The Pharmaceutical Journal
Vol 280 No 7491 p262
1 March 2008

This article
Reprint   Photocopy

PDF 50K, Acrobat Reader

Diverse roles in community pharmacy

A career in community pharmacy has provided opportunities to balance the needs of profession and family, says Michael Holden

Careers series

As a child I wanted to be an architect, exploring innovative ideas and turning visions into realities. But the prospect of funding a six-year degree was not realistic for my family, so I sought the advice of my careers master, who happened to have an old friend who was a lecturer at the Portsmouth School of Pharmacy, and the academic requirements matched both my strengths and my interests.

I lived in a small Lancashire village and was offered work experience in a privately owned community pharmacy in a nearby town. The owner enjoyed his professional role, was highly respected by his team, by his patients and customers, and by other healthcare professionals.

I watched him making a real difference to the health and well-being of the community and that potential sat well with the values I was brought up with, so I warmed to the prospect of this vocation.

A Saturday and holiday job in a large multiple followed and it was in Southport, the same Lancashire seaside town, that I completed my preregistration year in 1977 after a degree at Portsmouth School of Pharmacy.

The pharmacy and management team at Boots were excellent and the quality of training and development continued as I moved through my career with a variety of experiences including small and large stores, training, marketing, merchandising, operations and area management appointments.

A serious illness and the loss of my father in the late 1980s led me to rethink my values. Having moved away from the professional role, observed a downturn in the ethos and focus of the company and rarely seen my wife for 12 years, I decided to put down some roots and become an independent community pharmacist.

After being away from a dispensary for some time, the return to practice was challenging, but rewarding. I enjoyed building a team and professional practices to deliver what I think our profession does best — supporting healthcare in the community.

Over the next 13 years I worked closely with local GPs, nurses and NHS managers to ensure that the role of pharmacy was optimised in patient care. This led me into the development of the profession through involvement in the local pharmaceutical committee and other activities.

Consultative role

Once again my health and other factors made me reassess my position. We sold the businesses and moved into a consultative role at a time when the new contract was being debated and implemented. This called for a significant change in mindset, operational standards and skill-mix in pharmacy practices.

Supporting the management of change and developing, implementing and evaluating new services was demanding but satisfying, as it demonstrated the potential of community pharmacy to make a real difference.

The new role took me away from home for much of the week and a change in family circumstances meant I needed to be around more, so in 2005 I accepted the invitation to become the full-time chief officer of Hampshire & Isle of Wight LPC. Building on a good team and supporting over 300 community pharmacies is enjoyable, if challenging.

The function and purpose of the LPC needed to change along with the change in mix of multiples and independent pharmacies and the evolution of the NHS into a largely commissioning body. It required the development of the LPC team skill-mix, ensuring ownership of our core purpose (to optimise the professional and financial opportunities for community pharmacy), strategic priorities and operating framework.

The greater emphasis on delivery of quality and safe practice in pharmacies has meant that capability, capacity and competency have moved up to a new level. The LPC now finds itself supporting contractors and the pharmacy team to increase the opportunities to be more involved in patient care pathways within the primary healthcare team. To achieve this I had to develop and apply an extended set of skills.

Building relationships — influencing and negotiating with NHS managers, commissioners, medicines management teams and other stakeholders, including the local medical committee and secondary care — is central to my role. I work closely with local branches, the Centre for Pharmacy Postgraduate Education and national bodies, including the Royal Pharmaceutical Society, the Pharmaceutical Services Negotiating Committee, the National Pharmacy Association and the Primary Care Pharmacists’ Association.

Negotiating the commissioning of a new service, being involved in its development and implementation and seeing the benefits for patients, pharmacy and commissioners is hugely satisfying. With so many demands on the pharmacy team, limited funding and a mobile workforce, maintaining consistent quality delivery is a real challenge.

The spin-off from being fairly vocal is that people ask you to talk about what you are trying to achieve and what you are doing to get there. This is an activity I enjoy as long as it does not distract me from my main role. I also sit on a few advisory boards, but still make the time to do the occasional locum to ensure that I can “walk the talk” and experience the coal face; I still enjoy the patient contact.

More than 30 years in the profession has provided me with a stimulating mix of experiences and satisfying outcomes. Community pharmacy has so much potential, but often undersells itself, sometimes underachieves and rarely speaks or acts as a united branch of the profession, hence it does not receive the recognition it warrants and seeks from other healthcare professionals and the NHS.

I sometimes wonder whether I could have been more successful as an architect than a pharmacist. However, I will pursue my vision for a little longer.

Whether my family see the work-life balance is questionable. Next career step? Who knows?