What’s in it for me?
From Mr G. Hall, MRPharmS, and Mr R. A. Cattell, MRPharmS
At the recent Guild of Healthcare Pharmacists/UK Clinical Pharmacists Association joint conference, a workshop was held entitled “Professional leadership body — what’s in it for me?”. The aim of this session was to identify from the group of 40 GHP or UKCPA members what it was they saw as key to the reasons why members would join the new body which, ultimately, would define the success of that organisation.
We as a group offer the output of that meeting both to the wider profession through The Journal and to the Transitional Working Group. Indeed we have sent the TWG the unedited feedback from the delegates at that workshop with the hope that it influences their work, confirms elements of what they are already doing and challenges where they are not.
Two main areas were explored. First: “What’s in it for me?” We considered what should be provided by a professional body from the perspective of members. The organisation should provide strong advocacy, one voice for pharmacy and be credible. It should have a strong patient focus and enable pharmacy to work without sectoral boundaries.
One key function is the development, accreditation and help with delivery of standards for professional practice at all levels, pre- and post-registration, for those working in broad areas and those working in highly specialist roles.
Initial must-dos include help with maintaining registration through revalidation and also an offering to maintain and develop current professional networks.
The body should pick a unifying issue and lobby, represent and influence on behalf of the entire profession to create cohesion. It may be that the issue of decriminalising dispensing errors might provide such opportunity.
The second area explored in the workshop was communication. It was recognised that the professional body needs to spend more time communicating with its members and, in return, members need to communicate with it.
Imagination needs to be used to engage with the vast majority of a generally apathetic profession. Facebook, Twitter, text messaging, and methods such as those used in “Jamie’s Ministry of Food” are worth exploring. In general a multimodal communication strategy, including many forms of communication with single messages in bite-sized chunks, should be used.
The delegates at the workshop seem to agree with the main themes from the prospectus, have given some thought to how this might be developed and have some ideas around communication.
They would like as a group to offer their thoughts to the wider profession to stimulate discussion and help the Transitional Working Group put forward the best offering to their members.
The outputs and presentations from the workshop are available via www.ukcpa.org
Graeme Hall
Professional Secretary, UK Clinical Pharmacy Association, and member of the Royal Pharmaceutical Society’s Council
Richard Cattell
President
Guild of Healthcare Pharmacists
See also How advanced and specialist practice developments are to be taken forward
Let us discard our insecurities
From Dr B. P. Curwain, MRPharmS
In her Broad spectrum piece about a student code of conduct (PJ, 6 June 2009, p670), Kareen Inverne, a third-year pharmacy student, states that pharmacy has a self-esteem problem.
She states that “we are not sure whether we are a profession or rather that others are not sure that it [pharmacy] is a profession”. She has, I think, sussed us out early in her career.
Pharmacists writing to The Journal are forever talking about “the profession”. This word and its derivatives crop up with truly amazing frequency, and this speaks to me about the deep insecurities that some of us live with. It comes in part from the model of single-handed practice in the community and also may have its roots in hospital pharmacy, which, in the past, was more about dispensing than about a real clinical function.
Hospital pharmacy has changed in a big way over the past 15 years, and this same shift of emphasis is now taking place in community practice. The development of primary care and public health pharmacy have also exposed many of us to the experience of working in teams with other healthcare workers.
We absolutely deserve to discard this insecurity. Pharmacists are doing great work in every sphere. We understand clearly that patients come first, whatever our sphere of practice. We do so much, over and above the minimum required by our contracts, in order to make things better for patients.
Medicines now work to a degree unknown 50 years ago. The price of this is that they are also far more hazardous, and our skills and understanding have had to increase proportionately. Clinical science has also moved on so that we are more able to quantify the risks and benefits of particular therapeutic strategies. No other group of healthcare workers has the enabling background in the science behind medicine that we have.
The fact that dispensing errors still carry a criminal label is probably a contributory factor to our self-esteem crisis and the Royal Pharmaceutical Society’s welcome campaign on this matter has received significant publicity.
