Blooms The Chemist White Paper: Lessons Learnt from the Front of a Health Emergency

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Lessons Learnt from the Frontline of a Health Emergency Blooms The Chemist – COVID-19 July 2020

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Our network of community pharmacists, retail staff, Board of Directors, Support Office, and Leadership Team continue to work tirelessly to ensure there is minimal disruption to the delivery of our health services. I am most grateful to everyone in our Blooms family who has united despite the many challenges presented

by COVID-19.

LESSONS LEARNT FROM THE FRONTLINE OF A HEALTH EMERGENCY

Phil Smith, CEO, Blooms The Chemist

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Contents Acknowledgements

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Executive Summary

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Introduction 7 Pharmacy Practice: An Integral Role in Healthcare

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Chartering a Course Through a Health Pandemic

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Our People, Their Safety

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Ensuring the Community’s Access to Health and Medical Supplies

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Staying Connected with Our Community

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Providing the Best Healthcare Requires Working in Partnership

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The Economic Realities of a Pandemic

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Conclusion 30 Recommendations 31 The Final Word

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Appendix 33

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Blooms The Chemist thanks the staff and stakeholders who took the time to input into the White Paper.

Their feedback and insights have helped shape this document to be both a historical reference and future road map for navigating a business through a pandemic.

• Amber Ahern, Customer, Blooms The Chemist • Andria Aird, Pharmacist, Blooms The Chemist Port Coogee, WA

• George Meiliunas, Head of Organisational Development and Human Resources, Blooms The Chemist

• Pamela Bishop, Chief Marketing Officer, Blooms The Chemist

• Martin Olds, Chief Information Officer, Blooms The Chemist

• Craig Carson, Pharmacist, Blooms The Chemist The Pines, QLD

• Jillian Passfield, Retail Manager, Blooms The Chemist Raymond Terrace, NSW

• Eric Chan, Head of Pharmacy, Blooms The Chemist

• Sandra Pertzel, Retail Manager, Blooms The Chemist Wagga Wagga, NSW

• Rona Chiera, Customer, Blooms The Chemist • Andrew Crawford, Chief Financial Officer, Blooms The Chemist • Michael Foran, Head of Merchandise and Planning, Blooms The Chemist • Peter Green, Pharmacist, Blooms The Chemist Maitland, NSW • Dianne Hamilton, General Counsel, Blooms The Chemist • Andrew Ioannou, Pharmacist, Blooms The Chemist Marrickville, NSW

LESSONS LEARNT FROM THE FRONTLINE OF A HEALTH EMERGENCY

• Michael King, Head of Sales, GSK

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• Denise Sawtell, Retail Manager, Blooms The Chemist Warilla, NSW • Dr Anjan Sharma, General Practitioner, Private Practice, NSW • Phil Smith, Chief Executive Officer, Blooms The Chemist • David Tuffin, Pharmacy Sales Director, Blackmores Group • Emmanuel Vavoulas, Head of Retail, Blooms The Chemist • Stephanie Yeo, Optometrist, E Eye Place, WA

“ Key to the success of navigating our way through COVID-19 was that we are part of a network of like-minded healthcare professionals who support one another in the shared goal of supporting our community.

The assistance from our Support Office through the crisis provided great help during this time.”

Craig Carson, Pharmacist, Blooms The Chemist, The Pines, QLD

ACKNOWLEDGEMENTS

Acknowledgements

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In 2020, the world faced an unprecedented event in the COVID-19 pandemic. There was not a country, business, or person that was unaffected by this human health disaster.

In Australia, 1 March marked the first COVID-19 fatality of a Perth man who had been on the Diamond Princess cruise ship. By the week commencing 16 March, Australia had 298 cases, with five deaths.

This White Paper outlines the steps taken by Blooms The Chemist to put in place contingency plans across all the pharmacies in the brand’s network and with staff, customers, and suppliers to ensure the business would survive.

The Federal Government responded by placing restrictions on travel and imposing lockdown and stay at home measures. Panic quickly ensued and people started stockpiling essential items such as toilet paper, medications, personal protective equipment like face masks and gloves, and hand sanitisers.

The Blooms The Chemist’s White Paper addresses themes such as:

The healthcare industry, particularly those on the frontline such as pharmacies, faced a rapid spike in demand with customers stocking up on over-thecounter medicines. In fact, purchases for cough, cold and common-flu tablets increased by as much as 198 per cent.1 Google’s search volumes for COVID-19 related health products increased by as much as 200 per cent.2 According to Adobe’s analysis, online purchases of medical products such as face masks, hand sanitisers and antibacterial products shot through the roof—more than 800 per cent.3 The COVID-19 pandemic and the need for social distancing took a grip on the world that most people had never experienced. Businesses needed to adapt quickly to ensure their operating model could survive in the ‘new normal’.

• Leadership in a crisis.

• Best practice in pharmacy management.

• Learnings from an internal perspective, including pharmacists and the broader team.

• Insights from external stakeholders such as suppliers.

• Providing support to communities across Australia.

Blooms The Chemist pharmacies were already an integral part of many communities across Australia, and highly competent in providing health services, having provided essential pharmacy services for over 40 years. It was not just in the transactional health space that the Blooms The Chemist business needed to redesign during this time.

Key to their success in remaining ahead of the curve was ensuring the retail side of the business and the brand as a whole was agile and could action the needs of staff, customers, and suppliers to ensure their exceptional service to which their reputation relied on was as unaffected as possible.

“ COVID-19 brought about a significant impact to our business and agility was key. In March, when demand for product increased significantly and our pharmacies were extremely busy, our business adapted quickly to manage the situation. When the demand decreased, we were able to scale back accordingly. We monitored the impact across the business and adjusted where required.”

Andrew Crawford, Chief Financial Officer, Blooms The Chemist

EXECUTIVE SUMMARY

Executive Summary

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LESSONS LEARNT FROM THE FRONTLINE OF A HEALTH EMERGENCY

CONTENTS

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The vital role of local community pharmacies in the Australian health system has never been more visible than in 2020, where the COVID emergency and the bushfires across multiple states have strained and stretched the primary health care system. Through these challenging times, community pharmacies have stayed open to serve patients and ensure the continued availability of Pharmaceutical Benefits Scheme medicines and other products and services, including vaccination.

