds, right? Yeah. Have you got the right p And that that isn't necessarily, that doesn't come with a huge amount of staff, um, investment in there because the staff you already have in your pharmacy should be qualified and trained to be able to give the advice with those things.

Once you've got that, then there are certain categories that we say, yes, you've got to at least, you know, play in those categories. And I use that for, because if you don't, for example, have skin, uh, pain. 

Boo Dhaliwal: Yeah. 

Mandeep Mudhar: Pain, a bit of 

Boo Dhaliwal: dental, 

Mandeep Mudhar: first aid, a bit of, yeah. A medicated skin. Yeah. You know, the sort of things that people expect to, to, to, to have from you.

Once you've got that right, then it's a question of, in your business plan, do you want to invest in new categories? So yesterday, for example. I saw a survey that said actually the wellness categories now are really growing in healthcare. You know, that's something that pharmacy probably has never dealt with, you know, [00:22:00] and these are like the supplements and the, and the sort of areas that perhaps traditional pharmacy never 

Wellness & Supplement Categories
Mandeep Mudhar: dealt with.

I'm not saying tomorrow, go and start investing in that. But what I'm saying is, can you see if there's an appetite amongst the demographic of your pharmacy for something like that? You 

Boo Dhaliwal: know? And if you want to invest in it, buy from Alga. Right. 

Mandeep Mudhar: Or get the advice from Alga. Yeah. 

Boo Dhaliwal: So what, what I found, I'll tell you where.

I find difficulty in the sort of community pharmacies that, so when we talk about pharmacies, we talk about independent pharmacies. They're relatively small community-based pharmacies, majority of them. They're not big boot stores as such. Yeah. Not town center boot stores. And what you tend to find is most people that we find that are walking in, they, they're ad hoc, as in, they're not here to do the, no one comes in for their weekly shop.

No one's generally when it comes to vitamins, you might. We find it's a hard category because you might spend a long time explaining to someone what vitamin suits them, but other than selling it to 'em once, [00:23:00] they're pretty much going either to Amazon or to boots and you've that that cost of. It's not a customer acquisition.

That cost of first sale is, it doesn't make sense because you've only sold one and you're never gonna sell it again. Mm-hmm. And you've gone through all the training, all the explanations, sat down with them for 15 minutes. Yeah. So we find for independent community pharmacies, our ones, uh, that sort of range is when it's, when it's not, um, uh, uh.

An impulse purchase or a, uh, something you require there and then like a PMed. 

Mandeep Mudhar: Yeah. 

Boo Dhaliwal: We find we lose all them patients or we'll lose all them customers. 

Mandeep Mudhar: Yeah, it's understandable. But, but equally in this day and age, um, with AI and everything else. The knowledge that people now want to have or, or can get about specifics.

Like what level of magnesium, for example, do, do, do I want? You know, and I think they will expect that kind of information from a fancy, because they're not going to get it in, in, in a supermarket. 

Boo Dhaliwal: You know, it's a funny thing you should say that, Mandy. 'cause you know, [00:24:00] people now are so knowledgeable. 

Customer Knowledge & Clinical Expectations
Mandeep Mudhar: Yeah.

Boo Dhaliwal: They come in and they'll say something like, yeah, just like you said. What should what? How many micrograms of magnesium? I've been having this many, and I have to quietly pretend and go back to the computer at the back and quickly Google the answer. Because it's just shocking the amount of information that is out there and the amount people know.

Yeah. So they're well aware of what they, what they need nowadays. Yeah. But what you're saying is. The need for more and more clinical input is gonna increase, and we need to be prepped for it. 

Mandeep Mudhar: Ready for it. And, and, and, and that customer is also looking for your affirmation. You know, they, they might have gone on, you know, ai, Google, whatever.

Yeah. But to hear a healthcare professional giving them that assurance, whatever. Yeah. And then. You know, it is about, you know, either compelling or urging that that individual, that customer, to come back to your pharmacy. Now I know what you say, that they'll go and try and find the product online, but for example, one of the things that I know some of our members, for example, are trying a subscription models, you know, we see it 

Subscription Models in Community Pharmacy
Mandeep Mudhar: online, don't we?

Oh, 

Boo Dhaliwal: oh. 

Mandeep Mudhar: You know, right. 

Boo Dhaliwal: Really? 

Mandeep Mudhar: Yeah. [00:25:00] So, so 

Boo Dhaliwal: community 

Mandeep Mudhar: pharmacy. So why, why not try brick mortar community pharmacy? Yeah. Why not trying it out? So at least you've got some kind of a hook in to bring that patient back to you to, to make a repeat purchase of of, of that particular product. Online providers are doing it.

