The quality of being determined – those who succeed because of sheer grit and determination. That sums up my career quite nicely.
I haven’t got where I am because I’m different to other people, because I’m not. Jobs haven’t fallen at my feet, I’ve had to work very hard, sometimes under very difficult circumstances, to demonstrate that I’m worthy of a given role. There have been tears when I didn’t succeed and extreme joy when I did. I’ve not been complacent when it’s come to embracing life-long learning and have put myself completely out of my comfort zone to achieve qualifications I never thought were possible for me. Yes, that has meant personal sacrifices, but it’s all been worth it because at the end of the day I’m doing my bit to deliver patient-centred care.
Leadership is a decision
However, it has been a road hard fought for and I often question whether it should have been as hard as it was and still continues to be. With that in mind, I’m setting out my career path in the hope that it will make things smoother for others in the future.
Hopefully my reflections will either: Strike a chord with you, or help to make your own journey easier, or help you to make some else’s journey easier.
It was acceptable in the 80’s, it was acceptable at the time (Calvin Harris)
Most healthcare professions have a clear career pathway from the outset with plenty of opportunities along the way. When I qualified as a pharmacy technician in 1987 there were two roles in the hospital sector: pharmacy technician and senior pharmacy technician.
Today, there are more roles open to pharmacy technicians, but a clearly defined career pathway still eludes the profession, and I genuinely believe that this has contributed towards the difficulty in demonstrating that pharmacy technicians have so much more to offer than those traditional roles.
That fight has seen me: change sectors; leave traditional pharmacy technician roles behind; take a leap of faith into roles that don’t require pharmacy qualifications; and undertake a substantial amount of further study.
The BTEC in Pharmaceutical Sciences that I undertook as my basic qualification suited my social (interpersonal) learning style because it involved working in a classroom environment and networking with other participants. It also included experiential learning and involved elements of pharmacy practice. As my role in the hospital involved: dispensing; medicines management at ward level; extemporaneous manufacturing; sterile production; aseptic dispensing; and quality Control.
The experiential element was, for me, very important.
There aren’t many hospitals today that offer all those training opportunities to preregistration trainee pharmacy technicians.
The culture at the District General Hospital where I trained, was one of encouragement and where team work was paramount and it set out my expectations for the future.
If you’ve read my first blog you will know that fate has played a great part in my career and when I moved north, not long after qualifying, I realised that not every hospital was as supportive of on-going technician education and development. Even the roles I undertook were substantially reduced to dispensing and aseptic dispensing. There wasn’t a ‘Foundation Pharmacy Framework’ that the Association of Pharmacy Technicians UK (APTUK) has developed for today’s newly qualified technicians.
Pharmacy technicians were in very short supply at that time and I used that to my advantage and very quickly attained a post as a senior pharmacy technician in a specialist cardiothoracic hospital. Remember that this was the extent of the career pathway and I’d achieved it within 18 months of being qualified. Great you might say, but it left the prospect of further promotion looking pretty bleak. The concept of continuing professional development (CPD) didn’t exist and being a pharmacy technician was not a registered profession.
Back to the Future
By 1993 I’d been a stay at home mum for three years. It seemed unlikely that I’d ever return to pharmacy, so I sought a part-time job that I could fit around looking after my children. I stumbled into being a Tupperware™ sales consultant. It’s ok to snigger; many did at the time. It was, however, a time for seizing opportunities and this role taught me the art of presentation. We all know how important that is in the modern healthcare world, particularly if you are ambitious and I’m VERY ambitious.
A Tardis ride to 2000 sees me working in an aseptic suite. I didn’t stay for long as it was clear that career progression was still limited. However it was a good platform to get back into the profession.
In 2001 I took a leap of faith…
I accepted a prescribing support technician role in a Primary Care Trust (PCT). The learning curve was a vertical straight line and was very scary. There was no peer group. There was just me. I only had a pharmacist to refer to for half the week and being able to work autonomously became vital.
To compensate for that lack of a peer group I joined the Association of Pharmacy Technicians UK just as they were starting to discuss technician registration. I later became one of the first technicians to enter the voluntary register in 2005.
The pharmacist I worked with was (and still is) an academic and she was the catalyst behind the academic journey I ultimately undertook myself. I’d found someone who believed in me and gave me work that suited my competencies and not necessarily the qualifications I did or didn’t have. Eventually the prescribing support role morphed into community pharmacy development.
Keep a full bag of tricks
Portfolio working is a brilliant way to learn new skills and build networks. I embarked on this journey from 2004 and in addition to working in the PCT I had simultaneous roles in the following settings: NVQ Assessor – predominantly in community pharmacy; bank technician in a private hospital; and community pharmacy services facilitator for a Local Pharmaceutical Committee (LPC).
The NVQ assessor role saw me return to study after 20 years absence, setting the scene for more formal study later. Importantly, I had another line manager who believed in me, this time a fellow technician. The bank technician role maintained my dispensing competencies (vital for the NVQ assessor role) and the role with the LPC was crucial to how my future panned out because it helped me in the following ways:
To start to build extensive strategic networks with community pharmacy became a further example of valuing team members for their competencies and a chance to see community pharmacy development through the eyes of contractors instead of commissioners.
