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Henry Gregg helped rebuild the National Housing Federation’s relationship with the Conservatives and orchestrated a unified message on banning smoking at Asthma + Lung UK. Now his attention is on pharmacy. The National Pharmacy Association chief executive talks to Neil Trainis...

When Henry Gregg took office in May as the third successive National Pharmacy Association chief executive to come from outside of pharmacy, it didn’t really matter that he might not know the profession inside out.

Like his predecessor Paul Rees, Henry arrived with an impressive CV and good experience in campaigning. He was adept at turning ministers’ heads, which appears to be a prerequisite for any incoming NPA chief executive.

As we settle down to chat about the challenges facing him in his new role in one of the organisation’s stately boardrooms at its St Albans headquarters, he firmly makes the point that “changing people’s lives” is what motivates him. And he’s had plenty of opportunities to do that in health and social care.

Henry takes us back to July 2001 when he took on his first job as a caseworker for the Labour MP Karen Buck after finishing his studies in politics, philosophy and economics at Oxford university. He recalls the role involved quite a lot of “housing and immigration casework”.

“It was actually one of the most rewarding jobs I’ve ever had because I was able to sort out someone’s housing situation,” he says.

“I remember there was a young guy who was in a wheelchair and he had been put on the top floor and the lift was always breaking down. I managed to get him rehoused on the ground floor…stuff like that where you get that immediate feedback of helping change someone’s life.

“Similarly, there was a family whose asylum application hadn’t been processed properly and I worked with the Home Office in Croydon to essentially overturn that decision and get them to legally remain. Those kinds of things I really remember. And I’ve still got some nice cards from them at home. It was a really interesting start.”

Politically active father was my biggest influence

Henry would go on to work for the National Housing Federation, Circle Housing Group, the Health Foundation and two local councils in East London over the next decade. He insists he was “very interested in politics” during his nascent years.

He grew up in north-west London and attended a comprehensive school in Cricklewood and his father Andy, who he says was the biggest influence on him because he was “politically active”, worked in the voluntary sector for a race relations organisation. He still does some work as a non-executive at various charities.

A sociological thread runs through Henry’s family and also a musical one. His late mother was a folk singer and his half-brother Owen Williams is a musician who Henry enthusiastically reveals once won the “Welsh Mercury Prize” with a band marvellously called Joanna Gruesome.

“He beat the Manic Street Preachers. Unfortunately, there was no prize money for it. He only tells me every time I see him. He was in a band that was quite popular at the time.”

‘Gruesome’ may not be overstating the predicament many independent pharmacy owners find themselves in. Henry, who insists he has been visiting pharmacies two days a week and spoke to pharmacists before he started at the NPA, quickly got a flavour of how desperate it is out there.

“But I hadn’t realised how tough it was,” he says. “People were explaining they had to draw down their pension early, they’ve had to take out a loan, they’ve had to remortgage their house just to keep the community pharmacy going. I was quite shocked about how much personal sacrifice they were doing to deliver an NHS service.”

The other thing he found “quite shocking”, he says, is “the level of infighting within the community pharmacy sector”. I ask him to elaborate.

“Pharmacists attacking other pharmacists on social media takes the cause backwards because it damages the reputation of pharmacists in general.

“Also, if we want to be working with other parts of the health system, other parts of primary care and GPs, we need to show we’re a united group of experts, of pharmacists, and that we’re calling for the same thing.

“The danger is if you have disagreements between each other or you’re calling for different things, it’s much easier for the Government to ignore it or say ‘you need to sort out between yourselves what you want, otherwise we can’t give it to you.’”

What do pharmacists argue about on social media? “I’ve just seen a lot of posts challenging other pharmacists…you’re always going to get a little bit of back and forth between different types of professionals but I think we can present ourselves in a much more unified manner.”

Don’t wash your dirty linen in public

Henry subscribes to the view that internal differences are fine, so long as you don’t wash your dirty linen in public. He uses his time as director of external affairs at Asthma + Lung UK, where he spearheaded its campaign to get smoking for anyone born on or after January 1, 2009 banned, to illustrate the point.

“There were quite a few different organisations that were working on that but what we were able to do, which made it really effective, was come together around a single agenda and put those areas where we had policy differences aside to get that big achievement.

“The UK would be the first country in the world to ban smoking for a whole generation. It was introduced in New Zealand but it was appealed, so the UK would be the first. That’s one of my main messages…I want to see unity from the (pharmacy) sector because we’re not going to be able to achieve what we need to achieve without that.”

Henry resolutely believes that unity strengthens the power to persuade decision-makers. As head of campaigns at the National Housing Federation, he helped design a manifesto in the run-up to the 2010 general election which pushed housing up the political agenda and persuaded the Conservatives to invest in social housing when they came to power.