Mr George Tambassis, National President of The Pharmacy Guild of Australia

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Blooms The Chemist is an Australian network of community pharmacies. The business offers health products, wellness support, and pharmacy services.

There are currently 100 pharmacies in the Blooms The Chemist network, across Australia.

Blooms The Chemist’s roots go back to the early 1980s when a group of passionate pharmacists had an ambitious vision to build a successful partnership network and help younger aspiring pharmacists own their own pharmacy practice.

Today, the brand has stores across New South Wales, Queensland, Victoria and Western Australia, all delivering expert patient-centric care in both metropolitan and regional rural areas.

Blooms The Chemist is proud to be a truly a community-minded network of pharmacies, providing the highest level of professional health service and advice to the local communities they serve and is integral to the health of the community.

“ We understand the Australian health system is under pressure, and pharmacy helps support a strained system. We are mindful the health system will come under more pressure given the ageing population and the growth in chronic disease in Australia. Blooms The Chemist pharmacists are dedicated to facilitating better health outcomes for all Australians.”

Eric Chan, Head of Pharmacy, Blooms The Chemist

INTRODUCTION

Introduction to Blooms The Chemist

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Each community pharmacy determines their scope of practice based on their community’s needs and the Community Pharmacy Agreement (CPA). The CPA is an agreement between the Pharmacy Guild and the Minister for Aged, Family and Health Services and has been in place since 6 December 1990.4 Pharmacy practice has broadened in scope over the last few decades to help improve the health system, deliver better patient outcomes, and provide economical savings.

Blooms The Chemist is dedicated to delivering better healthcare for their communities. As such, Blooms The Chemist pharmacists took the lead expanding their scope of practice when the CPA changes came into place, being some of the first pharmacies in Australia to offer expanded health services as part of their pharmacy practice.

Like other healthcare professionals, pharmacists adhere to a strict code of professional standards.

For pharmacists this is outlined in the Professional Practice Conduct (PPS). The PPS reflects the important role of pharmacists in an evolving Australian healthcare landscape with “renewed focus on patient-centred collaborative care, and emerging professional activities such as vaccination and minor ailment services.”5

Four Key Areas of Pharmacy Practice

Foundations of Practice

Providing Therapeutic Goods

LESSONS LEARNT FROM THE FRONTLINE OF A HEALTH EMERGENCY

Pharmacy Practice

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Providing Health Information

Delivering Professional Services

Figure 1: Four Key Areas of Pharmacy Practice as outlined in the Pharmacy Professional Practice Standards (PPS).5

PHARMACY PRACTICE

Pharmacy Practice: An Integral Role in Healthcare

Patient-Centred Care Patient-centred care, also known as person-centred care, is central to pharmacy practice principles.

With a patient-centred approach, the patient, their carers, and families, collaborate in decision making for their ongoing health. This informed decision making takes into consideration the patient’s individual values and preferences, helping promote patient dignity, empowerment, and respect.6 Blooms The Chemist pharmacists have established a set of core values that are aligned to the principles of patient-centred care, to ensure that quality pharmacy practice is provided by all pharmacies in the Blooms The Chemist network to their local communities.

The importance of providing health information, professional services, medicines, and other therapeutic goods supports better patient care and is critical to ensuring better community health.

Unsafe use of medicines currently costs Australians more than 1.4 billion dollars per annum.7 Being integral to their communities, Blooms The Chemist pharmacists know they have a responsibility in supporting their community.

Medicine reviews and consultations have the potential to not only improve community health, but also provide economical savings.8 Customers, too, value these services cost savings, especially when they are aware of the knowledge able to be impacted by the pharmacist and pharmacy staff.” 9,10,11

“ We’ve seen multiple examples of our pharmacies supporting other small businesses in their communities. One example that springs to mind was where one pharmacist owner, whose pharmacy is located in a shopping centre, bought his staff coffees and lunch throughout the pandemic.

One café owner said they would have been out of business without the support of their local Blooms The Chemist.”

Dianne Hamilton, General Counsel, Blooms The Chemist

Pharmacy’s Role in Primary Care Pharmacies are often the first point of contact for primary care. This is especially evident when there is limited access to other health services, for example, in isolated communities.12 Community pharmacists and their teams are on the frontline of public health by serving as direct points of access for their customers and communities, vital therapeutic goods, health information and other health services.

Remuneration for such services is set by the CPA, established by the Australian Government and the pharmacy industry.

Blooms The Chemist – Leaders in Delivering Better Healthcare for the Community Blooms The Chemist has a team of over 2,500 people made up of pharmacists, retail managers, pharmacy assistants, health experts and Support Office staff. All are committed to delivering better healthcare for their communities through the shared values of Integrity and Respect, Honesty and Trust, Passion and Commitment. A guiding principle of continuous learning means there are expert staff in-store and throughout the business.

Better Community Healthcare

Integrity and Respect

LESSONS LEARNT FROM THE FRONTLINE OF A HEALTH EMERGENCY

Win-win Approach to Partnership

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Better Community Healthcare

Customer and Patient Experience

Figure 2: Blooms The Chemist Approach

Honesty and Trust

Continuous Learning

Passion and Commitment

Definition of Practice: Any role, whether remunerated or not, in which individuals use their skills and knowledge as practitioners in their regulated health profession. Practice is not restricted to the provision of direct clinical care. It also includes using professional knowledge in a direct non-clinical relationship with patients or clients, working in management, administration, education, research, advisory, regulatory or policy development roles and any other roles that impact on safe, effective delivery of health services in the health profession.13 Community Pharmacy Agreement (CPA) The CPA sets out pharmacy remuneration for services including medicine dispensing, and special health programs, which in turn determines community pharmacy’s scope of practice and role.

PPS Criteria for delivering Patient-Centred Care:5 • Recognising the cultural diversity of all Australians, including Aboriginal and Torres Strait Islander people.

Health services provided by Blooms The Chemist include:

• Ensuring that patient and community health needs, including cultural needs, are foremost in the delivery of care.

• Blood Pressure Evaluation

• Delivering holistic healthcare solutions.

• Cholesterol Screening • Diabetes Monitoring (Blood Glucose Screening) • Iron Screening Tests • Sleep Apnoea Testing • Stroke Risk Assessment

“ The sheer volume of information and updates was staggering.