Last week, Charles Willis, head of public affairs at the Society, and I took my local MP to visit a community pharmacy in his constituency. He was clearly surprised and delighted to learn of the range of services now on offer — some commissioned, some unfunded. He told us he had signed the Early Day Motion about dispensing errors.
Pharmacy is now represented in most places where health policy and practice are developed and monitored. We have people who can act with confidence in these situations. They need to be supported by a confident and mature body of practitioners. So, let us do it and let us start now.
Brian Curwain
Member of the English Pharmacy Board
New Professional Body; Doubts and fears
I know I am by no means alone in being concerned at, in particular, the governance proposals for the new Professional Body. I also know that I am not alone in being doubtful that it is necessary to have such a "one vote, take it all or leave it all" process. And I am in good company when I express both my deep concern at the pressure being put on us by the centre to vote Yes, the speed with which the machine swung into action and the relatively short time over which the campaign is to be conducted.
As a Fellow I have had a letter from the President urging me not only to vote Yes, but to use my influence to persuade others to do so. As one whose postal address is is England, and whose email address is registered with the Society I have received an email from the Chair of the ENB urging me to vote Yes. However I also know that letters using almost exactly the same words and phrases have been sent to colleagues in Scotland and Wales, and that those emails have been sent not from an address registered to the Chairs, to whom one might respond, but from "info@rpsgb.net". If I were of a cynical mind I might wonder whether the three Chairs actually knew the email had been sent! I know Beth Taylor knows there is much more to pharmacy than community practice within the NHS!
I have to say that all this reinforces my concern that the Establishment regards this as an opportunity to ensure central control over the profession, and to reduce the involvement of the ordinary pharmacist. I would remind those who are doubtful that financial control, including the fees, will be in the hands of the Officers, responsible not to the elected National Boards but to the Assembly, meeting no more than twice a year. Membership of the NRB will be, of course, be voluntary, and as a result if the fees are too high Members will leave. However, many will pay by Direct Debit, and it is quite possible that many will have their fees paid by their employers, if only to ensure support for CPD.
The argument has been put forward that once the New Body has been established, the members will be able to alter it as necessary, and that may well be correct; however the steam-rollering going on at the moment does not give confidence that the present administration at least will give other than a condescending nod in the direction of those who do not toe the party line.
Fortunately as a Branch Secretary I have access to, at least, the email addresses of those in my area, and am able to advise them to vote No!
Why England matters
From Mrs B. H. Taylor, FRPharmS
In debates with colleagues around governance structures for the new professional body, I have been struck by how often pharmacists in England underestimate the extent to which it is England, and not Great Britain, that determines their clinical and professional practice.
Let us use an example that I know well: sexual health services based in pharmacy, such as emergency hormonal contraception, pregnancy testing and chlamydia screening and treatment. The way that pharmacists provide these services is influenced by:
All of these apply wholly or mainly in England, with different guidance or policy in Scotland and Wales. So, what is still Great Britain-led?
There are patient and professional organisations, such as the Family Planning Association, British Association of Sexual Health and HIV and royal colleges but, surprisingly, little else.
This is why England matters so much to pharmacists in England and why a professional body governance structure that draws on elected members from boards representing England, Wales and Scotland is the only way forward in the 21st century.
Beth Taylor
Member
English Pharmacy Board
Undue haste is inappropriate
From Dr J. E. Rees, FRPharmS
The President has described as “dissent” the response by members who took the trouble to study carefully the proposed changes to the Royal Pharmaceutical Society’s Charter and to submit suggested alterations (PJ, 27 June 2009, p767).
If unwillingness on the part of some fellow pharmacists to accept a flawed set of proposals is considered to be “dissent”, then I would question the motives behind the consultation.
One of my own suggested alterations, relating to membership categories, was considered worthy of mention by Marcus Longley, University of Glamorgan, who analysed the responses for the Society.
But this recommendation, along with many other positive suggestions documented in Professor Longley’s report, was not incorporated into the document on which members are now being asked to vote.
