Professional leadership in pharmacy is set for a radical overhaul, with the creation of a “coherent, federated, UK-wide professional leadership framework with strong governance”, under proposals published today by the independent UK Commission on Pharmacy Professional Leadership, which was commissioned last June by the four UK chief pharmaceutical officers (CPhOs). 

The separate identities of the existing professional leadership bodies (PLBs) – the Royal Pharmaceutical Society (RPS), the Association of Pharmacy Technicians (APTUK) and the Pharmacy Forum Northern Ireland – and the plethora of specialist interest groups (SPGs) would be preserved under the proposals, which would be led by a transitional, collaborative Pharmacy Leadership Council.

In the foreword to their 66-page report, Commission chairs Nigel Clarke, former chair of the General Pharmaceutical Council and Professor Dame Jane Dacre, professor of medical education at University College London and a former president of the Royal College of Physicians, highlight concerns from respondents to it Call for Evidence that current professional leadership is “fragmented, does not project a unified or harmonious leadership voice, and is unable to meet in full the needs of patients and the public”.

The chairs add that a lack of clarity between leadership and representation of the professions (by PLBs and SPGs) and the representation of individual professionals as employees – “properly the role of trade unions” – has affected the situation. “Additionally, there is a lack of awareness within the professions of the role of pharmacy PLBs in supporting effective professional regulation.”

Arguing the case for the new Leadership Council, Mr Clarke and Dame Jane add: “The Commission has concluded that a step-change is required to implement its recommendations and build on the trust and creativity created by this process. The vision is the pharmacy PLBs and SPGs coming together across the four countries with mutual respect and equal status to work for a common purpose to lead and represent the pharmacy professions effectively for the benefit of patients and local communities, working alongside other important stakeholders.”

They go on to say: “Pharmacy is at its time of greatest opportunity; pharmacy professional leadership as a whole urgently needs a strong, united voice advocating for how the pharmacy professions can contribute to providing the right care at the right time and in the right place across the NHS and UK healthcare more broadly, working together effectively, and supported by employers, to realise the opportunities.”

The Commission’s report sets out five overarching recommendations for the functions and direction of travel that are “essential for the future of pharmacy professional leadership”. The recommendations cover: leadership, policy and professionalism; regulatory support; regional country and international relations and engagement, scope of practice for future pharmacy professionals; and professional education and training.”   

The full text of the five core recommendations is included at the end of this article.  

‘Disjointed voice’ holding back pharmacy

Those recommendations are a response to five core conclusions from the work over the second half of 2022. The Commission found that, despite the commitment of many talented professionals with the PLBs and SPGs, there was “insufficient collective leadership with the credibility and resources needed to help shape the future of pharmacy and wider healthcare.” As Governments and NHS leaders depend on authoritative professional leadership to help shape effective policy and delivery “the disjointed voice of the pharmacy professions is holding back pharmacy from making the best contribution”.

On regulation, a lack of support for the regulatory process from PLBs “undermines the quality of professional leadership and patient safety, care and trust”. In pharmacy, the Commission says that “the development of professional standards has taken place without a unified professional view which in turn means they are not necessarily recognised or adopted consistently”.

Disengagement from the professional leadership bodies undermines their ability to exercise authoritative leadership, while “the lack of a defined scope of practice” is holding back innovation in service design and effective integrated team working. The lack of progress in education and training, where comprehensive curricula have yet to be developed “is holding back individual pharmacy professionals and limiting the wider contributions of the professions to healthcare, as well as leading to unwarranted variability and a lack of consistency between sectors and countries”.

The Commission’s recommendation for a federated professional leadership framework would comprise a collaborative Pharmacy Leadership Council comprising PLBs and SPGs under an independent chair and “other expert members”, with clear and defined goals based on its five core recommendations. This would enable the PLBs and SPGs to enhance collaboration while maintaining their separate identities. The framework would be underpinned by a ‘duty to collaborate’ and supported by a secretariat.

In a statement issued to coincide with the publication of the report, the UK CPhOs Cathy Harrison, Andrew Evans, Alison Strath and David Webb said: “We welcome the Commission’s report and will now move swiftly to establish a collaborative, UK-wide Pharmacy Leadership Council to lead delivery of its recommendations and ensure we equip and support the pharmacy professions for the opportunities and challenges ahead.