There was a lot of noise about COVID-19 in the news and media which was quite overwhelming. The pharmacy teams were busy, it seemed impossible to keep up to date with the information. However, the Support Office issued a daily communication to pharmacists and pharmacy teams that summarised the relevant and accurate information they needed to be across; this was incredibly helpful.”

Jillian Passfield, Retail Manager, Blooms The Chemist, Raymond Terrace, NSW

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COVID-19 put a strain on health systems all around the world, and pharmacies were no different. Even during strict lockdowns, pharmacies remained open and were often the first point of contact for customers.14 As COVID-19 was unfolding around the world, Blooms The Chemist recognised that this pandemic had the potential to have a significant impact on their network of pharmacies and team of people. The safety of the staff and local communities of their pharmacies as well as their Support Office team was the number one priority.

Guided by the core Blooms The Chemist values, a safe environment for staff and customers was established, along with a process to navigate the many challenges in a constant changing COVID-19 environment. Acting fast, with a proactive and agile approach, Blooms The Chemist pharmacists, facilitated by Blooms The Chemist Support Office established a process to protect their biggest asset, their people.

LESSONS LEARNT FROM THE FRONTLINE OF A HEALTH EMERGENCY

Blooms The Chemist Support Office has an expert team made up of business, pharmacy, retail, human resource, technology, finance, legal, merchandise and marketing professionals. The centralised services provided by Blooms The Chemist Support Office became even more important during the COVID-19 period as the services provided enabled pharmacies in the network to remain focussed on delivering quality healthcare for their communities.

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The Support Office team has dedicated time and energy during the pandemic to planning for the future. The leadership team are carefully reviewing the brand strategy for the next two years and thinking longer-term, while the wider team plans for the next 12 months and preparing to manage the bounce, post-pantry stocking. The Support Office team planning for the future of the brand enables the pharmacy teams to focus on the here and now and offer their full support to their local communities.

During the pandemic, safety was a high priority for the brand. Other issues quickly surfaced as the COVID-19 situation evolved. Addressing these issues head on has ensured the sustainability of Blooms The Chemist pharmacies and overall business. Issues such as securing medicine supply, adapting to the changing government regulations for the pharmacy industry, and the increased pharmacist responsibilities had to be effectively managed. Along with this was the need to ensure pharmacy and Support Office teams and the local customer communities remained connected and calm in an unpredictable and changing environment.

‘’ At Blooms The Chemist, our values reflect our commitment to providing a safe, positive, inclusive environment for our customers, and our team: Integrity & Respect; Honesty & Trust; Passion & Commitment.”

George Meiliunas, Head of Organisational Development and Human Resources, Blooms The Chemist

CHARTERING A COURSE

Chartering a Course Through a Health Pandemic

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The utmost priority for Blooms The Chemist, and the biggest challenge faced with COVID-19, was keeping the entire team safe while providing a safe and trusted environment to continue delivering quality healthcare for the community.

Blooms The Chemist COVID-19 Taskforce included:

A Blooms The Chemist COVID-19 Taskforce was quickly instated to navigate, devise, and implement necessary operational action plans for the whole Blooms The Chemist business. The Taskforce quickly recognised the need to implement safety measures in pharmacies and provide clarity on safety and regulatory requirements, especially for their team of pharmacists and pharmacy store teams as frontline healthcare providers.

• George Meiliunas, Head of Organisational Development and Human Resources

• Pat Athanasopoulos, Executive Assistant • Pamela Bishop, Chief Marketing Officer • Eric Chan, Head of Pharmacy • Andrew Crawford, Chief Financial Officer • Michael Foran, Head of Merchandise and Planning • Dianne Hamilton, General Counsel • Kelly Hyland, Human Resources Manager • Daniel Kendall, Service Analyst • Sarah Kent, Assistant Paralegal • Zane Matthews, National Operations Manager

• Martin Olds, Chief Information Officer • Luke Owen, Pharmacy Compliance Manager • Casey Shannon, Professional Services Manager • Phil Smith, Chief Executive Officer • Emmanuel Vavoulas, Head of Retail • Annette Williams, National Communications Manager

“ The Blooms The Chemist brand has been built on the strength of understanding their local community and providing the best care and support to their customer. This is done through the experience of the pharmacist and the quality of the advice, health services and the quality of the products they are providing.”

David Tuffin, Pharmacy Sales Director, Blackmores Group

SAFETY

Our People, Their Safety

Safety Initiatives: in the Pharmacy Setting • Decreased contact within teams and external Anxieties were high as frontline staff faced their parties, by splitting rosters across all pharmacies own personal challenges in working at the forefront and suspending external meetings, including supplier of community healthcare. A major change in the meetings and training, instead moving to a virtual business during the pandemic was to split rosters, setting. Some direct deliveries to pharmacies were ensuring that there were two separate teams for also suspended temporarily to limit contact. each pharmacy. This was challenging to execute, however, it safeguarded pharmacy operations • Customer contact minimised through contact should a team member become ill, which would -less payments. Telehealth services were force an entire team into quarantine. Though instated. There was an increase in the number of split rosters resulted in separated teams who prescriptions sent via fax and email. Extra home missed seeing each other and having their normal deliveries were also introduced to help vulnerable interactions, greater connectivity was achieved customers reduce their chance of contracting across the network of Blooms The Chemist with the virus. These home deliveries were provided weekly virtual check-ins, leading to a real sense of free of charge. ‘family.’ No one felt as though they were being left to fend for themselves. Some Blooms The Chemist • Decreasing gathering in the pharmacy by texting customers when prescriptions were ready rather pharmacists also took it upon themselves to go above than having them wait in the pharmacy. Increased and beyond in looking after their teams throughout cleaning of surfaces, counters, and baskets to the pandemic by providing coffees and lunches, and decrease the risk of the virus spreading. in turn also supported their fellow local businesses.

• Reducing air-borne spread by turning off In the pharmacies, several initiatives were air-conditioning, using counter sneeze screens, implemented to communicate the new social and face masks during close contact. distancing requirements to both Blooms The Chemist employees and customers, and to minimise contact with staff and product. With pharmacies being on the frontline of healthcare there was a real risk that a team member could contract COVID-19 while at work, from a customer presenting with the disease.

