John D’Arcy
When you reflect on your time in pharmacy, what have been the highs and lows for the profession?
My career has spanned such a long time there have been many highs – and a few lows. Overall, I do feel that whilst community pharmacy does find itself in an extremely difficult period just now, it is in a much stronger political position than it was when I started out.
In my early career, no-one (including some pharmacists!) understood pharmacy’s role. There is much greater political and consumer awareness of the important role pharmacy can and does play at local level in terms of improving health and wellbeing. The highs are associated with the recognition being translated into action.
For example it has been fantastic watching the development of the flu vaccination service which has moved – over a period of years – from one of there is no way pharmacists can vaccinate people, to a nationally based service opportunity that community pharmacy has grabbed with both hands.
The lows are always associated with the instances where the policy or decision makers fail to appreciate the resource inherent in the community pharmacy network.
What’s been the greatest achievement in your career so far?
Managing to speak about community pharmacy at a Dispensing Doctors’ Association Conference and leaving with my knee-caps intact.
(Actually, I received the best reception I have ever had at that conference!)
Is there anything you would have done differently?
Not particularly. As you look back, there are always things you would have done or approached differently. But other than to look back and learn from experiences as a means of doing things better in the future, retrospectivity is a pointless exercise.
What career advice would you give to other pharmacists?
I would start by saying that pharmacy is a great degree. It is science based and has considerable depth and breadth in the curriculum. It is for me a superb base from which to launch any career and should not necessarily be viewed as a vocational subject that limits you to one field of practice.
I would say to young graduates, you have many years ahead of you, so experience different work settings before you commit to a final resting place. I would also say that you should embrace lifelong learning as a principle. A key part of this process is putting yourself in different situations and this at times requires taking a risk which may not pay off – but whatever happens – win or lose – learn from the experience.
To those in community pharmacy I would say that the key thing that makes the job worth doing is improving the lives of your patients and customers. Pharmacy does at times get a negative press, but patients love pharmacy. In many places the community pharmacy is the only retail outlet left and is vital to local communities as a source not just of medicines, but also advice and support. Every day, pharmacists make a difference to people’s lives and this is a great position to be in.
Is there a pharmacy-related job you wish you’d done?
No – I have been very fortunate in my career. I have had great jobs, worked alongside great people, been to magnificent places and had the opportunity to experience and learn from so many different aspects of life.
Community pharmacy in England is facing tough times. How can things be turned around?
The start of this process is to get the two sides across a table. The new CEO at PSNC provides an opportunity to ‘wipe a slate’ and to re-enter into dialogue.
The reality is that DH/NHSE have a real problem in balancing the NHS books and with capacity in terms of service provision. Community pharmacy provides a cost-effective solution to many of the capacity issues and should be regarded and deployed as such. There are any number of pharmacy strategies that carry similar themes around how community pharmacy can improve the health and wellbeing of local communities.
There is also cross-party political support for a clinically led pharmacy service. So let’s agree with DH/NHSE a service specification and process for making this happen and then agree on a properly resourced contract for its delivery.
Is technology a threat or an opportunity for pharmacy?
Both. Technological advancement and development are broadly outwith pharmacy’s control and will be deployed where they bring efficiencies or other benefits to the delivery of pharmacy services. We cannot stick our head in the sand on technology. Rather, we need to embrace it and consider where it fits in to our day-to-day practice.
But technology will only be part of the process where there is sustainable business case for its use. The pharmacy world gets busier day by day and there can be little doubt that technological solutions will play a part in creating headroom in pharmacy – particularly where it assists in the process of managing the ever-growing volume of prescriptions. But as we move to a more clinical role, this for me underscores the need for face to face contact with patients which must remain a core component of pharmacy practice.
How well do the various organisations work together/collaborate in pharmacy?
You only have to look at the number of pharmacy bodies purporting to represent the sector to know there is a problem here. The reality is however that democracy quite properly dictates that pharmacists should be free to join any organisation they like if they feel that organisation is relevant to them.
For me, it is not the number of organisations per se that creates the problem. The perception – and at times the reality – is that pharmacy speaks with a divided voice. Pharmacy – and within that community pharmacy – represents a relatively small group when compared with other professions – particularly doctors and nurses. We therefore need to do all we can to make our voice as big and as loud as possible. Instead we seem to become more and more fragmented thereby weakening and confusing our message.
What, if anything, frustrates you most about the profession?
An unwillingness or inability to stand up and be counted. Pharmacy is a great profession that does so much in a variety of scientific and healthcare fields (it was a pharmacist who invented Coca-Cola for goodness sake!).
And yet our role is still poorly understood and lacking proper recognition in some quarters. Many – including it seems the DH/NHSE in England – still see community pharmacists as simply overpaid ‘box shifters’ and an easy target to be hit with divisive clawbacks and unacceptable levels of bureaucracy. Somehow, we need to be louder and more focused in getting our message across. This is something, I have to say, that appears to be working to reasonable effect in Scotland.
In years to come, do you think community pharmacy will regret the demise of Pharmacy Voice?
This depends on what happens post Pharmacy Voice.
I was always a big fan of the Pharmacy Voice concept. As an umbrella organisation it brought together three principal community pharmacy bodies under a single voice and gave added weight and credibility to the pharmacy message. It is clear that the PV arrangements did no suit all of the constituent members, but the principle of the ‘single voice’ holds good alongside what I have previously said.
It is also worth noting that PV had a constituency only in England. In the other UK countries – Scotland, Wales and Northern Ireland – there is a more coherent approach in the form of Community Pharmacy Scotland, wales or Northern Ireland. This makes me feel that Community Pharmacy England must be close by, and with this we may have the opportunity to have greater clarity and cohesion in our political and negotiating message.
Who/which team have you most enjoyed working with and why?
I had two great – relatively lengthy – spells in my career at both the National Pharmacy Association and Numark. Both are membership bodies, and in both cases I worked with relatively small management teams in developing and delivering strategies that saw membership growth and increased business resilience.
Membership organisations are tricky in that you put a member proposition together and whilst you put much effort into leading the member to water you cannot force it to drink. The two organisations required a different balance in the representation, support, commercial mix and presented challenges in terms of the differing needs and expectations of members and the others to whom we were accountable.
In both cases I have had the great fortune to work with teams who are bright, passionate, committed and focused and been able to reflect always on a job well done in line with agreed strategy and on budget.
What motivates you?
Working with people who want to make a difference.
Who, if anyone, has most influenced you in your career?
Tim Astill – my predecessor at the NPA. He was a legend – a truly inspirational leader. He was witty and highly intelligent and someone who had the ability to at all times judge his audience to perfection.
Does community pharmacy have a future?
Absolutely!
Interestingly when I qualified in 1981, I was advised to switch career as there was no future for pharmacy. In the late 80s/early 90s all the talk was of there being no future for pharmacy. Indeed I remember in 1992 giving a presentation (I think in Halifax) to a group of pharmacists and the title I was given was the then usual: “Is there a future for community pharmacy?” I put the title slide up and before I could speak, a member of the audience – an elderly pharmacist – said: “Can I ask a question?”.
I replied that of course he could – although I did say that it was unusual to ask a question of a speaker before he had said anything.
“I have just read the tile of your presentation,” he said “and I just want to know, is the answer ‘yes’ or ‘no’, because if it’s ‘no’, I’m off home”.
I told him the answer was yes (although much of the smart money at the time would have been ‘no’).
Anyway, 25 years on, we are still here. And despite all the understandable negativity associated with ‘deaf’ opinion formers and financial attrition, we will remain – perhaps with some modification – because patients want us and need us.