Yeah. Aren't they? Everyone's trying to tie you into some kind of a subscription model. Yeah. So I'm not, and I'm not saying that that is necessarily the answer for everyone. Um, but, but surely, I, I think by and large. People who come into the pharmacy get all that advice from you. They have some loyalty towards you.

You know, you are still serving their families, you're looking after their health, their prescription. They all use some loyalty as well, and it's playing on that loyalty to get them back in. Then for that. Purchase, whether it's a repeat purchase or to come back to you for some advice on something else as well.

Boo Dhaliwal: The other, the other seismic change in pharmacy is independent prescribing, and no one really knows how to approach it. Some people are really running, you know, a hundred meters going for it. All the way, and there's just [00:26:00] so many unanswered questions. How do you guys, what, what do you go, what are you guys thinking in Al 

Independent Prescribing: The Future?
Boo Dhaliwal: Figo?

How, how do you think this is gonna play out Independent prescribing? 

Mandeep Mudhar: It's a really good question, and I think, um, you know, the, the last IPA meeting, um, uh, there was a presentation about the, the, the results of the Pathfinder program. And, and I, I think like you, we have to fully understand. The outputs from that, uh, Pathfinder program because if I remember, um, the two things that came out from there, the independent prescribers had delivered some really quantifiable clinical benefits.

Yeah. And have saved GPS quite a bit of time. But there was still a big question mark about the funding. You know, the, because at the end of the day, uh, there has to be some recognition that the pharmacists will be doing something they haven't been doing before, and there's some funding for that. So, yes, at the, for example, we have members in Scotland who are years ahead of perhaps everyone else in terms of how they're using their p 

Scotland's Advanced Prescribing Model
Mandeep Mudhar: qualification.

Uh, they have been in, endorse by their [00:27:00] health boards. They're providing a service that's being. Funded, reimbursed by the health board, uh, walk-in both walk-in and prescribing services for, uh, acute conditions, but also managing patients chronically. Now, that model in Scotland hopefully, is one that we will in England, for example, move, move to.

But I think it's slowly, slowly in England because at the moment, yes, we still have to have roles for all of these ips, and the main role at the moment for many of ips is to go and work in a GP surgery. Mm-hmm. There isn't necessarily yet a role in community pharmacy then. And you know, that's, I suppose everyone's waiting for the, the funding announcements from the new contract.

What will be the funding for an IP to be able to practice? You know, 

Boo Dhaliwal: I don't think there's gonna be any funding this year for that. 

Mandeep Mudhar: And then if that is a challenge, 

Boo Dhaliwal: maybe even next year. 

Mandeep Mudhar: Then I think then the IP program has to almost take off slowly and, and build up slowly because o otherwise, what we'll be doing is, you know, we'll be disappointing a lot of ips who, who will want to practice mm-hmm.

But won't necessarily have the support because [00:28:00] you as a pharmacy owner, you're not gonna necessarily have the investment then to, to be able to support someone. To just want to be an ip. So I think then it'll be a balanced approach to, for the ips to say, by all means, if there's an opportunity to exercise some of your IP in, in conjunction with some GP practices that are, are, are collaborating with you Yeah.

In, in managing chronic patients, for example, great. If there is some opportunity to instigate some private prescribing, great. But until then there is recognized funding. Let's not just. Fully in, in invest into that. So I think it's gonna be a slow burn, at least for the first few years until we, we know what that, you know, landscape looks like.

Boo Dhaliwal: So we know, um, we're pretty sure there's gonna be no margin coming in on the IP side. Definitely in the next year or two. We know dispensing is getting more and more pressured. Yeah. 

Mandeep Mudhar: Yeah. 

Boo Dhaliwal: We, everyone knows that private services something you could look up, but there's certain areas where private services is just a no go, as in, there's just not the, the, the, uh, the demographics just do not.

Um, [00:29:00] just mean that the private services just don't take off. People aren't happy to pay. Um, so where, where do you see, where do you see margin or are we gonna get more pharmacy closures 

Mandeep Mudhar: there? I mean, you know, there's still a risk obviously, of pharmacies closing and which is, which is extremely 

NHS Funded Services: Are We Maximizing Them?
Mandeep Mudhar: sad.

However, I. Yet we still don't see a complete uptake of the NHS funded services. You know, if you look at pharmacy first, we're still not achieving complete uptake of those services. Um, and, and it's been the same with, you know, the, the, the NMS service, for example. And now we have had the contraception service, the b the BP service, for example.

