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Alex Gourlay is clear that success for Boots lies in having a strong
pharmacy profession. “I start from the place of ‘What is
the right thing for pharmacy?’,” he says. “I don’t
start from the place of ‘What is the right thing for Boots?’,
because I know, in the end, the only way that Boots will be successful
will be if pharmacy is successful.
“I know with the brand we have and the people I’ve got in
the business that we’ll be able to get our fair share of [the UK
market], in a fair way,” he says.
Mr Gourlay joined Boots as a Saturday assistant in 1976. After studying
pharmacy at Strathclyde University he qualified in 1981 and then worked
as a pharmacist and manager in stores across the UK.
In October 2003 he was appointed retail director, before becoming director
of healthcare, store development and property in July 2005. Following
the private
equity takeover of Boots last summer (PJ, 9 June 2007, p662),
he was appointed managing director of Boots UK Ltd, the first pharmacist
to hold the post.
Mr Gourlay says that private ownership has allowed the company to be
much more focused on its internal business, particularly at a senior
level.
“People in public companies always want to update the shareholders
about how the business is doing, how they’re thinking and what
their plans are,” he says. “You end up with the most senior
people in the business spending a lot of their time just updating people
on
how they are thinking, how they are feeling. … [Private ownership]
has meant we are much more focused on the people and the business, on
developing the right thing for the future of the business. That’s
been the single biggest change.”
Partnership
Mr Gourlay in Boots’s Oxford Street store |
The principal development resulting from the merger
of the Boots Group and Alliance UniChem (PJ, 5 August
2006, p151) has been, Mr Gourlay says, a new focus on partnership. “I think, being very
honest about it, that in the old Boots organisation we didn’t
embrace partnership as strongly as Alliance UniChem did. I would be
the first
to admit
that.
The merger has been fantastic, he says, in terms of cultural change
inside the business. “My personal view is that we want to help pharmacy become
greater for everyone and be much more open to taking and giving and receiving
ideas about practice. There’s lots of great practice outside that we
don’t have, so we’re happy to look at any ideas to help the
business.”
Mr Gourlay also believes that although being a pharmacist may have given him
a different understanding of the detail of pharmacy — allowing him to
understand the opportunity for healthcare in pharmacy — it is for others
to judge any differences between his take on the role and that of previous
holders of the post of the managing director.
Nonetheless, he says he has gained a lot from his first six months in post. “The
biggest thing that I have learnt is that having the responsibility for a brand
like Boots comes with huge opportunities and huge challenges,” he says.
“The
opportunities to use Boots in a really positive way to deliver a better pharmacy
industry are just enormous. But the threat that Boots has for many people in
the industry is a challenge. So how do you make it a positive thing for the
industry and not a negative thing?”
He says he would like to see Alliance Boots being part of an “aligned” profession,
where everyone works together to create more opportunity for pharmacy. “I
think one of the relative weaknesses of the profession just now is that we
don’t have that level of alignment,” he says. This deficiency in
the profession leads, he suggests, to Boots and Lloyds, as well as independent
pharmacists, launching initiatives independently.
“The reason this happens is not because we are trying to steal a march
on the competition, it is because we become frustrated that we want to go faster
and
we cannot find the right way to do it,” he says.
There are some great examples of individual independent pharmacies doing
great work with their local primary care trusts — far more adventurous than
some of the work that Boots or Lloyds does, he adds. “But it would be
much better if we did it all together, and [if we did] work together it would
have benefits and clearly the best service provider would ultimately get the
best
benefit.”
For services to develop, pharmacists need to have confidence in themselves
and they need to instill in the Government real confidence that pharmacy
can deliver new services. Pharmacy also needs, he says, to put sufficient
resources
behind service development and to encourage the Government to support these
services by introducing the right incentives and also committing the necessary
resources. Professional body
A strong professional body will be needed to support the development
of pharmacy practice in a continuing and sustainable way, he says.
He wants to see bold leadership that enables pharmacists to be proud
of what they do and what they can do.
Pharmacy does not necessarily
need to try to grab space from doctors and nurses, he emphasises, but
can simply identify the big healthcare issues not being effectively
dealt with at present, and set out how pharmacists can help tackle
these problems.
He also argues that there needs to be bold leadership in terms of establishing
a new agenda for pharmacy.
“The supply chain agenda will always be there — it will always
be a big part of pharmacists’ role to dispense prescriptions accurately
as given,” he says. “But we need to be much more on the front
foot about being the real medicines experts in the UK, because pharmacists
are that and they can do other roles associated with that.”
Pharmacy also needs to capitalise on lessons learnt from the different
contracts in the devolved administrations, he says.