“It had quite a strong home ownership angle to it,” he recalls. “We got them to invest in shared ownership and managed to get £7.4 billion from them over three different spending reviews. That was quite a challenge at the time because the Conservatives had the bedroom tax which we campaigned on quite a lot.”

Rebuilding trust with the Tories on social housing

Henry says the Federation had a “big job” rebuilding its relationship with the Government to make sure they were “supportive of social housing”. In what might be interpreted as an echo of recent history, some thought the NPA’s ballot of its members last year on collective action in protest at poor pharmacy funding risked rupturing its relationship with Labour just two months after the party came to power.

Henry says he will spend the next few months “building relationships” and showing the Government it will “get a better system if they invest in pharmacy”.

“From my previous experience, the way you get money from the Government isn’t just to say ‘we need more to deliver the same’. It’s ‘we can do more but you need to provide the funding to support it.’”

He doesn’t agree the NPA’s ballot did any harm. In fact, he thinks it played a part in Labour’s decision to increase pharmacy’s global sum in March.

“I think the campaign was really helpful in making it clear how difficult the situation was in community pharmacy. It actually played a key role in the Government coming back with more than it might have done otherwise.

“We know it’s not enough but that noise and that campaigning and all the work community pharmacists did…when I got this job, a couple of people I spoke to about going for it, they said ‘oh yeah, I know the NPA, Save our Pharmacies’. They’d heard of the campaign.

“So, it had an impact outside of pharmacy and outside of health and I think it put pressure on ministers to try and find more and come to the table with more.”

Funding talks for 2026-27 could start next month and if the outcome of those discussions is unsatisfactory, collective action such as reduced opening hours and fewer services may return to the NPA’s agenda.

“I wouldn’t rule anything out,” Henry says. “You need to keep all options on the table. The focus for me over the next few months is to build relationships and given the 10-year plan has just been published, we need to have a dialogue with Government that says ‘you want this transition from dispensing prescriptions to adding clinical services and we can help you deliver that. Work with us.’

“Any increase in the contract is going to be further down the line. In the meantime, we need to work with our members to bring on some of those services.”

Understandably, there’s a little excitement in his voice as he talks about Labour’s 10-year NHS plan, even though it lacks detail. Neighbourhood health centres sound intriguing even if we don’t know if it will be community, general practice, hospital pharmacists or all of the above working in them.

“We’ve got a really good opportunity here,” Henry insists. “The Government wants to see a transition from a focus on dispensing prescriptions to delivering clinical services. How we support our members through that and make sure it’s fully funded because that’s absolutely critical…to achieve that, we have to all work together.”

What gets me out of bed every morning is changing Government policy

The theme of ‘changing people’s lives’ crops up again as we talk. When asked if he had a particular interest in pharmacy before arriving at the NPA, he says he had a particular interest in health.

“What has got me out of bed every morning throughout my career has been changing Government policy, changing legislation, to help people.”

His campaigns on the health and social care front have seen him help to reduce societal inequalities. It’s the Holy Grail. If you can improve social care, you will automatically make people healthier.

The proposed smoking ban, which is making its way through the Lords under the Tobacco and Vapes Bill, thrills him and he suggests it would be “pretty much the most impactful intervention you can have in terms of health inequalities” if it comes off.

“To do something like ban smoking for everyone born after 2009, if you think about the mortality gap between rich and poor, if you got rid of all cigarettes tomorrow, you would halve that mortality gap.

“I find it really rewarding to have those individual people I have helped but after a certain amount of time, especially if you’re frustrated with the system where you want to see change, you’d like to change the system to benefit more people.”

Changing lives on a large scale is intoxicating for someone with an interest in politics and health but Henry admits he has missed the “individual interaction”.

“I guess that’s why I’ve really enjoyed my visits to pharmacies because you get that, you can see where the NPA is helping them to do something like bring on a new service or support their business.”

Pharmacists have not been short of national coverage and they can expect their endeavours, struggles and successes to be continuously projected on to media’s ‘big screen’ while Henry is at the helm at the NPA.

In 2015, when the film director Ken Loach exclaimed on Channel 4 that a lack of affordable housing was “crucifying people’s life chances”, there was Henry telling the same channel “politicians need to pull their heads out of the sand”.

“I also ran the Homes for Britain campaign,” he eagerly tells me, “which brought together all of the different organisations in housing to say ‘look, housing has been ignored by politicians’ and actually, during that time, housing rose from the 14^th to the fourth biggest election issue. It was actually the number one election issue in London.

“All my career has been about trying to get the Government to recognise particular areas that need investment and then securing that investment.”  