Beth Taylor, the then chairman of the English Pharmacy Board, has urged members to vote “yes” on the basis that the new professional body will “truly represent your interests, and effectively lobby those that influence the future direction of the profession … [and] … will work to ensure proportionate and appropriate regulation by the new regulator” (Vote “yes” for pharmacy in England, 19 June 2009, info@rpsgb.net).
But there is nothing to indicate that the proposed changes to the Charter will do anything to achieve the desirable objectives that she describes. Recent history shows no evidence of either of these objectives having been met, for example, in connection with members’ expressed wishes regarding the draft Pharmacy Order 2009.
The Council failed to act on behalf of the members concerned (PJ, 30 May 2009, p632). So what in the Charter revisions changes this situation?
The pages of the PJ that have promoted the President and others advocating a “yes” vote seem to convey a desperate concern, even possibly a recognition, that the present proposals will not be acceptable to the two-thirds of the members who will vote, let alone the membership at large.
Regrettably, nowhere have I read the sound reasoning that I need to persuade me to vote “yes”. There is a remarkable level of spin, but it is not reinforced by factual information.
As far as I can judge, there is plenty of time for the necessary changes — as recommended by numerous members — to be incorporated into the proposals so that a further revised Charter can be drafted, which will be acceptable to members.
All that is needed is a will on the part of the officers and the Council to do what they say the new professional body will do in future: that is to listen to the carefully considered views of members. Undue haste is entirely inappropriate in such circumstances.
John Rees
Aylesbury, Buckinghamshire
Distinct lack of enthusiasm
From Mr A. O. Bond, FRPharmS
I would encourage the authors of the Original paper “What do Royal Pharmaceutical Society branches mean to pharmacists in Scotland” (PJ, 18 July 2009, p76) to read Bruce Rhodes’s excellent tribute to the late Ken Youings (ibid, p82).
He says: “We both attended Somerset branch meetings where we got to know each other and Ken became chairman and I the secretary. We did not have to enthuse each other about the profession; it came naturally. We organised the branch, we represented it at branch representatives’ meetings and annual general meetings, and we made sure that a good number came up for the special general meeting about trading restrictions at the Royal Albert Hall in 1965, which we both agreed was the most exciting professional meeting of our lives.”
I remember that meeting, but I especially remember that anyone visiting the Somerset branch meetings really did get to know other people and even to form lifelong friendships. The meetings were primarily about society (the situation of being in the company of other people) before any considerations of the workings of the Society and before any thoughts of the actual practice of pharmacy.
People drove several miles to be there and then probably drove many more on the annual car treasure hunt, for which some of the clues had a distinctly pharmaceutical twist. We had non-pharmacist speakers to widen our minds beyond the minutiae of day-to-day practice, before moving to any business to be discussed in the meeting.
The current obsession with continuing professional development or attendance certificates is not what the branch structure was designed for. Internet forums cannot be a replacement for face-to-face interaction.
The Society has already started crowing about the nearly 80 per cent vote (PJ, 25 July 2009, p85) for the new professional body. However, it still needs to start from the bottom up, never mind a “top light” structure.
Unless there are more people prepared to be led (more than 70 per cent of the membership could not be bothered to vote), there will be no need for leadership. There is a distinct lack of the groundswell of enthusiasm from the branches of the kind that Mr Youings and Mr Rhodes enjoyed.
In fact, even as a past chairman myself, I do not even know what is happening in the Somerset branch anymore. I was informed I would only receive future notices of meetings by e-mail and only then if I registered via the Society’s website. I did that, but I have ceased to hold my breath.
Andrew Bond
Glastonbury, Somerset
Where is the library?
From Mr D. I. M. Simpson, FRPharmS
I do not know whether anyone has been to Lambeth recently, but he or she will find the library there — which was the foremost collection of pharmaceutical literature in Britain — a shadow of its former self. In fact, they will have a job to find the library at all.
