Claire Anderson: ‘What you see is what you get with me’

“I must be mad,” says Claire Anderson, after I ask her why she wanted to become president of the Royal Pharmaceutical Society (RPS). After all, it is not a position where you can please everyone.

“What you see is what you get with me, I’m not going to pretend to be anybody else. But I’ve got to have as many people with me as possible, there’s going to be people who dissent but hopefully those will be silenced by the large majority.”

This mirrors her personality. Self-reflective, down-to-earth and incredibly pleasant to spend an hour with, chatting about the state of pharmacy on Zoom.

Anderson worked as a pharmacist for seven years in hospital and the community, before becoming a full-time lecturer at King’s College London in 1997. Her PhD, completed in the same year, looked at ‘Health promotion by community pharmacists’ and was an evaluation of the Barnet ‘High Street Health Scheme’. Her research into the health impact of pharmacy services has continued since then.

She has been professor of social pharmacy at the University of Nottingham since 2003, was chair of the RPS English Pharmacy Board from 2019–2021, going on to be elected as president of the RPS in July 2021.

What is it like to walk into a room with the leaders of other royal colleges, or leaders of other professions, as president of the RPS? What are they looking to you to provide?

Our vision and mission is all about being the leader in medicines. Increasingly, because of what pharmacists do out there, people turn to us for that and respect us for that. In a meeting with the other royal colleges, I feel like an equal with them, representing the profession that is the expert in medicine, just like they might be the experts in surgery, psychiatry, nursing or whatever.

What are the particular areas you would like to champion as president?

One of them is sustainability. It is really important that everything we do is sustainable, and that we support our members in that. With the UN Climate Change Conference coming up in Scotland [from 31 October–12 November 2021], that’s going to be important. The other thing is inclusion and diversity. We’ve started to collect data on our members in that area, but we want to learn about why people will or will not share data with us. We’ve already looked at the Fellowship process, and are looking at how this can be a thread through everything we do. And I guess the third thing — which maybe I could have put first given my background — is shaping the educational landscape. That was another reason why I was excited to be president at this time, because one of the biggest changes going on — probably since we got the MPharm in 2000 — is the change in initial education, which will lead to change across the whole profession. That’s incredibly exciting. It’s something I’ve worked towards my whole academic career, and finally we can become the clinical professional we were meant to be.

How will your presidency relate to your academic work?

Very much so. When I did my PhD, it was all about encouraging pharmacists to get involved in health promotion, which led to some of the policy work that established Healthy Living Pharmacies. And so I bring the vision to move things forward and I am always wanting to shape and change. If I can do anything to push us to become a more research-based profession, with more pharmacists getting research Fellowships, doing PhDs and carrying out research, then that would be really good. Because if we want more people to become consultants, they have to do meaningful research at that level and be supported to do that.

I get the sense from you that you’re not afraid to challenge or question things.

I like to see the evidence. I’m a qualitative health service researcher rather than a quantitative one. So it’s not always about numbers, although, of course numbers are important. But it’s looking at how people feel about change, as well as the outcomes. And I think that’s really important to me.

Is there a risk that you’re seen as an ivory tower academic and you can’t relate to the grassroots membership?

I hope not. I’ve got people around me on the boards who have grassroots roles. And, at the university, we have an awful lot of people who are doing half teaching and clinical roles. So they keep me very real. I have worked in the past, in the hospital and community, I do understand what it’s like and I try to talk to members and get out there. I plan to spend some time in a hospital and in some community pharmacies with people, because I think that’s really important. And I’ve already been invited to do that by different people — I will certainly take that up.

What do you think the vision for pharmacy’s future should be?

Very much medicine safety and use. And then, within that, our role in holistic health care — particularly in health promotion and wellbeing. Our vision should be that all pharmacists are prescribers and that we leave dispensing to other healthcare professionals and robots. Obviously, the clinical check is very important. But I’ve always thought that pharmacists should be out there talking to patients. Of course, we have the people who are not patient facing, like the industrial pharmacists, and they’re equally important because otherwise we wouldn’t have the medicines. The fact that we have the pharmaceutical science — we understand the pharmaceutical chemistry, how the medicines are formulated, how they’re designed and how they work — as well as the clinical side, it makes us very special as a health professional. I think it’s our future, and we just need to take that and run with it.

I often get a sense there’s a tension between mopping up the things that GPs may not want to do and also having a specialist role. How do you see that playing out?

I think there’s a lot of rhetoric about that, as you say. But when you talk to the people who are doing, say, the role in general practice, they certainly don’t see that. They are very much part of the team. We’ve had a lot of younger people in those roles, and so people are developing, and I think the frameworks and the training hasn’t been as good as for a GP trainee. That’s something that could be strengthened. I still think that that’s what we’ve got to be aiming for.

How do you feel about the idea of pharmacists on registration becoming prescribers? Will they have the skills at that point to prescribe?

I think they will because the course is going to change dramatically. A lot of the teaching will be patient facing going forward. Providing the Treasury fund the clinical training, which I hope they will, that will change things incredibly. Pharmacists are not going to go out there and start, say, prescribing cancer chemotherapy or CAR-T therapy on day one, are they? You get more competent as you practice. But, for example, in community pharmacy, pharmacists from day one are ‘prescribing’ a lot of the medicines in a way. They are ‘prescribing’ the pharmacy medicines. Contraceptives are now available over the counter, they are talking about statins becoming a pharmacy medicine. What’s going on in Wales and Scotland — where community pharmacy is using independent prescribers very effectively to run clinics for common ailments — is the way forward. A lot of people will be doing that sort of prescribing. As people develop and some specialise, and some become advanced generalists, people will develop naturally. I think the RPS has a big role in providing support for pharmacists along this journey because, as the newly qualified come out as prescribers, I think we’ve got to take the rest of the workforce with us as well.

As a professor of social pharmacy, what do you think the role of pharmacy is in society outside of health?

If I look back to my grandfather, who was a community pharmacist in a village in Wales before the NHS, people went to him about everything because they didn’t have to pay him. I think that role and the social capital that goes with it — I would hate us to lose that. And we do have it in spades in lots of places. It’s very hard to evaluate or put your finger on it, but it is really important because people really trust pharmacy. We’ve been doing some work at Nottingham, looking at how people feel about pharmacy and that ‘trust’ thing is very strong.

Should technicians become members of the RPS?

I think anyone who’s involved in medicine safety should be, so why not?

Should the RPS declare a climate emergency?

Very definitely. We’re working on that, so I can’t say any more. I think the climate and the ecological emergency is really important. And, of course, we have to do that along with all the other healthcare organisations and royal colleges — I think that would be very powerful.

Obviously, for many pharmacists this has been an incredibly stressful year, particularly for those redeployed to intensive care units, for example. There has been some wellbeing support put in place for them, but what support do you think needs to be ongoing?

They need ongoing access to wellbeing and mental health support — that’s really crucial. Within the NHS, that support is there but community pharmacists don’t always get the support that they should. People need to have breaks, and they need to have protected time to learn and develop as well. And I can only imagine how hard pharmacists in all sectors have worked because it’s been incredibly difficult. Unless we protect the workforce, people will leave and burn out. We’ve got our workforce wellbeing pledge and we need to collect examples of what good looks like, so that we can share that with, and support, our members. And that’s what we’re beginning to do. I think some of the things that have been done have been amazing. Look at COVID-19 vaccination, for example — that’s been fantastic. And people have really felt valued in that role and have had such good feedback from the public. They’ve taken that on and done thousands of COVID-19 vaccinations on top of their day-to-day job. I mean, I really admire them.