This was a defining moment in my career.
Beware of the big bad wolf
Agenda for Change brought with it great anxiety due to the mapping of core qualifications, which by then had become an NVQ 3 only. It’s a very clinically biased framework and it became a major barrier to career progression. It also brought with it role discrimination. For the first (but not the last) time I experienced meeting the person specification for the job:
Registrant of the Royal Pharmaceutical Society of Great Britain (as it was then)
A minimum of 5 years post qualification experience but being rejected for interview on the basis I wasn’t a pharmacist.
I suddenly felt very disconnected and not worthy despite having held the reins on that very same job for 18 months.
If you are a fan of Ted Talks you will have watched Brené Brown and listened to her say that the root of disconnection is shame and that ‘the thing that underpin(s) this is excrutiating vulnerability.’
What I didn’t understand at the time was that this when I first learned to build resilience. That’s really important, because as Brown also says, when we feel vulnerable ‘one of the ways we deal with it is we numb vulnerability.’ When we do that we numb other emotions, we feel sad etc. and it’s a vicious cycle. However when we embrace vulnerability and start saying ‘I’m enough … then we stop screaming and start listening, we’re kinder and gentler to the people around us, and we’re kinder and gentler to ourselves’ (Brown 2010). For me that opened more widely the doors to success.
I get knocked down but I get up again (Chumbawamba)
Part of the reasoning for not being granted an interview was because it was a role that required the incumbent to have a degree or equivalent experience. Those of you who, like me, have navigated Agenda for Change for many years will know that proving that you have equivalent experience to a degree is near on impossible. So, despite going through a very rough patch in my personal life I signed up for a Foundation Degree in Medicines Management and Pharmacy Services at the University of Huddersfield. It was one of the best decisions I have ever made and I graduated with a distinction.
It turned out that no-one knew what a Foundation Degree was and when I explained the response was: ‘Why don’t you give up your job and go and do a pharmacy degree?’ So three years of intense study whilst working full time and managing a challenging home life didn’t cut the mustard. The pharmacy world still only saw the qualifications that I needed to register as a pharmacy technician. It wasn’t interested in the competencies I’d gained along the way never mind my shiny new qualification that was designed to demonstrate that I was an advanced practitioner. To be frank not much has changed in the intervening nine years and there is still no advanced practitioner framework.
I never intended for my career to be anything other than clinically orientated however to do that I’d have had to stand still as there were no clinically orientated courses for technicians. I wasn’t prepared to do that and so
It was time to diversify
Moving into pharmacy contract management was a big move for me, not least because the role didn’t require me to be a pharmacy professional and so I risked leaving my hard fought for roots behind. However, I soon learned that being a pharmacy professional gave me so much more credence when talking to contractors about the services they provided because I was better able to understand their point of view and I could speak in a language that they understood.
On the education front, the universities that I approached to undertake ‘top-up’ modules to gain that elusive bachelor’s degree weren’t very forthcoming. In the search, I stumbled on a new course – Postgraduate Certificate in Leadership and Management in Health and Social Care. The course blurb said that a pre-requisite for the course was a 2:1 in a relevant subject. I prepared myself for another stomp of the foot but found that I didn’t need to: for the first time ever my (then) twenty years’ experience actually counted for something and I was accepted onto the course. I knew it was a massive jump from foundation level to masters level and I promised myself that if I failed a module I would admit defeat and leave the course because I had neither the time nor the inclination for repeating assignments. I learned a significant amount about self-belief during this time, because that self-expected failure never came and in 2012 I got to wear a cap and gown for the second time, not with a postgraduate certificate but with a full Masters in Leadership and Management in Health and Social Care.
Finally, I was able to meet the actual educational requirements that job descriptions that I was interested in were stating.
Do I finally feel accepted?
In a word – No!
Despite the qualifications and the competencies I’ve gained along my 30-year journey, I’m still battling with job descriptions that ask for a General Pharmaceutical Council (GPhC) registrant but what they really mean is ‘we want a pharmacist’. Why? Mainly because the social norms of the pharmacy world still dictate that senior roles are performed by pharmacists. I took a risk taking on roles that relate to pharmacy but don’t require a pharmacy professional to be in post. It was meant to be a short-term diversion to demonstrate the levels I was capable of working at. Unless those social norms are challenged it’s more likely that it will be a permanent move.
I have several challenges to end this blog:
- As pharmacy professionals let’s have a sensible and structured debate on establishing clear and defined career pathways for all pharmacy professionals.
- If you are a recruiter, think long and hard about the competencies you want a post to encompass and before you opt for the stereotypical ‘thou shalt be a pharmacist’ ask yourself if that is really necessary or could a technician with the right background, knowledge and skills perform that role just as well.
- If you’ve had a similar fight for your career, NEVER GIVE UP. Instead, share your experiences because without them we have nothing to learn from and most importantly nothing to build upon.
Alison Hemsworth is national programme lead, pharmacy contracts and projects at NHS England, and is an honorary visiting senior fellow in pharmacy policy at the University of Bradford School of Pharmacy
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