| Tall, no, very tall, bearded, magisterial and — already playing
his part in the Society — patriarchal. These are just some of the
adjectives that leap to mind when you first meet the new chief executive
of the Royal Pharmaceutical Society, Jeremy Holmes. Then, once you start
talking, the formidable exterior melts, you glimpse a smile, he appears
more avuncular and you start to suspect that this is the man for the
moment.
There is no doubt that he has a sharp intellect, and he probably does
not suffer fools too gladly. That will be no bad thing while he comes
to grips with what he has to do for the Society over the next three years
as it metamorphoses into the General Pharmaceutical Council and a professional
leadership body. And, as the Society unravels, he has to guide the Council,
and take the Society staff and, most importantly, the membership with
him. “I think it’s a great challenge and I am up for it,” he
enthuses.
Mr Holmes has no preconceptions or baggage about the pharmacy profession. “It’s
probably time for a fresh and dispassionate look at how the profession
can be led and be best served,” he says.
As managing director for 14 years of the Economists Advisory Group (originally
an academic think-tank) with a staff of about 120, he has had considerable
experience of managing change, not only within the EAG itself but also
within a variety of organisations that have commissioned him and his
teams to look at the impact of Government policy on their activities. “We
have also done work in the health sector and that is where you can make
a difference on the ground,” he adds.
You soon notice in his conversation that he has an ordered mind — often
listing two or three aspects of an issue, or three groups to influence.
As far as the Society’s journey is concerned there are three groups
on which he wishes to lavish energy: “First, the membership — and
we will have to be even-handed towards the different disciplines represented
in pharmacy — who will need to buy into the strategy; second, the
policy makers and regulators; and, third, other players in the health
care community such as GPs, nurses and primary care trust managers, and
specialists of all types who see the part pharmacists can play.”
Mr Holmes sees the future of health care rather like a jigsaw. Pharmacists,
he believes, must recognise the shape of their piece and create a picture
of the way services they offer will fit in to the wider vision of improving
the health care of patients. He says he intends to reshape the two organisations
in a positive and productive way so that they will be rewarding for members
to belong to, satisfying for staff to work for and, in the end, improve
quality of services provided. “It is not worth doing if it doesn’t
do that,” he declares.
He also is a supporter of Government policy. “The mission, as set
out by the White Paper, is non-negotiable and, to my mind, the right
mission. We have to face up to that and we can’t duck it. We have
got to work with the grain of Government policy. There is no point in
having an adversarial relationship with Government,” he states.
Collaboration and co-operation
However, as he points out, Government policy on its own does not deliver
patient care; it needs the health professions to do it. He sees that
as a collaborative process, and intends to find opportunities to work
closely with the College of Pharmacy Practice, the National Pharmacy
Association and other pharmacy bodies for everyone’s benefit.
“We
have no monopoly on doing smart things. I don’t really mind where
the bright idea comes from. Wherever that is we must work together.
We need to find mechanisms for learning from the best in pharmacy,” he
explains. “I have also been involved in stakeholder management
before but here we have a very wide and diverse range of stakeholders:
individual pharmacists, other bodies, patients. We have got to manage
each of those groups and be sensitive to the needs and ambitions of
those groups — and that is exciting.”
An example from Mr Holmes’s previous experience that has parallels
with what is happening in pharmacy is work he did on behalf of the European
Commission on the impact of the single market on business. “There
were three problems: we were having to relate the macro picture, which
was on a multinational scale, to what was happening on a small scale — in
other words, relating the big picture to what was happening on the ground.
Then there was the overlap of industrial policy, science policy, education
and tax policies, for example. It was a question of joining
up the dots and fitting the pieces of jigsaw
together.”
And he clearly relished dealing with the third problem — the politics: “The
EU is interesting at all levels of politics,” he explains. “As
well as working with national politics, we were dealing with groups lobbying
on behalf of pension providers and those with an interest in working
hours, for example. We had to manage and wrestle with those politics,
as well as answering the chunky fundamental questions. Was the single
market any good? Did we get greater productivity? Did consumers benefit?
And the answer is,” he says with a smile, “yes, in some sectors.”
Mr Holmes goes on to explain that when dealing with these large political
questions you have to be aware of the interests of different groups.
As far as the future of the Society is concerned that will be the profession
as well as other health professions that are relevant to pharmacy. “Lambeth
has to connect with what is going on in health care on the ground (be
it community, hospital or industry) and not become detached from real
life. We have to be clear what [support and services] pharmacists in
the real world want in the interests of delivering best patient care.”