We're still, so, there are still NHS funded services that we are not yet still maximizing the opportunity. And, and, and there is still, there is still some way to go there. So even if you know, and, and I'll, I'll give you about the demographics. Even if there isn't an appetite at this stage for private services, are you doing enough on those services that are being currently funded on, on the demographic side?

It's really interesting. I have been to some really [00:30:00] deprived areas 'cause I go and see members at least weekly, you know, and, and go to different parts of 

Boo Dhaliwal: even now still. 

Mandeep Mudhar: Oh yeah, definitely. That's part of my job. Okay. If I don't, then I, I, I'll lose touch with, with. 

Boo Dhaliwal: I thought you just like drunk coffee and chill in 

Mandeep Mudhar: the office.

No, unfortunately I am pretty much so to get out there. Otherwise I'm not close enough to what's going on with with pharmacy. And you'll be amazed, even in deprived areas how much, uh, people want to invest in their own health and pay for their own healthcare. You only have to see what's going on with weight management 

Private Services in Deprived Areas
Mandeep Mudhar: currently.

Yeah, travel health people still want to travel and those slow services are not available through, through, you know, um, the, the NHS anymore. So again, before, even if you have a pharmacy in a really challenging area, before you decide that perhaps your, the demographic there haven't got the money, just assess that first.

You might be surprised for the appetite that people have to pay for certain elements of their care simply because they're not getting it anywhere else. 

Boo Dhaliwal: Let me move on to [00:31:00] specifically Alphega now. Okay. Yeah. Now, what we find as a contractor, what we find is there is a lot of providers offering very much overlapping services.

Sometimes not exactly the same, but for example, uh, standard operating procedures that are offered to pharmacies that you can do. You might find there's. Half a dozen pro providers that can offer you something like that. So what do Alga, first of all, what do Alga do? Okay. Why even bother 

What Does Alphega Offer Pharmacies?
Boo Dhaliwal: becoming a member?

Mandeep Mudhar: Okay. 

Boo Dhaliwal: Um, and then. Have you got anything that sets you apart? 

Mandeep Mudhar: Okay, so you're absolutely right. You know the multitude of providers for different areas of support for pharmacy and fantastic. You know, you should have choice in that, and I would never be be the one to say, you know, ours is a million times better or whatever.

What I would say to anyone, first of all, is. At some point, you're gonna need different types of support and re uh, and help from, from, from an organization like Vega. It might be SOPs today. It might be a mock [00:32:00] GPHC inspection tomorrow because you, you're concerned you may be having one. Well, 

Boo Dhaliwal: you guys 

Mandeep Mudhar: do 

GPhC Mock Inspections & Support Services
Mandeep Mudhar: that as well.

We do that as well. That's a, 

Boo Dhaliwal: that's an odd one. 

Mandeep Mudhar: I've not heard that. That's definitely a unique thing. And it is, especially now post, uh, COVID, you know, sort of, uh, the, obviously the inspections are up or it might be planogramming, you know, for your retail offer. Or it might be a digital product that you want that helps you improve efficiencies.

So what I would say is, first of all, look at it as who can provide you with the whole suite of services that you don't perhaps need every day, but you can call on when and if you, you need it. And for something like, um, Vega for example, we have that whole suite of services. We've got support services under digital.

We've got touch pads, we've got, you know, um, areas around the hub, for example, that you can access services. We've got retail support, planogramming merchandising, we've got SOPs, we've got contractual support. You know, we, we've got all of that. It's there for you. When and if, when, and if you need it, and if others are doing the same, fantastic.

You know, and, [00:33:00] and, and, and good that you have a choice there. What probably sets someone like, uh, Alger, um, apart or makes us unique is we then have the business mentors as well. We have 12 business mentors. These guys literally are there to come and help you hold your hand, spend as long as it takes to get you, um, to solve whatever the challenge is that you have in your pharmacy.

So, so let's say you're worried you're gonna be having A-G-P-H-C inspection. The business mentor will spend however long it is. To go through all of the elements of what that inspection will entail and help you get ready for that. So that's the G-P-H-C-A mock inspection. You say to them, look, I'm really nervous.

I'm not really driving my private services at the moment. You know, I'm just not. But 

Boo Dhaliwal: that's a 

Mandeep Mudhar: big 

Boo Dhaliwal: one, right? There's 

Mandeep Mudhar: gonna be a lot of people 

Boo Dhaliwal: who are finding that difficult. 

Mandeep Mudhar: Exactly. Particularly with them, you know, GLP one, weight management. Um, the business mentor will sit, put a plan together with you.

