Amandeep Doll: ‘We have to become more comfortable with the uncomfortable’

In January 2020, Amandeep Doll took up the role of co-ordinator for the Royal Pharmaceutical Society’s (RPS) inclusion and diversity (I&D) programme. This programme launched in August 2019, and a five-year strategy — designed to address discrimination and inequality “wherever it presents itself” across the pharmacy sector — was published ten months later, in June 2020.

This strategy includes plans to create an inclusive workplace pledge for pharmacy and the setting up of an Action in Belonging, Culture and Diversity (ABCD) group to inform its progress. Doll hosted the first meeting on 27 August 2020.

Doll is no stranger to the Society, having previously worked as an RPS regional liaison pharmacist. She was also a chief pharmaceutical officer’s clinical fellow between February 2016 and September 2017. Based at Health Education England, during her fellowship she worked on key projects around national healthcare priorities. Her career also encompasses eight years as a hospital pharmacist.  

Doll described her experience as I&D co-ordinator as “a steep learning curve”, but it is clear from speaking to her just how driven she is when it comes to breaking down the barriers that many still face as they navigate the pharmacy workforce. It’s a drive that comes, not least, from some personal experience; as she says as we begin our discussion, “I have a disabled sister whom I’m a carer for. And obviously I’m a woman from a BAME [black, Asian and minority ethnic] background”. 

Here, Doll speaks about what the RPS, with its members, aims to do with its I&D strategy over the next five years.

How can the RPS, as a professional leadership body, make a difference to the lives of pharmacists who are experiencing discrimination?

In the survey that we did, 83% of respondents said the RPS needed to support I&D. Understanding more about I&D within the profession will ultimately improve patient care, because you are more mindful of things that you may not be experiencing yourself. 

What we heard was that we could be doing more about celebrating diversity. Within pharmacy, there is a bit of a false sense of I&D because we are 45% BAME, and predominantly women. Although we may seem diverse, that doesn’t necessarily make us inclusive. We don’t always celebrate that diversity, and we don’t always give people a voice.

One of the key things we want to deliver from our strategy is the workforce pledge

As RPS we can really make sure that diversity is celebrated. We can work with the networks that already exist, like the UK Black Pharmacists Association (UKBPA), to give them a platform. We can listen to what our members, and members of the whole profession, are saying. Getting that intel means we can shape our strategy and projects, and we can encourage other organisations to do the same.

One of the key things we want to deliver from our strategy is the workforce pledge, [including] recruitment panel support, interview support, and thinking about inclusive language. So there is something we can do to support the profession. 

You recently held the first meeting of the ABCD group. What are the objectives of this group, and how does it propose to meet them?

We want to do something different. The networks that already exist, such as the UKBPA, Women in Pharmacy, and the Black Pharmacists’ Collective, are doing great things. We didn’t want to create another network: we wanted to bring everyone together.

From my own perspective, when you join a network you can feel like you only bring that one protected characteristic. If I’m part of a BAME network, then I’m BAME: but I’m also a BAME woman, with caring responsibilities. Sometimes that intersectionality is missed.

The aim of the group is to celebrate our diversity by bringing everyone together

With this [ABCD] group, we are hoping that you bring your whole self, with all your different protected characteristics, giving an intersectional view to what we are trying to deliver. 

But we are not just our protected characteristics: that’s such a binary consideration. We are also people, with our own personal and professional experiences from different sectors. We wanted to harness that.

The aim of the group is to celebrate our diversity by bringing everyone together, help us shape the strategy, and to deliver a co-created calendar of events, like the Women in Leadership event, around Black History Month and an annual I&D event.

Sometimes with this kind of work, you’re preaching to the converted. How do you get white senior leaders, both male and female, to see that it is also their responsibility to lead on this? It can’t just be the people who are discriminated against who fix the problem. So within this group we will invite allies to come and listen, to hear those stories and take it back to their workplace. 

Is the group still open for membership?

Yes: it will always be open to new members; there will never be a cap. But to make sure it is a safe, open space for people to share, we ask members to sign up to particular behaviours: just things that you would expect, like courtesy. We hold meetings every two months.

How is the RPS Early Careers Pharmacy Advisory Group working with you on I&D? 