The books and journals have largely disappeared (offsite, I believe) and the place is stuffed full of administrators’ desks. The information pharmacists have been relocated to another floor. How the staff are able to carry on in such circumstances is beyond me, but they do.
All of this bodes ill for the Royal Pharmaceutical Society after the split. The more reasons that there are to join once membership becomes voluntary the more members will sign up.
Having a library — and this is more than just a few computer terminals — must be an essential feature of such a body, particularly if it has any pretensions to be a body akin to a Royal College to work alongside the new General Pharmaceutical Council, supporting excellence and professionalism.
And surely members in the future will want print-based information to support research or their continuing professional development.
However, all the signs are that the library, and the museum, too, have been put into mothballs until the split has taken place. This is madness. The library and the museum should be preparing with confidence for the new opportunities that the future will bring instead of having the stuffing knocked out of them.
There seems to be an unfortunate view that has taken hold at Lambeth that the Society is a body with a future and no past. Or that the past was bad and that only the future will be good. This is a travesty of the truth.
The Society has considerable achievements of which it should be proud, not least its array of first-class books and journals (one of which I used to edit), as well as the library and museum. But its greatest achievement has been in leading the development of the pharmacy profession in Great Britain since its foundation in 1841.
The Article by Briony Hudson, keeper of the Society’s museum collections, marking the 150th anniversary of the death of the Society’s founder Jacob Bell (PJ, 6 June 2009, p676) serves to remind us of the Society’s long history.
It also reminds us of the great personal sacrifices made by Bell and of the enormous affection in which he was held by his close colleagues and by pharmacists throughout Britain. Bell, above all others, laid the foundations of the Pharmaceutical Society and set it on its path of consolidating and developing the pharmacy profession in Britain. His legacy is in danger of being betrayed.
Douglas Simpson
Beckenham, Kent
Our libraries have disappeared
From Mr I. M. W. Caldwell, FRPharmS
Are we truly the first philistine profession? Our Royal Pharmaceutical Society used to have two libraries and now we have none. Like Douglas Simpson, I was appalled to find that the London headquarters’ library has already ceased to exist, gone with never a whisper.
The book stacks, shelving and computers have been replaced with a glass-screened area into which only strangers from the General Pharmaceutical Council can enter. The remaining tiny rump of the library has only bound journals and Registers, a computer and a bench seat.
Edinburgh lost its librarian last year and is effectively closed. It is suggested that the Lambeth book stock may be stored at York Place at present. How accessible it is if this is the case is unknown. I have always believed I am a member of a learned society on a par with the Royal Society of Chemistry.
What other learned body has deliberately disposed of its history, its artefacts and its library? What learned body intentionally divests itself of some of the prime tools of learning?
I note that we have stopped buying any new books and there is also a proposal to “ethically dispose of the majority of the print collection”. Apart from being Lambeth-speak, what is “ethical disposal”?
Access to hard copy is not all that a library is about, but not every member has access to NHS or academic sources so his or her route is via the professional library for literature search, document supply and copying and inter-library loan — yet all of these services seem to be about to disappear. The point is well made that future, and perhaps present, information services will be electronic. With electronic material, as with print, we have an obligation to future generations to provide continuing access to the whole range of knowledge of our profession. It would be nice to know who will carry this responsibility, from where and how it will be funded.
The electronic resources section of the library and information centre document makes the astonishing claim that it will aim to “ensure that all pharmacists have access to their national electronic health libraries and support them in using this appropriately in their practice”. A worthy ambition but the oncoming and much diminished Society had better quickly get used to the idea that non-members pay at least an economic rate for services or facilities that the members will provide and pay for within their membership fee.
Not only have our libraries disappeared and our museum artefacts been shut off in some lock-up, but where are we going in Edinburgh? The bequest of a complete, historic pharmacy provided us with a unique professional asset and public attraction. The Scottish Directorate is about to move to a new location, but with never a nod towards the fate of either the library or the historical collection. The National Museum is in the process of renovation and our singular exhibit would probably be a welcome addition to its refurbished displays. Even if it were prepared to offer new housing for our artefacts, I can already hear the caveat “you will, of course, be providing ongoing funding for its maintenance”. The answer, given our new, slimmer Society, is that we will not.
