This interview was published in Scottish Pharmacist Magazine: Issue 8 2018 http://www.scottishpharmacist.co.uk/ 

Harry McQuillan was appointed to the role of Chief Executive Officer of the Scottish Pharmaceutical General Council in July of 2006 and has been at the helm as it evolved, drawing in the Scottish Pharmaceutical Federation and rebranding as Community Pharmacy Scotland in 2007.

John Macgill asked him to reflect on the journey the organisation has made, how it fits in with other pharmacy bodies and, as moves are rekindled towards a single body for community pharmacy in Northern Ireland, whether the Scottish model is one he would commend. 

HM: At the time that I joined the then Scottish Pharmaceutical General Council it was clear that the new contract we were working within was different and that the organisation had to change and upgrade so that, as new services were being introduced into the community pharmacies, we had the support structure that was going to get behind contractors to help them change the way that they operated. So we rebranded and started the evolution into a new entity with a different way of thinking and a new way of supporting people to allow them to deliver the contract the NHS and the Scottish Government were looking for. We had always been a negotiating body. Back then it was the primary function. Now, while it still remains a big part of our activity, we do a lot more as well to support community pharmacy. 

JM: In continuing to broaden the role and services offered by Community Pharmacy Scotland, how do you avoid overlapping and duplicating the work of other bodies such as the Royal Pharmaceutical Society which, like you, had to reform and change its direction, in its case because of the arrival of the new regulator.

HM: I like, where I can, to keep things simple. So, I see the Scottish Government as the policy directors: they are the “why” we should be doing things. For me the Society, as a professional body representing the whole of the profession, is about “what” pharmacy can do and “what” those services might be. And our organisation – yes, we can suggest services and do – above all, we are about the “how” we do it. I really think there is room for all these types of organisations. It is about having a mature adult debate about what each organisation's role is in the delivery of the healthcare system. And our bit is about how to make it happen. 

JM: Do you speak for all community pharmacy? Are there community pharmacists in Scotland who choose to sit outside Community Pharmacy Scotland? 

HM: Yes, there are currently. We have a contributing membership of 1254 out of the 1257 contracts. I think that those who sit outside miss out on the support that we can provide for them, and we miss out on their contribution to the collegiate network that is everybody else, from the largest multiple to the small independents. 

JM: How important is it that there is a single voice for community pharmacy?

HM: I think the single voice is important in the recognition of the pharmacy network at the heart of the communities, in a place that adds value to the community and brings important social capital in today's changing NHS. There are other contractor bodies who operate at a UK level and in other UK nations. We speak to them and it is good if we talk about the same things and have a similar message. It’s much easier when we are aligned strategically, when all contractors share the same core vision of the future. 

JM: We look across the water and we see new conversations about bringing together the Ulster Chemists’ Association and Community Pharmacy Northern Ireland. Would you encourage those involve to try to see this through? 

HM: We did it here in Scotland when the Scottish Pharmaceutical Federation amalgamated with the Scottish Pharmaceutical General Council very early on in my tenure here. So there is a model of where marriages like this have worked well, in my own opinion, and if that is something that our Northern Ireland colleagues are considering as a way forward, we could certainly advise them that it is has been delivered here in the past and has been successful. 

It came about because I think the Scottish Pharmaceutical Federation itself had looked at the overlap with what they did as a Federation and what we did as the General Council. We were both lobbying on the same things, we both represented  members including independents and, ourselves, bigger organisations who were members of the Company Chemists’ Association. The simple question was, would this not be better done with a unified voice? I have to say it is easier for all concerned, including politicians and civil servants, to deal with one recognised body rather than speaking to one team one week and another the next. And we also remove any temptation to divide and conquer. 

JM: Over the period, how would you characterise the way that the negotiations have felt. Do they get tougher each time?

HM: These are challenging times in terms of how much there is in the public sector purse and how it is used. The money part, how it is funded, is important. It is also at the same time about looking ahead to what the new service looks like and how do we fit with current government policy. For us, it is trying to maintain the current accurate and high-level supply level function that we provide and, at the same time, moving into a care-focused environment that keeps people at home. So, in terms of the negotiations, it is how do you deal with the fiscal bit in challenging times of austerity while, at the same time, moving the services along to mirror what the policy direction is. We have to be changing in a changing healthcare system because, if we stay with the same rigid approach or remain wedded to services of the past, that is where we will be left: in the past.

JM: As more is expected of you, is there ever any more money on the table or is there always a gap between what is expected of community pharmacy and what is available to spend on meeting those expectations?

HM: We’ve seen both. We have been successful in managing to get some form of uplift, perhaps not always keeping up with inflation, but equally we face the same expectation as every other part of the health service that there will be efficiency gains in whatever we do. And there are times when there is nothing left in the pot and we have to look at how we tailor what we do so we don't deliver any less but get better at serving the cohort of patients with whom we know for sure that we can actually make a difference. 

JM: How difficult is it to bring over 1200 pharmacists with you all at the same speed?

HM: It can be challenging. It's the typical bell curve. We are always going to have those who are on the leading edge and others following. What is clear is that we cannot wait on 1200 all being euphoric about the direction of travel. We have to go with the majority and assist the rest to follow us. After all, patients vote with their feet. It's a good thing about community pharmacy, I think, that if your service level is not up to what a patient wants, they will move to someone who will deliver the service that they are seeking. We have to keep an eye ahead, looking to the future and meeting government policy and the expectations of patients. Rose Marie Parr [Scotland’s Chief Pharmaceutical Officer]’s Achieving Excellence in Pharmaceutical Care strategy is helpful, and we need to be ensuring that we fit with that vision.

The organisation has worked hard over the last year with the policy development team getting consistent messages out to members through a weekly newsletter, using soundbites and snapshots because we recognise that our colleagues in the community are not short of work at the moment. It’s really important to share information with members to help keep them on board, and informed and able to accept some of the changes that we're looking to implement.

JM: What do you think lies ahead? 

HM: I genuinely think that there is a bright future ahead – if we want it. We have got to be fully aware that things are changing. We've got the health and social care partnerships but how do we link into the social care agenda because everything is telling me in policy terms that people want to be treated at home, or closer to home, and kept out of hospital? When you've got a network of pharmacies that are recognised as being in the heart of communities – and Audit Scotland’s report tells us that many of those pharmacies are in areas that are classified as deprived communities – is there more we can do to be recognised as the first port of call for health interventions? If we have that structured network already, how do we make that work in this time of evolving healthcare because, when we are involved, we can link to supply, we can link to pharmaceutical care and I see a bright future if we want it. 

We need to change. It's not wholesale change, but we need to be aware that this is dynamic – things are changing. And it is about us keeping ahead of the game, being involved in innovation and getting involved in developments locally. I think we have a real role to play.