Seeing the big picture
A vote in the Royal Pharmaceutical Society elections will not bring change. The Society has an over-engineered governance structure, is prone to secrecy and works like a Victorian organisation, says Mohammed Hussain…
Election fever was in the air this month as candidates battled it out for places on the England, Wales and Scotland national boards of the Royal Pharmaceutical Society.
This year was a super RPS election, with the ballot postponed from last year due to the Covid-19 pandemic rolled into this year. In England, there were 22 candidates standing for election, including four incumbents, for nine of the 14 seats.
The large number of candidates was a positive sign but change does not come from candidates alone, it comes from engaged, active, selfless Board members acting in the best interests of the organisation and the profession.
The RPS is an organisation in difficulty. It appears they are losing members, has a typical election turnout of 10 per cent and seems unable to change course. As a lifetime member and Fellow of the RPS and its predecessor organisation, I wish to see a vibrant and effective leadership body for my profession.
This is essential for the profession to flourish. I have been an engaged critical friend to the RPS in recent years. I am a serial Board member having served on the General Pharmaceutical Council for two terms, an associate non-executive director at two NHS Trusts and now a non-executive director at an acute NHS foundation teaching trust.
My diagnosis is that the RPS has an over-engineered governance structure, is prone to secrecy over transparency and works like a Victorian organisation, although many forget that the organisation was only created in 2010 after the Royal Pharmaceutical Society of Great Britain lost its regulatory function.
The RPS has three national Boards of elected members. These Boards then elect members for the Assembly, an overarching GB-wide board that in turn elects the treasurer and president. The Boards and Assembly meet only three times a year.
A board is expected to act as a balance to the executive. It is there to ask questions, to seek assurance that performance, plans and proposals are in line with the strategic aims of the organisation and to hold the executive to account. The board looks at the sea whilst the executive steers the ship across the waves.
The RPS splits this role across the Boards and the Assembly. Combine this with meeting only three times a year and I find it difficult to see how the Boards can ever discharge their governance duties effectively.
It would seem that even some Board members and candidates are confused as to their role. One husting during the election campaign gave the clear impression that the Board is consulted but the final decisions are made by the executive as they are present every day and the Board is not.
This is not how a good Board works and I was pleased to see the RPS clarify that it is the Board that should make the final decisions.
The problem is that meetings that are only once a quarter and cannot be conducive to effective decision-making and oversight. A Board member elected to a three-year term may only have nine meetings in their tenure. The executive does not get the benefit of a fully engaged Board at a frequent enough cadence to make timely decisions.
I would like to see monthly or bi-monthly Board meetings, a salary system akin to most other Boards and more effective control on expenses.
Other issues are about transparency. The elections to the Assembly are held in the open business of the Boards but the votes are secret. Either an item is sufficiently sensitive to be in closed business or it needs to be fully transparent in open business. Secret voting can lead to highly unusual voting behaviours.
The issue of Board accountability and refresh is important. The English Pharmacy Board has some members who have been there for the past decade, some for nearly two decades if the predecessor organisation is counted.
The EPB expenses and attendance fees for meetings are also at significant variance to the other two nations, although ostensibly they all have the same remit and the same core meetings. The annual report provides no indication of the number or type of meetings attended. How can members judge if this appropriate?
Being a Board member is a specialised skill, and it needs to be developed. The Board should offer development training by experts as not everyone is suited to being effective Board member. The skill is to ask questions. Are you holding the executive to account and helping to steer the future direction of the organisation in a balanced way? The best question a Board member can start with is ‘why?’
I want to see a successful, vibrant RPS. I voted for change candidates and for a more balanced board reflecting the various sectors in our profession. A vote alone will not bring about change as the issues are structural as much as personalities.
Some say that governance is not a priority but this is to fail to understand that most things that go wrong in organisations are due to poor governance. Good governance is essential but it is not automatic.
As a profession we must keep pushing to give the Boards the tools to do their job and to hold them to account.
Mohammed Hussain is a non-executive director at Bradford Teaching Hospitals Foundation Trust and an independent contractor.