For some years Mr Holmes has also been an executive trustee with the
Carnegie UK Trust, which has some of the same focus on social issues
as the Rowntree Foundation. When he first joined, the trust was used
to making a lot of small grants, “picking up the casualties of
the system rather than improving the system”, he says. Over time,
it started to set up inquiries and become far more strategic, examining
issues such as rural community development, civil society and democracy,
and looking at ways to involve young people in decisions affecting their
lives.
“The trust has the ear of Government because we are, first,
genuinely independent and respected and, secondly, take a long-term view.
The advice is research-based and we are not tied to the electoral cycle
or to annual reporting structures.” This model, Mr Holmes believes,
will be of value to pharmacy as it develops an independent voice that
Government will listen to and respect, and that is heard to be arguing
in patients’ interests.
Although Mr Holmes is clearly well connected, he places a lower premium
on personal networks and believes they are less important than the strength
of the argument. At this stage of the proceedings his major personal
aims include making sure that the profession sings with one voice so
that everyone can buy into what the Society will become. “That
way,” he emphasises, “other players will listen and take
note, ie, the regulators and the policy makers.”
He also suggests
that some mechanisms need to be put in place to make that happen and
ways found “to keep the energy going”. He lists the mechanisms
as structure, funding and governance. A third challenge is to connect
with what other health care bodies are doing. “It would be entirely
wrong to set up a professional body in isolation from what other health
care professional bodies are doing,” he adds.
As far as the establishment of the GPhC is concerned, Mr Holmes is clear
that it is the job of the Government to lead it. “We should take
the lead in the development of the professional leadership organisation.
And what I mean by that is that leadership should stand for best practice,
innovation and representation to influence policy.” Ownership of change
Mr Holmes intends to set up an internal task force, peopled with Society
staff members: “This will be the centre of gravity for the change
process.” He believes it needs to interlock with Council, and
listen to feedback from the profession and other pharmacy bodies but
he is clear about one thing: “I will give ownership of the change
to this group.”
Mr Holmes believes that the next year is critical to the success of
the Society. “We have a timetable set for us which has its attractions.
We can’t duck it or be swayed from our destination. That is a nice
challenge. It is a process more like a line graph than steps, although
at times the line will get quite steep. In a year’s time we will
need to take stock of where we are.”
He has a few words of caution: “You can talk and you can listen,
but time is of the essence. We have got to get on with it.”
Outside his professional life he can be found playing the bassoon in
an orchestra, the Wycombe Sinfonia — which, assuredly, will play
to the highest amateur standard — in south Buckinghamshire, being
an on-call taxi-driver for his two teenage daughters and keeping fit
and lean exercising the family labrador. “I try to cook once a
week, but I am not much good; I am sure I will be given a cookery book
at Christmas in order to improve my pathetic culinary skills,” he
says.
“I have been very lucky. I have done some fascinating things and
I love new things and getting stuck in. This job is up among the best — it
certainly gets my taste buds going.” He adds: “The Society
has so much going for it. There is so much head-room. But to lead the
profession you have to have buy-in from the membership so you have to
serve them.”
And if there is a sound-bite that sums up his vision
it is “Lead and serve”. He draws a parallel with two other
groups: “The best MPs serve their constituents. The best football
managers serve their teams. We need to serve our professionals.”
Those professionals attending the British Pharmaceutical Conference in
September, will not be able to miss him. The image comes to mind of a
benign Pied Piper — cloaked, playing the bassoon and leading the
profession up a steep road to a better place.
Joining up self-care
Jeremy Holmes led the evaluation of Joining Up Self-Care, part
of the Working in Partnership Programme funded by the Department
of
Health. In the first instance he was appointed to the steering
group and than ran the team that conducted the evaluation.
It revealed that there were many disparate things happening at
primary care trust level that were not joined up — coronary heart disease
prevention, health promotion, the Expert Patient Programme and minor
ailments schemes — and that were happening in little pockets. “We
did not find the philosopher’s stone,” he smiled, “but
we did learn things that should inform policy at national level and
how funds are invested to engage people to use GPs and A&E
services more appropriately and other services, such as pharmacy,
instead.”
There was a successful pilot in south Derbyshire, as well as a
number of other beacon primary care trusts. The message, he believes,
that
is relevant to pharmacy is how lessons learnt in one area can be
scaled up so others in the profession can learn and more patients
can benefit. |
|
The
Pharmaceutical Journal