Look at how you'll market that service, show you what you know best. Best case, uh, best practice looks [00:34:00] like, oh, might get this guy to 

Boo Dhaliwal: run my whole business. 

Mandeep Mudhar: There you go. He sounds I need to retire. Honestly, the knowledge these guys have is, is incredible. And, and what, what I always say is give them your problem statement.

What is it that you currently have that is challenging you? And you'll be surprised what they'll do for you. 

Boo Dhaliwal: Oh, there's gonna be a long list. They get comfortable. 

Mandeep Mudhar: Um, 

Boo Dhaliwal: I have a bone to pick with a figa. Okay. I have an issue, a real, real bad, a Figa. They used to do a conference and it 

Monaco to Telford: Conference Evolution
Boo Dhaliwal: used to be in Monaco.

Mandeep Mudhar: Mm-hmm. 

Boo Dhaliwal: And I've been multiple times to Monaco. 

Mandeep Mudhar: Okay. 

Boo Dhaliwal: Right. Yeah. Actually, no, I tell a lie. I think I've only been twice. Yeah. Twice I think. Okay. A feel com. And. It was great. Yeah, it was a good laugh. It was a getaway and it was absolutely lovely. Nowadays you guys do your conference in Telford. Now I'm gonna say that again.

It used to be in Monaco and now it's in. Telford. Yeah. Now I know no other providers doing it in, in, in Monaco anyway, but I just wanna [00:35:00] know when you are looking up. Alright, we're not gonna go to Monaco. Where should we go? How did you decide on, no offense to anyone from Telford, but. Be free to take offense, but anyway.

Mandeep Mudhar: Yeah. 

Boo Dhaliwal: Telfa, how did you end up at Telfa? I 

Mandeep Mudhar: think it was more about the sort of strategy that the, the, the business has been through. So when you were fortunate enough and I never got to go to Kong. Oh, you never got to go to Meco? Unfortunately not. I wasnt with, with Aga the time. Ah, 

you've 

Boo Dhaliwal: been 

missing 

Mandeep Mudhar: out.

We were part of, um, we still are part of a European network. The events and the, the sort of view at that time was to have European conferences to bring everyone together from different parts of the country, of different parts of Europe. Yeah. Idea. Yeah. Why 

Boo Dhaliwal: did they give the hug? 

Mandeep Mudhar: I think because every country feels that, because we've got so many local.

Um, agenda issues that pharmacies need to, to, to look after. 

Boo Dhaliwal: Yeah. 

Mandeep Mudhar: The needs of the UK are very different to those, for example, of Spain, Mon Spain, or Portugal. I'm sure the needs of MoCo are much different, that the [00:36:00] conferences should be more national, you know, and, and so that we can deal with, uh, with the issues that are challenging our pharmacists in the uk.

Yeah, that's why we, we. We decide to make them reckon you can kick out the 

Boo Dhaliwal: chain to say, if they can bring them back. 

Mandeep Mudhar: I'll, I'll give it a go. 

Boo Dhaliwal: I can promise there's a serious concern between the membership that Telford just isn't cutting. It's not quite the same. 

Mandeep Mudhar: I'll do my best. 

Boo Dhaliwal: Everyone who comes on Mandy, we always ask them to contribute to their chosen charity.

Pharmacy Support Charity & Bursary Scheme
Boo Dhaliwal: So, uh, it's the same with you and Alga. So what would AGA's chosen charity be? How much would you. Like to contribute. And why did you choose this charity? 

Mandeep Mudhar: That's a fantastic idea. Um, our chosen charity is Pharmacist Support. Okay. Um, this is our third year of supporting, uh, the bursary scheme within pharmacy support, which is really meaningful because it helps, uh, those pharmacy.

Um, trainees to become pharmacists who might be having challenges in being able to complete their education to become a pharmacist. And so [00:37:00] we'll be really delighted to donate a thousand pounds towards that scheme with pharmacist support. 

Boo Dhaliwal: Well, that's fabulous. Pharmacist support. I know I should have probably heard of these charities.

Um, I'm gonna look it up, but it sounds like. It sounds like a great charity. 'cause pharmacists, as soon as you said pharmacy support, I was gonna line up right behind to say I think I'm part of the charity. I think I should deserve to get something from this one. But no, that sounds good. So it's a bursary that helps support disadvantaged students Yeah.

To be able to get through the course. Yeah. Yeah. So it 

Mandeep Mudhar: gives qualifiers, pharmacists, 

Boo Dhaliwal: yeah. 

Mandeep Mudhar: And be able to practice and do the things that we've been fortunate to, to be able to do over the last 

Boo Dhaliwal: three years. Yeah. You know, that's, that's, uh, brilliant. And I think that, uh, thousand pound donation's gonna be, uh.