• Concise communications for staff helped reduce stress on what was required. Critical information was sent directly to the pharmacist via text message, a daily email update provided a concise overview of all relevant information, and an in-house intranet platform was used as a key communication tool. Weekly virtual meetings held Initiatives undertaken by Blooms The Chemist over video call provided further opportunity to connect with other pharmacies and team members. to maintain a safe environment included:

LESSONS LEARNT FROM THE FRONTLINE OF A HEALTH EMERGENCY

• Clear communication of social distancing with floor decals marking safe distances and limits on the number of people allowed in the store at one time.

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• Safety equipment was used to protect staff including sneeze guards and accessible hand sanitiser. Face masks and gloves were also used for close contact activities, such as administering health services for example, flu vaccines.

• Trusted and up to date information helped keep local communities informed about health and government messages. The marketing plans booked into radio, social media and the website for product promotion were quickly adjusted to focus on providing customers with trusted information on COVID-19, promotion of free home delivery services and promoting proactive health measures, such as having a flu vaccine.

Continuous learning is a guiding principle for Blooms The Chemist to ensure we are experts in our field.

We invest heavily in the personal development of our people and this has not stopped during COVID-19.

Additional training was made available on our online learning centre for pharmacy teams and several knowledge-sharing and personal development initiatives were run for the Support Office team.

Pamela Bishop, Chief Marketing Officer, Blooms The Chemist

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Safety Initiatives: in the Support Office Like many Australian corporate businesses, the Blooms The Chemist Support Office followed the Australian Government advice and moved the team to working from home. This ensured Support Office staff could continue to support the pharmacies during the crisis.

The main initiatives included: • Government regulation changes needed to be deciphered and implemented quickly to ensure safety.

• As the Support Office is located in Sydney, protocols were introduced for team members who live interstate, and guidelines were introduced to simplify things given different states and territories had different rules.

• Technology needed to be efficient and up to date to meet the increased demands to support pharmacies and enable Support Office staff to work from home.

• An in-house intranet platform was used as a key communication tool for accurate and timely dissemination of information directly to pharmacists and their teams.

• Work from home was enabled for the Support Office team, using the in-house intranet platform and other collaborative technology platforms to support meetings and communications.

LESSONS LEARNT FROM THE FRONTLINE OF A HEALTH EMERGENCY

• Maintaining connection was important to keep teams motivated and to support their wellbeing.

Teams met for virtual check ins and virtual end of week socialising drinks. Regular video meetings allowed for further interactions between departmental teams and encouraged open and transparent conversations.

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• Safety Guidelines were updated and distributed to all staff.

• Minimised contact meant all travel and face to face meetings were suspended.

Safety: Top Challenges • Contagious nature of COVID-19.

• Ensuring teams remained connected despite working remotely.

• Splitting the pharmacy teams reduced inperson connection. Some pharmacies with smaller workforces had to reduce hours for team members to ensure the pharmacy could operate for as long as possible.

• Supporting frontline team members who were vulnerable such as those with elderly parents, health issues, and pregnancy, as well as team members who needed to care for young children at home.

Safety: Top Successes • Safety protocols were successful across the entire network of 100 pharmacies; not one team member contracted COVID-19 from working in a Blooms The Chemist pharmacy and at the time of publication not one pharmacy had to close due to infection.

• Delivery of quality healthcare to local communities and seeing the brave, committed and selfless pharmacists and their teams in action.

• Keeping teams up to date on all safety, regulatory, operational, and business changes in a clear and concise manner.

• Connected and healthy teams. Ensuring teams remained connected and healthy despite distancing measures.

A Key Learning A key to Blooms The Chemist success in navigating through the COVID-19 pandemic and keeping its people safe was being agile, taking decisive action and communicating effectively. Being transparent and open in their communication with internal and external stakeholders and providing clear and concise information on safety measures and regulatory requirements ensured all parties were clear on the actions needed to ensure safety for all.

• Managing the plethora of information and constant changes.

“ It is an absolute credit to the entire Blooms The Chemist family that we all worked together to ensure no one got sick.”

• Regulatory changes increased workload and responsibilities for pharmacists.

Sandra Pertzel, Retail Manager, Blooms The Chemist Wagga Wagga

• Ensuring safety of staff and local communities was maintained.

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The COVID-19 pandemic created the perfect storm for a health crisis in which pharmacists and pharmacy store teams were on the frontline. The demand for many products was unparalleled, creating a strain on supply chains and much stress for the pharmacies. The surge in demand was seen across various medications and categories including cold and flu products, thermometers, paracetamol, disinfectants, hand sanitisers as well as personal safety items such as surgical gloves and face masks.

Ensuring Supply: in the Pharmacy Setting Government and regulatory changes were introduced to support medicine supply for customers through increased pharmacist responsibilities. This included allowing medicines to be dispensed from faxed and emailed prescriptions as well as allowing pharmacists to dispense certain medications without prescriptions. Along with an increase in General Practitioner telehealth appointments this led to an increase in paperwork and workload for pharmacists, as pharmacists needed to find the relevant information for each customer. There was a lot of confusion between healthcare providers and their customers on how to manage these regulatory changes, and pharmacists were often required to contact the prescribing doctors to further clarify what was needed. The new government measures also aimed to prevent medicines stockpiling, with pharmacists required to limit dispensing and sales of certain prescription and over-the-counter medication.

Blooms The Chemist helped manage customer expectations with clear and regular communication.

The one daily source of information to all staff ensured everyone was aligned and clear on messaging and requirements, that in turn were clearly communicated to customers. Unfortunately, medicine shortages could not be avoided when suppliers were out of stock; for example, some asthma-relieving inhalers were temporarily out of stock. This caused a strain on pharmacy staff who were faced with anxious customers in many instances.

Providing regular updates on product availability, including when products returned to stock, helped inform and support the pharmacy teams.

Blooms The Chemist pharmacies also supported the local community during these product shortages. In some cases, pharmacies donated hand sanitisers and disinfectants to other essential services to enable them to keep running, as well as to local schools and community groups.

“ Unprecedented demand for cough and cold medications caused a knockon effect and surge in buying from customers. Customers stocked up on all their regular medications, pain and fever medications, hand sanitisers, thermometers, and masks. This caused a strain on pharmacy staff who were faced with anxious customers in many instances.�

Emmanuel Vavoulas, Head of Retail, Blooms The Chemist

SUPPLY

Ensuring the Community’s Access to Health and Medical Supplies

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How Blooms The Chemist Supported the Community • Donation of personal protective equipment to St. John of God Care Centres in Western Australia when they were not able to secure supply to maintain their essential health services.