Over recent years, the Council has bleated repeatedly about its transparency of process. I submit that it is completely unclear what the Council has caused to happen to our library, museum and information services in both London and Edinburgh. It is equally unclear what will be the site of the new facilities, how they will be staffed and funded, how much they will cost and if the new Society will be able to afford them.
Ian Caldwell
Larkhall, LanarkshireSociety response
Bernard Kelly, director of finances and resources at the Royal Pharmaceutical Society, responds:
On preparing itself for its future as a professional leadership body, the Society has been reviewing all of its activities to ensure it is positioned to provide services to its members at a cost that is affordable and relevant. Both the library and the museum have been subject to this review.
At the moment, the options for establishing the museum and its collections within a charitable trust are being considered. In the meantime, the artefacts of the museum remain on display as they have always done. Mr Caldwell can rest assured that we are preserving the heritage of the library. The archive of historic publications will be moved to the museum so that it can be kept and curated in appropriate conditions.
Increasingly, pharmacists are using electronic resources for information, partly because they can do this from their homes or workplaces with no need to visit a physical library and partly because it enables more efficient and comprehensive searching of material.
In 2008 less than 1 per cent of members used the library lending service and about 1 per cent made a visit there (although these groups may overlap), so the total proportion of our membership using the service in this way is small.
In effect, the other 99 per cent of the membership subsidise a facility they do not use, despite considerable promotion on the part of the library team. This will not be sustainable in a new professional body that is looking to provide the most relevant and user-friendly services to its members.
The development of the electronic myLibrary service through myRPSGB is a good example of such a service, and one that makes internet use much more targeted than use of a general search engine.
Given the low level of use made of the printed materials within the library (over 35,000 items) the budget for purchasing new books has been suspended while a review is undertaken to consider how the Society’s limited resources can be best allocated to provide information sources that best serve the needs of the majority of the profession.
Given the low level of usage of the library, the devotion of limited and valuable space to storing books that were rarely accessed has led to the underutilised space being reallocated and fitted out to produce revenue in the form of rent and service charges from the General Pharmaceutical Council.
The library in the Scottish Office remains open, although the small usage could not justify the cost to members of replacing the part-time library assistant when she left.
The Scottish Pharmacy Board has, for some time, been considering options for relocating the Scottish Office to premises that are better suited to meeting the needs of our members and the outcome of these careful deliberations will be announced in the near future.
In preparation, the contents of the library and the Victorian pharmacy have been fully catalogued for the first time. We are committed to continue providing an information centre for members with a range of current books and journals, and improved access to electronic information sources. We will also transfer and display the most important historical artifacts in a way that will enable better access than the existing arrangements and, as suggested, find an appropriate home for those items we cannot accommodate. In doing so we will be able to provide improved services for members and ensure that our professional heritage is safeguarded.
Closing down departments is not an option
From Mr P. M. Worling, FRPharmS
I am glad to see that Ian Caldwell has raised the question of the future of the library and museum of the Royal Pharmaceutical Society since this is a subject that I, too, have been concerned about. From my own experience I have found a number of professional and learned societies have had problems in recent years in deciding how these parts of their organisations should best be funded. Each body has approached this in different ways appropriate to its own needs. None so far as I know has responded, as Bernard Kelly has suggested in his reply, by closing them down to save money.
The President in his address at the British Pharmaceutical Conference has promised that the Society will, in future, respond to the needs of the future and its members’ requirements. If our new body is to be the centre of excellence for pharmacy and maintain its place with other learned societies, it has a responsibility to future generations of pharmacists to maintain a first class collection of artefacts and the history of pharmacy, and to hold a historic and current collection of the writings of pharmacy. It is an exciting experience to see the fine pharmacy museums and collections maintained throughout continental Europe and to be infected with the enthusiasm of both students and curators.