Um, they'll be well appreciated by them. I sure. Thank you. Um. 

Manesha : You know, you've gotta make it flow, right? You can't just, 

Boo Dhaliwal: I forgot what I was talking about. This is the problem. When you're not a professional, Mandy, you end up forgetting what you're talking about. [00:38:00] You end up going completely off Mandeep as you know that we've got a revolution going on.

Mandeep Mudhar: Yeah, 

Boo Dhaliwal: the uh, make Pharmacy great again, revolution. I've got loads of merch for you. 

Mandeep Mudhar: Thank you. 

Boo Dhaliwal: This one's for you to take away. What you gotta do is you've gotta spread the word. 

Mandeep Mudhar: Okay. 

Boo Dhaliwal: Yeah. So this is like the best cult on earth. Yeah. The pharmacy cult. So you've gotta, you've gotta, you know, like a, it's, it's almost like a, it's like a giant Ponzi scheme.

You've gotta tell the next person who tells the next person, I look at you and you come across as a bucket hat kind of guy. 

Mandeep Mudhar: What do you think? Fantastic. Yeah. Thank you. 

Boo Dhaliwal: Make pharmacy great again. That 

Mandeep Mudhar: fit me. 

Boo Dhaliwal: Cool. 

Mandeep Mudhar: Yeah. 

Boo Dhaliwal: Yeah. You look the business, right. I've got some quick fire questions for you. Okay.

Quick Fire Questions
Boo Dhaliwal: These are AI generated questions as always. Right? Okay. So I don't generate them. We don't know. I don't know what they are until they hand me them. 

Mandeep Mudhar: Okay. 

Boo Dhaliwal: Um, if you weren't in pharmacy, [00:39:00] what would you be doing? 

Mandeep Mudhar: Pilot. What? Yep. 

Boo Dhaliwal: Pilot. 

Mandeep Mudhar: Yep. 

Boo Dhaliwal: How did That's a bit of a difference. It's a bit of a 

Mandeep Mudhar: change childhood ambition.

Boo Dhaliwal: Really. 

Mandeep Mudhar: Yeah. 

Boo Dhaliwal: Why don't you do it? 

Mandeep Mudhar: Never had the opportunity 

Boo Dhaliwal: really, but have you ever, like 

Mandeep Mudhar: did, did I've done a couple of private lessons, but not taken it beyond that 

Boo Dhaliwal: really? What was that like? 

Mandeep Mudhar: Fantastic. 

Boo Dhaliwal: Well, the little propeller plane things. 

Mandeep Mudhar: Yeah. Yeah. 

Boo Dhaliwal: It's a bit dangerous though, isn't it? The little planes.

Mandeep Mudhar: Oh, the thrill of being on a plane. 

Boo Dhaliwal: Really? 

Mandeep Mudhar: Yeah. I'm like a kid even now. Seriously, plane. Yeah. 

Boo Dhaliwal: How is that's, that's, that's proper. Well, how come you only did a couple, did you not get your, you know, this license or what have 

Mandeep Mudhar: you? It's a lot of investment time and, and money isn't, just, haven't had the opportunity.

Boo Dhaliwal: It's that, it's like a few hundred pound an hour, isn't it? For that? 

Mandeep Mudhar: Yeah. 

Boo Dhaliwal: Yeah, it's ridiculous. 

Mandeep Mudhar: And exams 

Boo Dhaliwal: and, oh yeah, after. That's the last thing you need. This is a odd one. Okay. If you had to survive on one meal forever, what are you picking? 

Mandeep Mudhar: Oh, that's a really good question. 

Boo Dhaliwal: Just one meal. Think about it.[00:40:00] 

Mandeep Mudhar: Oh, I give me lamb chops any day. 

Boo Dhaliwal: Lamb chops. 

Mandeep Mudhar: Yeah. 

Boo Dhaliwal: They've gotta be cooked, right? 

Mandeep Mudhar: Yeah. 

Boo Dhaliwal: Otherwise 

Mandeep Mudhar: you, they're not 

Boo Dhaliwal: cooked right? 

Mandeep Mudhar: They don't work does. They're not. Exactly. They're not then. Yeah. 

Boo Dhaliwal: Yeah. You don't want too and tough on the stuff. Right. You, you've gotta get Right. 

Mandeep Mudhar: You know exactly what 

Boo Dhaliwal: we, we'll get some lamb chops.

Lee, 

Mandeep Mudhar: thank you for watching the Pharmacy Planet Podcast, like subscribe, share.