A group of Blooms The Chemist pharmacists quickly banded together to provide the donation so these important health services could continue uninterrupted.

Out of stocks, however, were inevitable, especially as the suppliers themselves began to experience stock issues due to ingredient shortages, longer product lead-times and shipping issues.

Daily communication with suppliers, which was then conveyed to all pharmacies, was key in communicating expected stock deliveries to allow pharmacies who were faced with anxious customers in many instances.

• Donation of thermometers, personal protective equipment, and hand sanitiser (valued at $3,000) The rapid change in regulatory requirements to Aruma Disability Services (formerly House With No Steps) by Blooms The Chemist Saratoga, for pharmacy dispensing required an immediate process and technology solution that had to be so Aruma could continue it’s services. easily and effectively implemented across all • Nursing home visits and donations – pharmacies. The Blooms The Chemist COVID-19 Pharmacist Kurt Smith donated hand sanitisers Taskforce promptly approved additional and thermometers while visiting the local expenditure to ensure the delivery of healthcare Saratoga nursing homes. to local communities continued with as little interruption as possible. Blooms The Chemist • Donation of hand sanitiser to local police – pharmacists collaborated in the development Blooms The Chemist Queanbeyan donated of the technology and processes ensuring it hand sanitiser to local police to help keep could be easily adopted and supported the them protected on the frontline. pharmacists’ workflow.

Ensuring Supply from the Support Office

LESSONS LEARNT FROM THE FRONTLINE OF A HEALTH EMERGENCY

Blooms The Chemist has a win-win approach to business partnerships and working with supplier partners during a pandemic was no different.

When faced with the unpredictable surge in demands from the COVID-19 pandemic, Blooms The Chemist immediately engaged with key supplier partners to mitigate stock issues with regular forecasts and planning.

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“ Governments of various countries have indicated that they will be looking at the relevant level of future proofing their supply chain and manufacturing capabilities to ensure essential services are maintained in situations such as COVID-19. Procurement and sourcing strategies will be areas of heightened focus.”

Michael King, Head of Sales, GSK

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Case Study 1: Blooms The Chemist Burwood was commended

by Father James Collins, the Rector of St. Paul’s Anglican Church, Burwood for ongoing support during COVID-19 of the church’s Parish Pantry. The Parish Pantry feeds more than 450 people each week as well as providing toiletries, sanitary products, clothing, and food to those who are in dire need.

“Amongst those in our community who are being amazingly kind and generous are the wonderful staff at Blooms The Chemist Burwood.

Lorena, Emmanuel, and all the staff are invariably thoughtful, kind, generous, and caring.

The wonderful staff at Blooms The Chemist Burwood are credit to your company and deserve high praise. These fine people are part of the fabric of society that holds our community together, especially in times of need such as we are experiencing through the pandemic.”

Father James Collins, Rector of St Paul’s Anglican Church, Burwood

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Top Challenges

Top Successes

• Supplier out of stocks, especially when customers were not able to obtain critical medication.

• Implementing new and updated process and technology solutions to manage the influx of emailed and faxed prescriptions.

• Managing pandemic surge in demand for products, including the implementation of government enforced purchase limits.

• Opportunism is often rife during a crisis.

Some opportunistic suppliers emerged during the pandemic, offering items in demand at inflated costs to pharmacies. As a brand, Blooms The Chemist made a conscious decision not to entertain opportunism that would result in the need to inflate prices to customers, to maintain ethical pricing, and at all times hold true to the business’ core values.

• Managing customer expectations, and at times, difficult behaviour.

• Supporting staff with heightened anxieties, especially in difficult circumstances.

• Immediate implementation of government enforced regulatory changes.

LESSONS LEARNT FROM THE FRONTLINE OF A HEALTH EMERGENCY

• Increased workload with extra home deliveries, increased number of prescriptions and increased pharmacist responsibilities (dispensing and telehealth). There was also an increase in outbound and inbound phone calls and email as pharmacists managed communications with doctors and their patients with the changed prescribing and dispensing regulations.

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• Product availability was clearly communicated to both pharmacists and their communities on out of stocks and expected availability.

• New opportunities allowed team members to take on new roles and responsibilities, learn new skills, and develop professionally.

• Effective collaboration between the Support Office team and pharmacies to implement new policies, procedures, and communications.

• Win-win approach with key supplier partners to develop contingency plans and secure stock.

Key Learning A key to Blooms The Chemist’s success in navigating through the COVID-19 pandemic was having a leadership team whose members knew they did not have all the answers. They worked as part of the Blooms The Chemist COVID-19 Taskforce and trusted the judgement of their broader team of pharmacies and Support Office staff. By working collaboratively with open and transparent communication, they were able to find immediate solutions at every level of the business.

Through the pandemic, the ‘Blooms The Chemist family’ rallied together, and it was this sense of ‘togetherness’ that helped find solutions and bring everyone through the crisis.

“ COVID-19 has highlighted how imperative community support and care is, and Blooms The Chemist is always focussed to provide that care.”

Andrew Ioannou, Pharmacist, Blooms The Chemist, Marrickville, NSW

Our pharmacies were impacted by product shortages.

Daily meetings were held with our wholesaler throughout the peak of the pandemic to anticipate shortages and to secure stock. Updates regarding stock were included in the daily communication sent to pharmacies.

Michael Foran, Head of Merchandise and Planning, Blooms The Chemist

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Pharmacists are the most accessible healthcare professionals in the community, and one of the most trusted professions in Australia,15 having provided essential community health services for more than 150 years.

But when panic started to ripple through the community about the implications of COVID-19, the patient-centric model of care was tested as it never has been.

Pharmacies and pharmacists provide critical health services and support better health outcomes.

Pharmacies have been shifting to greater levels of patient-centred responsibility for decades, working with customers and other healthcare professionals in new models of care beyond medicine dispensing.16 The many health services provided by the pharmacy, including vaccine administrations, health checks, medication checks and general health advice, is especially important when supporting an already over-burdened health system.17

With community healthcare at the centre of the Blooms The Chemist mission, it was apparent that maintaining and supporting the community with clear communications was necessary. The Blooms The Chemist marketing team swiftly and successfully pivoted to support COVID-19 related communications.