The UK has a proud history of development in pharmacy and medicine and correspondingly excellent facilities should be available. We are fortunate in having a first class curator at Lambeth, whose work and effort has made the collection accessible and relevant. The cataloguing of the Victorian Pharmacy in Edinburgh has now been finished — a much needed step. This needs more work to make it into an attractive small museum. At least it is now in a position where it can be visited by groups and individuals, thanks to the work of our local staff. Visitors from Europe and Japan have been accommodated and if the facilities were made available, regular visits from visitors to the city and residents could be easily organised.
As one of the 1 per cent users of the library in Edinburgh, which also doubles as coffee shop and meeting room, it would be difficult if the complete collections of The Pharmaceutical Journal and Chemist & Druggist were not maintained locally. It is a small library and it seems to work without a librarian but, of course, there is no facility for obtaining other volumes. It is true that more references are available electronically. I recently had to obtain an article on dispensing “Guilebbe Gemmato”, which is in the ‘Teatro Farmaceutico’, Venice, 1681. I did not try the library in Lambeth but obtained a photocopy of the page from the library of Madrid University. The point is that, irrespective of the amount of electronic information that is available, it is still necessary to go back to the original sources.
If our new professional body is simply concerned with finance then it may well be that new methods of funding and a new approach to services will have to be found. Sponsorship and joint activities with other interested bodies may well give us opportunities to pursue. Simply closing departments down is not an option for our future.
Peter M. WorlingHonorary Vice-President, British Society for the History of Pharmacy
In assessing the value of libraries, a long-term perspective is
From Mr S.W.F. Holloway
Ian Caldwell, a past president of the Society, and Douglas Simpson, a former editor of The Pharmaceutical Journal, have drawn attention to the closure of the Royal Pharmaceutical Society’s libraries in London and Edinburgh. Together their letters demonstrate how important it is for the future of the Society that the libraries are maintained and developed as they have always been during the past 150 years. Without repeating the arguments so forcefully presented in their letters, I would like to comment on Bernard Kelly’s response to Ian Caldwell.
When membership of the Society becomes voluntary, its income will fall considerably. It is right that all its activities, including its library services, should be subject to review. Libraries, however, are such an integral part of professional organisations that their maintenance has become an index of status. No visitor to the library of the Royal College of Surgeons or that of the British Medical Association could doubt the power and prestige of those learned institutions.
Their libraries, like those of the Society, have existed for more than a century. Each collection of books has become a unique configuration of knowledge, requiring stewardship for future generations.
In assessing the value of libraries, a long-term perspective is essential. Mr Kelly justifies closing the Society’s libraries on the basis of what he calls “low level of usage” in one particular year. He claims that only about 1 per cent of members visited the library in 2008, but he does not state the actual number. We know that during the previous year nearly 1,000 pharmacists came to Lambeth to use the library. This represents 2.5 per cent of members resident in England and Wales, and more than 10 per cent of active members (ie, those who vote in elections).
The Society will depend upon members such as these after 2010. But it is nonsense to judge the usefulness of a library by the number of people who use it. How many people benefit from the use that a single individual makes of a library? If Darwin had sat alone in the British Museum reading Malthus, would not his presence have justified the expense of keeping the Reading Room open? If a branch secretary discovers information of use to all his members, what weight should be given to his library visit? The knowledge gained by just one library reader may be spread to hundreds, even thousands, of others. Libraries create new knowledge; they are not passive repositories.
Mr Kelly seems to think that “electronic resources” have made the “physical library” redundant. In 2008, the Society’s library at Lambeth held more than 80,000 books and constituted the largest specialist pharmaceutical library in the UK.
In London other professional organisations have retained their own specialist libraries, but have used them as the foundation for state-of-the-art online services. The website of the Royal College of Nursing reveals how the transformation can be made without the loss of irreplaceable books. The library of the Royal Pharmaceutical Society could and should have been modernised to become the information and knowledge centre for pharmacists in the 21st century and beyond.
Sydney Holloway Leicester