In Profession

Follow this topic

Bookmark

Record learning outcomes

By Rob Darracott

A strong professional body, speaking up for pharmacy and pharmacy professionals and leading and guiding them at a time when every healthcare system is facing the twin challenges of budgetary pressure and technological transformation, is “a big deal”, according to Sir Hugh Taylor, independent chair of the UK Pharmacy Professional Leadership Advisory Board (UKPPLAB). 

Speaking as the Royal Pharmaceutical Society consults on draft interim regulations that will support its transition to a Royal College, Sir Hugh says: “I don’t expect people to spend their life worrying about how professional bodies are formed or created. But taking pride in your profession, seeing it celebrated, and seeing it continue to flourish and develop, that should be of interest of every professional working in pharmacy. I would hope they feel this is something that matters to them.

“Every healthcare system in the world is struggling with its budget, with the pressures of ageing societies on health and care services. To the extent there is an answer, it lies in technologies, like new therapies, new medicines, new AI and digital transformation.”

Service integration blurring boundaries in and between professions

“Just think about the drive towards integration of services. That’s blurring the boundaries between secondary and primary and community services. That’s going to demand closer working with other health professions in almost every setting and it’s going to require pharmacy to work closely across the boundaries within pharmacy. AI raises huge questions for patient safety, which really needs to pre-occupy pharmacists and pharmacy technicians. These are really exciting developments and pharmacy needs to keep ahead of that game, and frankly to be leading other parts of the system in how to respond to those drivers for change.

“Professional leadership, clinical leadership, is vital to any healthcare setting or organisation,” he says. “I’ve seen that in practice. I was chair of the Board at Guy’s and St Thomas’s for 12 years. That was an organisation that prided itself, rightly, on having professional leadership throughout the organisation; professional leaders who not only looked after the people within their own professional setting, but looked out to see how they could collaborate with other leaders as well. 

“You can’t run successful healthcare services without strong professional leadership. That means having people in place in leadership positions in organisations, at all levels, who are professionally qualified, who are skilled, and who bring experience and learning to bear in supporting their colleagues in their profession.”

Multiplicity of bodies 'failing to deliver’ for professionals

The UKPPLAB was formed as one of the recommendations of the UK Commission on Pharmacy Professional Leadership, established by the four UK chief pharmaceutical officers to examine a shared concern that the multiplicity of pharmacy bodies and special interest groups were failing to deliver the professional leadership pharmacists and pharmacy technicians needed and deserved. 

Sir Hugh, whose long and distinguished civil service career includes senior roles in the Department of Health and Social Care, the Cabinet Office and the Home Office, as well as the NHS Executive, says the creation of the Board – which is advisory and has no executive powers – was a transitional moment for pharmacy professional leadership, after the Commission’s critique of the current situation.

“We’re building a stronger collective voice for pharmacy at one level, by bringing eight of the leadership bodies in pharmacy to work together on the Board, with a group of independent expert members to support and challenge them. So, collaborating more effectively on day-to-day issues.

“We are also using that opportunity to think about how to create that more sustainable and effective model of pharmacy professional leadership for the future right across the UK,” he says. “Can we create a model which really brings the separate voices of professional leadership organisations in pharmacy together, and makes something which is more than the sum of those parts, in the interest of pharmacy going forward?”

Advisory Board established: three plus five, plus 10

The Board is comprised of representatives from three professional leadership bodies: the Royal Pharmaceutical Society (RPS), the Association of Pharmacy Technicians (APTUK) and the Pharmacy Forum of Northern Ireland (PFNI), together with five specialist professional groups, representing primary care (PCPA), students (BPSA), and pharmacists and pharmacy technicians working in oncology (BOPA) and mental health (CMHP), and clinical teams (UKCPA). The 10 independent expert members were drawn from across pharmacy were appointed in an open selection process. 

Other elements of the pharmacy landscape, including the regulator, trade union, educators and trade bodies, are engaged via a Stakeholder Forum, while a Patient and Public Reference Group provides lay input and challenge on a regular basis. 

“It’s lively,” Sir Hugh says. “We’ve had our moments of challenge, as there should be, but everybody contributes. If you walked into one of our informal sessions and you didn’t know the people in the room, you would not be able to tell, for example, the pharmacists from the pharmacy technicians. There’s a real sense of people getting on well and better as leaders and, importantly, beginning to get to know each other’s organisations too.”

Vision and common purpose prove to be ’liberating moment’

He describes the Board’s agreed statement of vision and common purpose as “a liberating moment”. He says: “It proved we could do something together. It gave people a sense of confidence this was in the right direction.” 

The vision has five themes: co-creating unified, effective and inclusive leadership, collaborating to achieve shared objectives, enhancing advocacy and public awareness, embracing advancements in practice to benefit patient care and prioritising education, innovation and research. 