The communication was inclusive and helped customers feel cared for and well-informed.

LESSONS LEARNT FROM THE FRONTLINE OF A HEALTH EMERGENCY

Blooms The Chemist also encouraged customers to maintain chronic disease management by seeing their regular General Practitioner, accessing Blooms The Chemist pharmacy teams noticed their pharmacy health services, and maintaining their regular medication. Customers were also customers’ anxieties were particularly heightened encouraged to speak to Blooms The Chemist at the start of the COVID-19 pandemic. People health experts regarding any health concerns were coming into the pharmacy confused with and take a proactive approach to their health what they had been hearing in the media and management through flu vaccinations and other concerned about whether they were going to be able to get the medication and health supplies they means to support wellness. needed. The situation was magnified when General Practitioners embraced the telehealth model, leaving patients without the option of face to face contact. This drove more people into the pharmacy, leaving pharmacists to triage and consult customers as well as dispensing their medications and provide their healthcare supplies.

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“ Blooms The Chemist Forestville staff are exceptional – I have the utmost trust and respect for them all. They were very good at communicating with locals when they had new supplies of hand sanitiser and masks back in stock after initially running out.”

Amber Ahern, Customer, Blooms The Chemist

COMMUNITY

Staying Connected with our Community

23 COMMUNITY

Case Study 2: Social distancing and self-isolation were also having an impact on some of our most vulnerable communities: the elderly.

To help ease this impact, one Blooms The Chemist pharmacy went above and beyond by donating gift-wrapped hand creams for Mother’s Day to all the female residents at an aged care facility.

Delivering better healthcare to the community is at the core of Blooms The Chemist’s mission, so ensuring this could be done despite COVID-19 challenges was critical.

Ensuring the pharmacy teams were safe was the number one priority. Then communicating regular changes, and updates to the community helped keep everyone informed. Next was to build in systems and processes to ensure medicines could continue to be delivered in a changing regulatory landscape, along with securing medicine supply. Vulnerable community members were further supported with free home deliveries and telehealth services.

24 COMMUNITY

The expansion of telehealth services was key to continuing to provide health services to customers who were fearful about attending the pharmacy in person. The drop in the number of people seeking out health screening services was so dramatic that it drew a response from a consortium of health organisations, including The Pharmacy Guild and the Pharmaceutical Society of Australia, who issued an open letter to all Australians18 on 26 May, stating:

LESSONS LEARNT FROM THE FRONTLINE OF A HEALTH EMERGENCY

Telehealth has been expanded to make healthcare easier to access. You can now have consultations with your doctor, pharmacist or other health professionals through video chat or phone calls and have lifesaving medicines delivered to your home. Remember, health services are also open and can see you in person – safely. Healthcare professionals are taking all the necessary hygiene measures and other precautions to keep you safe when you need to visit in person. Pharmacists and other pharmacy personnel are readily accessible in community pharmacies and as such ideally placed to support consumers with self-care.

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The World Health Organisation describes several functions of pharmacists involved with self-care requests,19 the primary function being a ‘communicator’.

The pharmacist engages with a consumer to obtain information relevant to the enquiry and provides information to assist the consumer to select appropriate medication or refer the consumer to another health professional when necessary.

Similarly, professional organisations recognise the pharmacist’s role in the provision of Over The Counter (OTC) medicines and the supervision of pharmacy personnel in the supply of these products.20

“ During the pandemic, I noticed fractured communication between Federal and State Governments. I have twins with special needs who rely on my pharmacy, hospitals and community, so it put my family in a difficult situation.

My pharmacist communicated well with me during this time and I found the Blooms The Chemist team was always ready to provide knowledgeable advice to support and reassure customers.”

Rona Chiera, Customer, Blooms The Chemist

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Australia’s health system is one of the best in the world.

It provides quality, safe, and affordable healthcare and is one of the reasons why Australians enjoy one of the longest life expectancies in the world.21 Key to the success is a system where healthcare providers work within their scope of practice, but together to achieve optimal health outcomes for patients.22 Blooms The Chemist pharmacists work within their local communities alongside General Practitioners and allied health professionals, each using their clinical training to ‘assess then treat or refer’ based on the patient’s needs. This contribution provides timely access to care and reduces the burden on general practice and hospitals.23

During COVID-19, with the mandatory closing of some healthcare settings, other than for emergencies, such as dentists, optometrists, and the like, meant there was even more reliance on partnerships between healthcare practitioners.

“ Pharmacists build rapport with the customer and offer support through additional education, e.g. probiotics with antibiotics. Our relationship with Blooms The Chemist has always been strong and remains strong during this pandemic. We work well together, and both make an effort to stay in touch with our elderly patients.”

Dr Anjan Sharma, General Practitioner, Private Practice

PARTNERSHIP

Providing the Best Healthcare Requires Working in Partnership

26 PARTNERSHIP CONTENTS

Case Study 3: Stephanie Yeo, Optometrist from E Eye Place said with the increase of people carrying out DIY jobs during the COVID-19 pandemic, there was an increase in patients with small foreign body injuries to their eyes.

Many patients went straight to their pharmacist, instead of the emergency department, for over the counter medication, having a good optometristpharmacist relationship means better quality of care for them. It is a win-win for all. “More than ever, during COVID-19, the local community relied on the circle of local health professionals to provide essential care.

The pandemic also highlighted the need to help people who are most vulnerable during these times.�

LESSONS LEARNT FROM THE FRONTLINE OF A HEALTH EMERGENCY

Stephanie Yeo, Optometrist, E Eye Place

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27 PARTNERSHIP

Healthcare is a Partnership

Pharmacist

Patient

Allied Health Practitioner

Figure 3: Healthcare Practitioners Work in Partnership

General Practitioner

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For Blooms The Chemist, there has been less focus on profit and more focus on ‘doing what’s right’ for people throughout this crisis. Blooms The Chemist has a people-first mentality, and this was not compromised during the pandemic.

Profit is always a key consideration for any forprofit business; and ultimately businesses must “remain profitable.” While there are some costs associated with the COVID-19 pandemic that were foreseeable, there were some that were necessary, regardless of the cost to ensure the safety of staff and customers.

To Our Business • Additional cleaning.

• Additional signage – decals, posters, TV screens etc.

• Installation of perspex screens.

• Protective gear for staff including gloves, masks, hand sanitiser etc.