“There’s a lot of stuff that we know works already,” he points
out. Pharmacists can meet with Government and explain how pharmacy can save the
Government money, take pressure off doctors, play a bigger role than it does
today and be rewarded for it. Talks such as these will lead to changes in the
supply chain and to services becoming a much bigger income stream for pharmacy,
he believes. Compliance
Compliance is a key area in which Mr Gourlay thinks pharmacists have
a crucial role to play. “I find it almost to the point of unacceptable
the low level of compliance to drug taking in the UK,” he says. “I
find it wasteful.” He says it is unforgivable that patients in
the UK end up taking the wrong medicines at the wrong time because
pharmacists have not been enabled to make a difference.
Pharmacists can help tackle this poor compliance but cannot do so alone,
he says. “There’s 101 small things we can do, but there also
needs to be a mindset change in Government, as well, of the new role
of pharmacists,” he says.
There needs to be recognition at a Government level, he stresses, that
ensuring medicines compliance is the role of pharmacy and that pharmacy
should we rewarded for fulfilling that role.
Another problem pharmacy can help tackle is health inequalities. Mr Gourlay
believes Boots, as well as pharmacy as a whole, can play a role in this.
He admits that Boots backed out of small communities in the 1970s and
has not, as yet, returned into these areas.
However, the rebranding of Alliance Pharmacy stores to Boots stores — which
will happen progressively over the next two to three years — will
mean that Boots can provide services in these communities with the strength
of a large multiple, but in the tradition of independent pharmacy,” he
says. “As a result of that, we’ll be in a lot more areas
where people will have access to great products and great people.”
He also believes that pharmacy needs to recognise the role it can play
in tackling inequalities. “I am not sure that pharmacy, or Boots
in this context, has really understood fully yet how we should position
ourselves to make sure that people who have big health issues — because
of their diets and because of the way they have been educated — really
start to feel pharmacy as something that they can trust that can help
them to change their lives.” Focus
Mr Gourlay joined Boots as a Saturday assistant in 1976 |
As pharmacy’s role develops it is important to remain focused on
roles that lie within pharmacy’s key skill areas, Mr Gourlay believes.
Without that focus, pharmacy will start to be seen as grabbing other
people’s territory or trying to get more money for pharmacy in
the wrong area, he argues.
“The danger is that we become too adventurous,” he says. “We
go outside these boundaries and we bump into other professions when there’s
a big job that we can do, and be paid for in, as medicines experts. …the
thing that pharmacists do that no one else can do.”
However, Mr Gourlay says he is mindful that increased regulation could
end up driving pharmacists to do less, rather than more, for patients.
What he hopes it will do is allow pharmacists to feel more comfortable
to give better advice and fair advice, rather than holding back professional
opinions.
He thinks that the upcoming
White Paper on pharmaceutical services (PJ,
4 August 2007, p118) will lead to a safer dispensing system which is
more automatic, more joined up, and developed through a systematic approach.
“It
is about freeing pharmacists to be more able to give of their professional
knowledge and skills and feel free to do that, not constrained in any
way,” he says.
Another big regulatory change facing pharmacy — the introduction
of the responsible pharmacist — will require legislation written
to encapsulate what Mr Gourlay sees as commonsense examples of when a
pharmacist should be able to leave the pharmacy.
“The view that I hold and the view that the business holds is that
you need a responsible pharmacist on the premises for the majority of the
time,” he says. However, he believes there are some occasions when
pharmacists should be allowed to leave the
pharmacy.
“If you have a pharmacy where there’s a heavy flow of patients
coming for over-the-counter advice but a low dispensing business then the
responsible
pharmacist role would be supervising, developing and supporting the teams,
and the people here giving advice is very important,” he says.
“But
there may be times in the day when pharmacists can go out and maybe do
some home visits for an hour or so. But it has to be absolutely within
a framework which is safe for the patients here on the premises.”
He gives another example: “In many community pharmacies across
the land — both independents and chains — the pharmacist
needs a lunch break. And if a prescription has been clinically checked
and is fine, why can’t that be given out when the patient happens
to come in at lunchtime? …These are commonsense things.”
But these examples are exceptions which will need to be worked through,
he emphasises. “The rule should be: on the premises, responsible
for their operation, responsible for the patient care and the accuracy
of the dispensing process.”
He admits it will not be a simple exercise
to capture these exceptions in legislative wording. “But I think
with the right aim and the right intent it can be done.” Looking to the future
Mr Gourlay says his biggest fear for the coming year is that pharmacy
gets caught in conflict with the Government over money, rather than
services and issues. “We have to challenge the Government, we
have to make sure we receive our fair share of money but my biggest
fear is that that becomes a negative spiral,” he says.
He adds: “My biggest hope is that we continue to really invest
in pharmacy to provide a fantastic environment for young pharmacists
to deliver the new role. It is our responsibility as senior pharmacists
with influence to do that for people coming through. That is our legacy — it
is not self-interest — a legacy of creating great pharmacy.”
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The
Pharmaceutical Journal