We had a workshop with them last week. We want them to consider I&D as a core part of their work ethic. They are our future leaders, and so we want to address barriers to becoming a leader. If we have an initiative we want some ideas on from an early careers perspective, we can take it to them.

The UKBPA’s Elsy Gomez Campos welcomed RPS’s work, but also asked “Why is it that we do not have people that look like me, or sound like me, leading the RPS or the GPhC?” What would you say to that?

I think it is a fair comment. From a personal perspective, I worked in a hospital for eight years. The people I worked with looked like me — I think the average pharmacist is an Indian woman! I thought pharmacy was diverse and inclusive, because there were people who looked like me in the senior teams. It didn’t occur to me, then, that there was an issue. 

Doing my fellowship ignited my passion to help make it fairer for everybody

Then when I did my chief pharmaceutical officers fellowship, I started noticing that [pharmacy] is not diverse from a senior leader perspective. Once you see it, you can’t unsee it.

There are so many of us at a Band 6, 7, 8a level: but beyond that, it really does dwindle down. From a personal perspective, I never thought I could get there [into leadership], so I never bothered to try. Everyone I did see who was like me; you get married and have children and then do your job part-time. That isn’t what happened for me so I thought: what do I do now? Doing my fellowship ignited my passion to help make it fairer for everybody. 

It can be very difficult to get back into practice following a period of maternity leave. What practical help can the RPS offer a pharmacist who is struggling with this?

These are the things that we want to work on over the next five years. I’m aware from talking to women who have had children that many would like to have Keep in Touch days: these are optional, but are the sort of initiative we’d like to see implemented. It may feel that when a woman is on maternity leave, she is just written off for a year. We should be asking them what would work for them.

This is where the RPS can have an influence: how to have those conversations, if you are going on maternity leave — and paternity leave too. Attitudes to wanting to work flexibly, or going on maternity leave, need to be addressed. I have seen some very negative responses when people have become pregnant.

The I&D strategy mentions developing “concrete plans” to address “any disparity in black students’ registration assessment pass rates”. Can you give us an update on progress regarding this?

That is a priority area. We have reached out to the General Pharmaceutical Council (GPhC) and we are talking to them about how we address this. They need to take ownership in this space, especially around the preregistration exam.

What we’re hearing from the ABCD group is an advocacy piece from the RPS. But this is a friendly challenge: we are the voice of our members, and this is a challenge in a good sense: ‘have you considered this; what are you doing?’.

We’ve also reached out to the Pharmacy Schools Council (PhSC). They put out a statement addressing BAME issues for both staff and students, and they are really keen to work with us. There are a couple of issues. With the awarding gap, there may be structural racism as part of the institution, which needs to be addressed internally. Then there is the matter of diversifying the curriculum and the lecturers to inspire students.

That is where the ABCD group can help. One action that we want to take forward is to potentially create a network of black pharmacists who can go in and lecture at universities that don’t have any black lecturers. So we don’t have to wait for the GPhC or the PhSC to make changes; there are people who are interested in helping us, such as the UKBPA and the ABCD group, to move things forward.

Disability was identified as the biggest barrier to pharmacists in the RPS survey. What is being planned in this area?

Next year we will launch a disability campaign. Within that, we are looking at having experts — not necessarily pharmacists. There are companies that do it very well, outside of pharmacy, so we need to work with them to see how we can bring down those barriers.

There is a range of disabilities, and not every disability is visible, so how do we work with the individual?

The campaign will address some of those issues. If you are more vulnerable in this society, it feels like you have to try ten times as hard. Everything is designed to fit around the majority of non-disabled people. We need to empower pharmacists to be able to speak out, and work with employers on these issues.

If you are more vulnerable in this society, it feels like you have to try ten times as hard

Sometimes it is a fear thing. You don’t want to upset anyone so you just ignore it rather than trying to help with the issue, because it makes people feel awkward. If we can educate employers and organisations on how to have conversations in a meaningful, effective way, and how to empower employees to say “This is what’s wrong”, then you can meet in the middle. Some people don’t even declare their disabilities because they are afraid that they will be penalised or will not get a job.

It’s a big education piece. And, in turn, it will impact patient care. I have seen it from my own experience: I’m a carer for my sister, who is disabled, and often people don’t talk to her: they talk to me. Because they don’t know how to talk to her. We have to become more comfortable with the uncomfortable.