• Additional administration and training to ensure government regulations were being met.

• Ensuring the split-roster structure worked across all areas of the business(es) from week to week.

• Managing the initial increase in foot traffic and business, then the decrease as shopping centres closed and people stayed home.

To Our People • Additional hours worked by Support Office, and long days for pharmacists and retail managers in the pharmacies and at home as they were often on virtual video meetings starting from 7am and into the night to stay connected and up to date.

• Reduced hours for retail staff due to split teams = reduced income.

• Emotional toll – the anxiety of being on the frontline during a health pandemic and trying to maintain a sense of calm in-store.

Some Blooms The Chemist pharmacies had to operate on reduced hours due to the shopping centres they were located in restricting opening hours, whereas others had to reduce their hours because the split team system meant they simply did not have the workforce to operate at full capacity. While the pharmacists and retail managers were working longer hours to run the business, the reduced hours and split team rosters meant a reduction in wages for some staff.

To Our Customers

LESSONS LEARNT FROM THE FRONTLINE OF A HEALTH EMERGENCY

• Less incidental purchases as shoppers decreased • Strain on local communities. their in-store browsing time.

• Not being able to get essential items due to panic buying.

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• Scared, fear of the unknown.

“ We have brought in extra staff just to answer the phones, reply to questions and sort faxes and emails from our customers. We have also added delivery drivers and route software to go with the staff to streamline our delivery process and keep track of who, when and where the deliveries are. “ Peter Green, Pharmacist, Blooms The Chemist, Maitland, NSW

ECONOMIC REALITY

The Economic Realities of a Pandemic

At Blooms The Chemist, there is no blueprint or limitations on how we support our community – we just do what is needed. Last week I witnessed a beautiful scene, watching my young pharmacy assistant communicate with a confused non-English speaking elderly lady using an online translation tool. The customer was so appreciative, and I could clearly see the relief and happiness on her face.

Andria Aird, Pharmacist, Blooms The Chemist, Port Coogee, WA

30 CONSCLUSION

Conclusion Australia had an ‘advantage’ of being one of the later first world countries to have confirmed cases of COVD-19.

Reflecting on the lessons learnt during the COVID-19 pandemic, there were three key learnings:

Around the world and locally, pharmacists are continuing to provide services amidst the COVID-19 pandemic, including triage and referral services.14 They are on the frontline of healthcare during this pandemic.

2. We Must Communicate Often – giving people accurate and timely information was essential. Communication was critical and transparency built trust.

Businesses across Australia continue to watch what is happening around the world as the situation rapidly evolves. There are still no ‘best practice’ action plans to adopt – and it is very much a case of adapt to survive and learn as you go.

1. We Must Act Fast – implementing innovations, technologies, policies, and procedures in a timely manner.

3. We Must Stay True to Our Brand – working from who Blooms The Chemist is at its core: a caring and customer-centric community pharmacy brand.

In relation to Blooms The Chemist’s experience, it was important to find a balance within the communication channels from the Support Office to the pharmacies. There was a need for transparency to show what the Leadership Team were doing to keep the business moving forward.

The Leadership team learnt it was important to demonstrate their visibility and presence throughout periods of uncertainty.

In Australia, at the time of printing, Blooms The Chemist safety protocols have been successful; across the entire network of 100 pharmacies, not one of the staff contracted COVID-19 from working in a pharmacy, and not one of the pharmacies had to close due to infection.

LESSONS LEARNT FROM THE FRONTLINE OF A HEALTH EMERGENCY

In fact, the sentiment across the business is that the COVID-19 pandemic has created a stronger bond between the retail teams, pharmacists, and Support Office.

“ We have all gained plenty of learnings from this pandemic. Blooms The Chemist became much more flexible, agile, and collaborative over the past few months – it is important we keep these traits going. The entire business was brought together like never before with a common purpose. Everyone in the business had to adapt and adjust, and everyone worked tirelessly together. The entire team became stronger in a crisis and are even more aligned and united as we move forward.

I believe we will come out of this a better team, and a more resilient organisation.“ Pamela Bishop, Chief Marketing Officer, Blooms The Chemist

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31 RECOMMENDATIONS

Recommendations The development of a new best practice in pharmacy management was demonstrated and implemented across the network of Blooms The Chemist pharmacies in a short period of time. The ability of Blooms The Chemist to be agile, pivot and flex where needed, held it in good stead to ride the COVID-19 pandemic.

Blooms The Chemist has a goal of becoming an employer of choice. The pandemic experience provided an opportunity to do things differently when striving to achieve this goal, post-COVID-19.

While Blooms The Chemist became much more flexible, agile, and collaborative during the pandemic. It is important these traits are carried into the future.

Another area of burgeoning importance, for all businesses post-pandemic, is how best to embrace the digital space. The longer the COVID-19 crisis goes on, the more likely it is we will hit warp speed in the decades-long march toward eCommerce.24 Embracing more digital solutions and an eCommerce platform would enable pharmacies to prioritise their supply chains and more easily deliver medicines direct to doorsteps.

Having an online or eCommerce channel to deliver pharmaceutical products is an area for exploration and investment by Blooms The Chemist. However, rushing blindly into the digital space is not the right move for any brand. Having purpose, getting the systems right, and developing the right product and marketing strategy is crucial.

Furthermore, for Blooms The Chemist, any plans to venture into the eCommerce space must be aligned to the brand mission of being leaders in pharmacy and delivering better healthcare for the community. It must also be supportive of the overarching brand strategy, to be a true community pharmacy brand. Blooms The Chemist is proud to be part of the local community, and equally proud of the meaningful connections pharmacy team members hold with their customers. Any online offer would be designed to complement the instore experience.

The COVID-19 pandemic has already and will continue to change the world in countless ways.

There will continue to be lessons learnt and failures, but businesses that adapt and embrace the ‘new normal’ quickly will be the ones to survive and to continue to be able to serve their communities.

“ During the COVID-19 pandemic, technology has played a crucial role in keeping our business functional and enabling our team to collaborate virtually. These technologies will likely have a long-lasting impact, beyond COVID-19.”

Martin Olds, Chief Information Officer, Blooms The Chemist

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As someone at the helm of a business, with livelihoods depending on the decisions you make, it is confronting that we are not yet out of the woods. The rates of COVID-19 continue to climb again with the state of Victoria returning to lockdown. The pandemic is far from over, and neither are the challenges it presents to our business.