“They’re all important,” he says. “Let me pick out two things. It is vital for professional leadership to want to be at the leading edge of research and innovation and not flinching from some of the change it’s going to lead to. We’re living in one of those rare moments, with life-changing medicines coming out for the first time in decades.  Keeping on top of that, helping the public with more complex therapies that are emerging, all these are vital roles for pharmacy going forward.

“The second is translating the work of PPL into stuff people can touch and feel on the ground, to help them develop their careers and to flourish, to perform safely and confidently, operate to the full extent of their licence if they’ve got the right circumstances. If a leadership body is doing that, it's a long way to creating an environment which will enable it to suck back expertise, knowledge and skill into the organisation, celebrate it, and play into the wider discussions going on in the health space. It’s a very virtuous circle.”

The meat and drink of leadership  

Sir Hugh says at the outset the Board was tasked with two things. “One was to take forward a programme of work in what I would call the meat and drink of professional leadership – education and training, professional standards, scope of practice. One of the things we prioritised was post-qualification training and education for pharmacy technicians. We have begun to contribute to the mapping out what that might look like. It exposes how difficult it is for a small body like the Association of Pharmacy Technicians UK to develop new models of education and training. They’ve had support from the rest of the Board in highlighting that the system needs to work together. 

“Compared to some other professions in health, pharmacy’s profile in education and training is lower. It's got to get stronger. At the moment everybody trying to do things in small organisations is a real constraint for pharmacy professional leadership.”

There are other positive signs. “We’ve begun,” he says, “to see some good examples in professional standards, where colleagues in the Royal Pharmaceutical Society have been putting much stronger emphasis on working collaboratively to develop new areas to look at. The College of Mental Health Pharmacy and UKCPA have worked with the RPS on an accreditation process. We need to see much more of that happening. Combining expertise and depth of resource will be required to create a stronger offer for people on the ground. 

“The second part of our role has been this wider remit to steer and seek a way through the creation of a more sustainable and effective model for pharmacy professional leadership (PPL) in the future across the UK.” He says the Board has had to seek to align its work to the reality of the Royal Pharmaceutical Society setting a course to form a Royal College. 

Early support for RPS's Royal College move

“We’ve set some important markers. We came out early in support of the move to a Royal College – there was some understandable hesitancy – and we are very committed to an inclusive approach.”  With the RPS focused on the needs of its members, this has meant engaging other organisations, in particular those representing pharmacy technicians, with what a Royal College might mean for them “and look into some of the understandable scepticism around the issue”. 

He says the interests represented by both the Patient and Public Reference Group and the Pharmacy Stakeholder Forum must be features of any future PPL landscape. “The Patient and Public Reference Group is there to keep our feet on the ground: to remind us what we’re for and to test things with. Members of that group, for example, are interested in what we are saying on education and training, they raise good and challenging questions about outcomes, about how this translates across to the interests of patients and the public.

The test of a future body will be: first, at a strategic level, is it keeping that kind of input going, to its board and to its senior people? And second, is it embedding effective patient and public engagement it the way it thinks about education and training, the way it thinks about the services offered at local level? I’m very pleased that the RPS has put into the key objects of the proposed Royal College is that it’s there to serve patients and the public. It’s not only about looking after the interests of pharmacists. In itself, that’s a powerful defining call.”

"The Stakeholder Forum we’ve got is massive; but every time we talk to them somebody says something that gets you sitting up and thinking: how does professional leadership sit alongside the regulator, the trade union and all these other bodies. We continue to think about that, and any future Royal College needs to give it even more weight. You get that kind of challenge if you expose yourself to the views of other stakeholders.” 

Board hears of impatience and scepticism

Earlier this year, the Board launched its ‘Big Conversation’ with pharmacists and pharmacy technicians. Sir Hugh says that while some of the Board would have preferred thousands of responses, he says the hundreds they got were both “reassuring and provocative”: strong support for the direction of travel but an element of impatience. 

“There’s a common feeling that pharmacy professional leadership needs to get its act together. Leaders need to stand up and lead and bring it together in a new way. To emerge with a stronger, better offer. Utter impatience was one message I took quite strongly away from those engagement exercises, alongside people sceptical about whether anything is really going to change. Those voices need to be listened to.”­­­­ He adds that the Board probably did not hear enough from people in their early careers: the soon-to-be newly qualified prescribers who “will change the face of the profession”. 

As for what Sir Hugh calls the $64,000 question: is the prospect of a Royal College the golden opportunity to create the sustainable and effective model of PPL that everyone is looking for? In other words, can and should the Royal College become the single unifying body that meets the aspirations of all professionals working in pharmacy, potentially covering all four UK nations and both pharmacy professions? And, if so, what would it take to make this happen over time, and in a way which works the various organisations represented and their members?