“The vision is for authoritative leadership with a co-ordinated voice to lead and represent the pharmacy professions effectively for the benefit of patients and local communities, working alongside other important stakeholders.”

In a formal response issued on Monday as the Commission's report came out, the Royal Pharmaceutical Society said it recognises the challenges for professional leadership. "We are pleased to read that the co-chairs share our ambition for a more inclusive, supportive and collaborative approach." The RPS says the report will require "careful and detailed scrutiny". Its priority is "to listen to our members and to pharmacy organisations and to understand everyone’s views on the findings and recommendations."  

The RPS set out its vision for professional leadership in a submission to the commission last year. "We remain committed to this vision for the profession," the Society says, adding that an additional Assembly meeting has been scheduled for 20th February to consider a response and next steps. "We recognise our role in pharmacy professional leadership needs to be different and more inclusive. Our commitment is to work collaboratively with our members, the wider pharmacy community and the Chief Pharmaceutical Officers to deliver the professional leadership our great profession deserves." 

APTUK president Claire Steele said: “APTUK acknowledges that pharmacy professional leadership needs to evolve to meet the rapidly changing needs of healthcare provision. In doing so the pharmacy technician profession must be enabled to lead on matters pertaining to their profession, be fairly represented and listened to at all levels including relevant decision-making forums.

We are pleased to see our collective efforts recognised in the recommendations for parity, equal status and mutual respect. It is important for APTUK to see these key points for the Pharmacy Technician profession being upheld throughout any subsequent process. We will take time to consider the recommendations and listen to our members’ views before providing any further statements.”

The Commission’s call for evidence received over 1,200 online responses and webinars conducted by the Commission using Mentimeter polling involved more than 460 people, while further engagement webinars involved 650 people. There were also discussions with a wide range of pharmacy bodies. The Commission also convened five working groups, on the areas covered by the core recommendations, all chaired by members of the 23-person Commission.

Those recommendations in full

1. Leadership, Policy and Professionalism

To convene a transitional, collaborative Pharmacy Leadership Council tasked with developing an inclusive Federation involving existing UK pharmacy professional leadership bodies and specialist professional groups, with an independent chair and other expert members.

• The Council would lead delivery of the Commission’s vision and recommendations for the benefit of patients and the public.
• This professional leadership framework would include robust processes for governance and accountability, and outline a clear identity for the Federation and its unique proposition and goals.

2. Regulatory Support

Through the Council, to continue to facilitate the development of professional standards to support the practice of pharmacy to develop in the public interest, with standards on professional values and behaviours a priority.

• Professional leadership bodies and specialist professional groups are expected to have a ’duty to collaborate’ with each other and the regulators and to manage conflicts of interest effectively.
• The development of standards would include a process to quality assure, accredit, update or endorse professional standards including standards developed by special interest groups or faculties.

3. Regional, Country and International Relations and Engagement

Through the Council, to lead an approach to develop a coordinated and authoritative voice for pharmacy professional leadership, enabling Federation members to work together to support and develop greater engagement with priority audiences including:

• Patients, the public, governments and third parties.
• Pharmacy professional leadership bodies, specialist professional groups and individual pharmacy professionals across all career stages.
• Across countries (including internationally) and with other professions.

4. Scope of Practice for Future Pharmacy Professionals

Through the Council, to enable professional leadership bodies and specialist professional groups to be aspirational for and optimise the contribution of pharmacy professionals, supporting the vital role and expertise of pharmacy professionals in the safe and effective use of medicines, promoting excellence, and championing research, clinical academic development, innovation and the development of new areas of practice, and supporting their adoption.

• This includes putting in place the infrastructure to keep abreast of current and emerging research, medicines and practice; and commissioning scopes of practice, best practice standards and guidance.
• The work would need to include and represent the diversity of patient- and non-patient facing practice within the professions across the continuum of pharmacy and medicines practice, supported by visible role models.

5. Professional Education and Training

Through the Council, to contribute to the collaborative development of aligned UK curricula for post-registration education and training for integrated pharmacist and pharmacy technician practice.

• This will include: post-registration practice standards; credentialing or its equivalents, linked to the further development of career pathways including specialisms; and an assessment process aligned to current and future service need.
• There is a need to facilitate a UK educational infrastructure to support recording and assessment of post-registration education and training activities for pharmacists and pharmacy technicians and ensure equity of access for both professions to enhance professional mobility.