This White Paper has discussed the strategies and tactics that we have put into place so far, which will continue to hold us in good stead to ride out the second, and any other future waves of the disease.

With a vaccination not yet conceived, there will continue to be many more hurdles for us to overcome.

Right across the network of Blooms The Chemist pharmacies, our greatest asset is our people.

Their safety has been my number one driver in every decision I have made to date. In taking care of our people, everything else naturally fell into place.

Our people were on the frontline of healthcare during COVID-19. They were brave, committed, and selfless. I am most appreciative of all their efforts, and I congratulate them on their dedication to providing such a high level of care to their communities.

Reflecting on our experience as a business during this pandemic, I must say the senior management team demonstrated exceptional leadership. The team members are committed to our values and are data-driven. They are focused on the same vision and mission. The decisions that were made during this crisis not only safeguarded the business during the pandemic but will also help shape our future.

We have been building alignment in our business for some time. A crisis like this can test alignment, but despite all the challenges, anxiety, and stress, the team calmly got on with what needed to be done.

We listened to each other, and together we found a better way to do things. We all worked extremely hard and put in long hours. We communicated frequently, with transparency. COVID-19 presented many challenges, and we were able to switch gears quickly and easily due to the alignment that we have.

This experience has enabled us to become more effective and has elevated us to a new level of business best-practice. It has been an honour for me to lead such a values-driven team and organisation.

There is a famous quote that I refer to often, “culture eats strategy for breakfast.� I believe this quote is more relevant today than ever before. Across Australia and the world, as this situation continues to evolve rapidly, organisations are reviewing their strategy and adapting plans to ensure businesses remain viable. That is, of course, very important, but what is even more important is having the right culture in place. A positive and aligned underlying culture is essential for the strategy to succeed.

LESSONS LEARNT FROM THE FRONTLINE OF A HEALTH EMERGENCY

Our culture, our alignment, our strong leadership, and our people-first mentality has so far got us through the pandemic. We are now focussed on planning for the future, while also remaining acutely aware of the realities posed by the ongoing presence of COVID-19.

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We have some seriously exciting plans for the next few years. Our absolute focus remains on our people and becoming the employer of choice in community pharmacy. We have a strategic goal to improve and do better for our people. At Blooms The Chemist, we have a powerful and unique culture, and I believe this is going to take us to the next level as an organisation and enable us to deal with whatever comes next.

Phil Smith CEO, Blooms The Chemist

THE FINAL WORD

The Final Word

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References 1 https://useinsider.com/strategies-pharma-marketers-can-adopt/.

2 https://useinsider.com/strategies-pharma-marketers-can-adopt/.

3 https://theblog.adobe.com/how-covid-19-is-impacting-online-shopping-behavior/.

4 https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/FlagPost/2020/February/ Pharmacy_Agreement 5

Professional Practice Standards – Version 5 – June 2017; 2017.

6 Government, N. Patient Centred Care (Person Centred Care) https://integratedcare.nnswlhd.health.nsw.gov.au/patient-centred-care/.

7 https://www.psa.org.au/wp-content/uploads/2019/01/PSA-Medicine-Safety-Report.pdf 8 Sarah, D.-G.; Shalom, I. B.; Victoria, G.-C., Primary health care policy and vision for community pharmacy and pharmacists in Australia. Pharmacy Practice 2020, 18 (2).

9 SAUMITRA V. REGE, C. M., Unlocking the value: Communicating the value of the pharmacist to the patient. Pharmacy Education 2019, 19 (1).

10 Seubert, L. J.; Whitelaw, K.; Boeni, F.; Hattingh, L.; Watson, M. C.; Clifford, R. M., Barriers and Facilitators for Information Exchange during Over-The-Counter Consultations in Community Pharmacy: A Focus Group Study. Pharmacy (Basel) 2017, 5 (4), 65.

11 Vincent, C.; Hung, T., Purchasing Over-the-counter medicines from Australian pharmacy: What do the pharmacy customers value and expect? Pharmacy Practice 2016, 14 (3).

12 Hays, C. A.; Taylor, S. M.; Glass, B. D., The Rural Pharmacy Practice Landscape: Challenges and Motivators. J Multidiscipline Healthcare 2020, 13, 227-234.

13 (AHPRA), A. H. P. R. A. Glossary. https://www.ahpra.gov.au/support/glossary.aspx#P. 14 Bukhari, N.; Rasheed, H.; Nayyer, B.; Babar, Z.-U.-D., Pharmacists at the frontline beating the COVID-19 pandemic. Journal of Pharmaceutical Policy and Practice 2020, 13 (1), 8.

15 https://www.psa.org.au/career-and-support/pharmacy-as-a-career/.

16 Clark, B., Pharmacy’s shifting focus: from medicines supply to patient-centred care. Health Voices Journal of the Consumers Health Forum of Australia 2016, (17), 20-21.

17 Journal of Multidisciplinary Healthcare 2020:13 227–234 227 © 2020 Hays et al.

18 https://medicinesaustralia.com.au/wp-content/uploads/sites/52/2020/05/220520-An-open-letter-to-Australians-V6.pdf.

19 World Health Organisation. The Role of the Pharmacist in Self-Care and Self-Medication, 4th ed.; WHO Consultative Group on the Role of the Pharmacist: The Hague, The Netherlands, 1998.

20 Pharmaceutical Society of Australia. Professional Practice Standards—Version 4—June 2010; Pharmaceutical Society of Australia: Deakin West, Australia, 2010.

21 https://www.health.gov.au/about-us/the-australian-health-system 22 https://www.psa.org.au/wp-content/uploads/2019/02/Pharmacists-In-2023-digital.pdf 23 https://www.psa.org.au/wp-content/uploads/2019/02/Pharmacists-In-2023-digital.pdf 24 https://www.digitalcommerce360.com/2020/05/14/the-coronavirus-pandemic-exposes-brands-that-were-slow-toembrace-ecommerce/.

APPENDIX

Appendix

34

LESSONS LEARNT FROM THE FRONTLINE OF A HEALTH EMERGENCY

CONTENTS

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Level 3/304-318 Kingsway, Caringbah NSW 2229 www.bloomsthechemist.com.au enquiries@bloomsthechemist.com.au + 61 2 9526 3800

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