The Board and the RPS have recently established a Co-Creation Liaison Group, chaired by Sir Hugh and RPS president Professor Claire Anderson. “We do need to align the work the Board is doing with the RPS’s work on setting up the Royal College,” he says. “The RPS has publicly committed to co-creating the Royal College. They’re very clear that the Royal College on day one should not be what the Royal College is on day one plus x; they want to see it evolve.

"They’re very open to co-creating that model and they’re also very open to input on the strategy. If this is a make-or-break opportunity, whether or not we are able to seize it will involve a process of real engagement, of consultation with memberships across the organisations involved in the Board.” This will be absolutely critical if an when the time comes, he says. There will be no decisions made without complete transparency and consultation with those memberships.

Ambition not enough – professionals need to gain

“Just saying we’ve got an ambition for the Royal College won’t cut it. What are we going to start to do about it? Nobody should be reassured until they see some product. It’s all getting quite tight because they are talking about launching the Royal College next April. So can the Board input to that process in a way that helps? All I can say is I think we’re a lot closer to that moment than we were even a few weeks and certainly months ago. 

The Board will next consider progress in December. Sir Hugh says he hopes to be able to take a proposition from the Liaison Group to that which, if supported by Board members, would lead to a position statement early in 2026 setting out how the Board thinks the Royal College could become a more inclusive body. 

“That doesn’t mean we will get there, because anything that involves change is difficult, and to some extent the RPS has already got its hands full just doing the transition, but what I have been really pleased with is the way in which people have accepted that they have got to think very hard about this. 

“What I invited people to do – I’m sure they wouldn’t mind my saying this – is to take off their organisational hats, not to forget them, and to think as leaders about the future of pharmacy and the interests of patients and the public they’re serving. I think people have responded to that invitation with real keenness.”

With eight professional and specialist bodies around the table there’s a lot of experience across organisations, some of whom are relatively newly established from scratch, that should be useful. “People have a strong sense of identity,” Sir Hugh says. “To put it very crudely, you wouldn’t want to join a Royal College in order to lose something. You want to gain. It’s how you bring specialist groups together with the other PLBs in a way which means it's a gain for everybody, not a loss.  I think there are ways of doing that, but it requires imagination, and it will require time and a real solid commitment to continuing collaboration and co-creation.”

The pointers for long-term success

So what will success look like? “Any leader, or leadership body, has to have credibility, both as individuals and as a collective force,” he says. There has to be a vision and a  purpose, and a commitment to values. “In health care and health care systems, there has to be a driving commitment to serving patients and the public, and looking for new and effective ways to support people on the front line doing really tough jobs, enabling them to work confidently and safely as the trained professionals they are.”

Sir Hugh is realistic. “It’s easy to see what good looks like. It’s quite often difficult to achieve, because people are people. You get tribalism, all those sorts of things creep in, but we’ve been able to work together to create a sense of vision and common purpose, to work across boundaries, and to look out as well as into the professions represented on our Board. 

Sir Hugh was supposed to stand down at the end of September. “I recognise that this is a tricky moment. We are potentially six months away from establishing this Royal College, and the question has to be addressed now, not down the road. If the answer to the question is yes, then this is a make-or-break opportunity. If we can do all those things, then I think the Board will have done a lot of the job it was set up to do, quite frankly. Let’s keep going, not least because I think it matters to pharmacy. 

“There is a sense in which there is a little bit of unfinished business here. I was in the Department when we split the RPS into a regulator and a professional body. I think the regulator has made positive progress, and good things have happened in pharmacy professional leadership too, but I think there is a sense, highlighted in the UK Commission report, that fragmentation has weakened its overall collective voice. So, if I can help push this over the line in a way which is right for everybody, that would be great. In the end this is about what do the pharmacy professions and pharmacy professionals want. And have they got the will to make it happen.”

What's in it for me?

“Anyone qualified as a professional should feel a sense of pride in their organisations, a sense of being part of a bigger thing. Being part of a profession is a precious thing and something not to be ignored. It is not just a question of a loyalty card; you have to get something out of it, and that means real support in developing your career, particularly post-qualification.” He cites leadership, management and people skills, and keeping on top of the latest developments in medicines “to make sure as far as possible that you and your colleagues are operating at the leading edge of practice”.  

“Being associated with a professional body gives you a chance to give back to your profession, to give to other colleagues the benefit of your experience, from a training and education perspective or, for example, producing guidance.”

“Another part of this is celebrating the diversity of voices across pharmacy. In the area of scope of practice, we’ve put together about 100 case studies, drawn from the organisations across the Board. They are stunning examples of the depth, complexity and range of roles that are being performed by pharmacy technicians and pharmacists.”

Will you join a Royal College of Pharmacy? If so, why? If not, why not? Let us know your views. Email us.