His career trajectory has inevitably given him encounters with pharmacy, so he has not been oblivious to the profession. He keenly recalls that when he was at Asthma + Lung UK, a lot of his focus was on prevention, much like pharmacy.

When he chaired the Taskforce for Lung Health, he “did a lot of work with community pharmacy on vaccines, like RSV and pneumonia but also smoking cessation as well”. And at the heart of those roles was a desire to reduce health inequalities. 

Lungs conditions were most correlated to deprivation

“When I was working at Asthma + Lung UK, lungs conditions were the most correlated to deprivation, so people with lung conditions are far more likely to die if they’re from poorer backgrounds.

“The Taskforce for Lung Health was like a coalition of all the organisations in lung health…we were trying to push for the management of long-term conditions through community pharmacies.

“For example, there was a pilot in the Isle of Wight where they did asthma reviews with inhaler technique checks in community pharmacies and it was really effective. It reduced hospital admissions by 50 per cent but also gave a really good service to people who had asthma.

“We were pushing for more of that to be done and actually, when (the NPA) job came up, it was doing some of the same stuff on a wider scale. What I saw when I was working with community pharmacists was the potential they’ve got to deliver more if it’s properly funded.”

Having established Henry is familiar with pharmacy, it’s still tempting to ask him what his knowledge of hub and spoke, pharmacy supervision, self-selection of medicines and Category M is like.

“It’s definitely getting there. One of the things that’s really helped which you can’t substitute is being on the road and meeting pharmacists. I’ve been to Belfast twice, I’ve been to Edinburgh, Cardiff, Cambridge and Birmingham.

“Visiting pharmacies of different sizes gives me an interesting insight into different jurisdictions. For example, with hub and spoke, some of those visits have been to really big multiple pharmacies where they can talk about how they’ve made it work internally within their organisation.

“We’ve also talked about the possibilities of hub and spoke working between different organisations, which is what’s going to be enabled by the legislation. And I’ve seen automation as well. I’ve seen how robots have freed up time.

“In Scotland, I’ve seen how they’re using an expanded Pharmacy First offer compared to England and how independent prescribing is being used as well.

“I’m learning something new. But those conversations with pharmacists are the quickest way to learn what the situation is on the ground and how the health system works.”

The NPA has voiced concerns in the past about hub and spoke, especially its impact on funding and competition. Things are changing but Henry suggests “it would be a danger to think it’s going to bring huge efficiency savings”.

“Our position on hub and spoke is it may help some pharmacies. When you look at the 10-year plan, the Government wants to transition to delivering more clinical services really quickly.

“Our message is in order to do that, you’ve got to have stability and consistency on the dispensing side because if pharmacists don’t know what their income is going to be in the next few months or the next year, it’s very difficult for them to invest in automation, in hub and spoke, in additional consulting rooms because they don’t know they’re going to get their money back.

“They’d have to take out loans, put money down, and what I’ve been told by numerous (NPA) members is ‘I don’t know, because of the drug tariff and how that operates, what my income is going to be over the next few months, therefore it’s hard for me to make those investments’.”

Labour must close that £2.6 billion gap

He insists Labour must “close that £2.6 billion gap and give people more consistency and predictability in the money that will come in through dispensing” and give pharmacists the confidence to invest more in their pharmacies.

“What would be a mistake is if the Government thinks you can take the money out of dispensing through efficiencies and put it into the new services. You need new money for the new services otherwise, I don’t think there’s enough capacity for members to take it on.”

Pharmacist prescribing has and will continue to open new revenue streams but Henry says he’s “worried services will not be in place” for newly qualified pharmacists to “use their prescribing skills” from next year.

“Clearly, they will need support and we’ll need to have proper governance around it but for me, the issue is have we actually brought on the services for them to really take advantage of those new skills?”

It’s a good question. One accusation levelled at Labour is it has failed to produce a detailed blueprint around a community pharmacist prescribing service, something it promised to fulfil in its election manifesto.

At times, it feels like Keir Starmer and co are muddling through without a clear plan on anything, often resorting to their stock phrase ‘we inherited…’

It’s a similar theme with their 10-year plan. “A lot of detail needs to be filled in,” Henry says. “It’s looks like these neighbourhood health centres are going to be GP-led which is fine as long as pharmacists are involved as early as possible. What we want to avoid is a centre that is created and duplicates the work pharmacists are going to do in their expanded role.

“Also, some neighbourhood health centres are not going to be physical centres. They’re going to be a bringing together of different services in the area. Not all of them are going to be bricks-and-mortar.”

One hopes community pharmacy has solid foundations in years to come. Whatever happens, it promises to be another interesting chapter in Henry’s career journey.