The UK Commission on Pharmacy Professional Leadership’s report highlights an ugly situation but what it missed were the reasons why the Royal Pharmaceutical Society has so spectacularly failed after 12 years, says Mohammed Hussain…

The report on professional leadership commissioned by the UK’s four chief pharmaceutical officers has been published. It provides much food for thought. As I write this, I am listening to Ennio Morricone’s soundtrack to the film, The Good, the Bad and The Ugly, and it is a good metaphor for where we are.

The report highlights the current ugly state of affairs in pharmacy leadership. The Royal Pharmaceutical Society has squandered its mission to lead the profession, jettisoned its founding objectives (to become a Royal College), abandoned its membership and is seemingly incapable of openness. I have written before about FIP membership, secret decisions and last year’s exit of three pharmacist directors.

Founded in 1841 and reformed into its current role as a professional leadership body in 2010, the RPS has lost the confidence of the majority of pharmacists and, it seems, even that of some of its architects, who are also the authors of this report.

In summary, the report says pharmacy professional leadership isn’t working. It proposes that a transitional Collaborative Leadership Council (CLC) is established for five years consisting of the current professional leadership bodies (PLBs) and specialised professional groups (SPGs). An option at the end of that period is for there to be a new PLB, one that seeks Royal College status and a Royal Charter. That is a clear and unambiguous threat to the future of the RPS.

The Good …

There are some important innovations in the report that I strongly welcome. A federated leadership model that builds on the independent health policies in the countries of the UK looks interesting. Opening professional leadership to other organisations and not simply accepting the RPS as the voice of the profession is a positive step and reflects the modern plurality of leadership in pharmacy. Creating a formal place for the SPGs is a good innovation.

I have criticised the RPS where I have felt it was due, and I still feel the RPS is doing far too little, far too late to address its strategic and tactical failings, but I wish for it to be reformed not abolished. Perhaps this report is a shot across its bow, a warning for the Society to put its house in order. Perhaps it will even work, but given the dire leadership and archaic structures within, I fear the good ship RPS is on its final voyage.

…the Bad…

The RPS has lost its way and it’s a mess, but it’s our mess. A leadership body beholden to the government is not what we want. That is not the answer and I, like others, have concerns about this. I hope they will be unfounded and the independence of both the transitional Council and the status of the PLB is enduring.

The Pharmacists’ Defence Association has raised legitimate concerns that the government and NHS leadership will have too much control over the profession. What happens if a future government seeks to impose major changes to working conditions for the profession in a manner that is not in its best interests?

I have concerns about the appointment process to these CLC positions. We need to ensure that all voices are heard, not just the ones that agree with any one view. The CLC positions must be scrupulously independent and open to all via an independent appointments panel.

What was missing? For real change we need the employers and the regulator to take meaningful action. My prescription is that it should be an essential criterion to demonstrate professional development to be a member of a PLB or SPG.

In time, it should be a regulatory requirement as part of revalidation, just as indemnity insurance is required today. Allowing a plurality of leadership bodies will give registrants the flexibility to join the group(s) that work best for them, whilst ensuring they are a part of a leadership organisation.

There also needs to be more open thinking on allowing pharmacists to get that leadership from organisations such as the Faculty of Clinical Informatics, and not be limited to historically pharmacy-focussed organisations. The world has changed, and new models need to recognise that heterogeneity.

… and the ugly

In my experience, one of the major factors undermining professional leadership has been the number of senior pharmacy leaders openly questioning the value of such membership and questioning the point of a PLB.

I have personally heard chief pharmacists in hospitals mocking junior staff for their “naivete” in joining the RPS. That’s the wrong approach. Whatever future model we adopt, unless senior leaders also buy in and lead by example, it will fail.

What was also missing from the report were the reasons why the RPS has so spectacularly failed in only 12 years. We do not want to make the same mistakes again, otherwise we could simply be rearranging the deck chairs for a repeat performance. A second report should be commissioned to learn these lessons before we head into a redesign.

A role then for the employers, and the NHS as the biggest employer of pharmacists, to lead the way by making a leadership body or SPG membership a requirement in job descriptions, the regulator to recognise the value of this and mandate it, and finally for the senior pharmacists to lead by example.

Mohammed Hussain is an independent contractor and non-executive director of Bradford Teaching Hospitals Foundation Trust.