If you can put your hand on your heart and say you've never complained that PCTs don't understand pharmacy, or moaned that pharmacy doesn't have enough influence within PCTs, then you're probably in the minority of community pharmacists.
And those concerns have scaled a notch or two since the publication of the Health Bill in January paved the way for PCTs to control market entry and exit, not to mention the plans afoot to devolve pharmacy's global sum down to local trusts.
But there is a role that ensures pharmacy is seated at the table on the bodies that, under the NHS policy of local healthcare for local communities, seem to gain ever increasing power: the PEC pharmacist.
All PCTs have a PEC, a professional executive committee of healthcare professionals that provides clinical leadership and commissioning advice to the trust. But not all PECs have a pharmacist, as individual PCTs are free to determine their constitutions. However, the Department of Health “fully expects” PECs to “reflect a range of clinical professions” - so the argument to include a pharmacist is strong and, at PSNC's last count, about two-thirds of PCTs had.
Kurt Ramsden spends three days a month as a PEC pharmacist at Middlesbrough and Redcar & Cleveland PCTs. This involves going to meetings - all the way up to PCT board level - that affect his portfolio of interests, which include flu pandemic planning and cardiovascular screening. His role, he says, is to bring a pharmacy perspective to the discussions - and the resulting impact on patient care. “It's amazing to see how the pharmacist angle, or the perspective that pharmacy brings, isn't always reflected through general practice,” he says.
And it works both ways, says Alison Rogers, a former PEC pharmacist at Herefordshire PCT. “It gives the PCT an opportunity to understand pharmacy,” Ms Rogers says of the role, “but also gives you as a pharmacist the opportunity to understand the PCT.” This can be hugely beneficial for pharmacy locally, says Lambeth PCT's PEC pharmacist (and vice-chair) Ash Soni. “You learn the language that the PCT operates by and that's quite useful in terms of trying to put things together for developing services - that's a big benefit.”
However, Ms Rogers, Mr Soni and Mr Ramsden all agree that promoting pharmacy's interests is not the PEC pharmacists' raison d'être: patient care is. “You might be a pharmacist but you're not there to represent pharmacy,” explains Mr Soni. “That's quite challenging, because sometimes you have to be able to say, actually, the best place to deliver that is not pharmacy.” Improving patient care is its own reward, the PEC pharmacists agree.
The work is not without its frustrations, though. “The NHS is a slow-moving beast and it takes time to make change,” says Mr Soni. “You have to be willing to keep banging on the door.” And along with patience and patient-focus, to be a PEC pharmacist you'll also need confidence - “You have to be able to hold your own working in an environment that can be doctor-dominated,” says Mr Soni - and self-motivation - “If you don't know it, be prepared to find out... You have to be responsible for what you do.”
If you've got all that then you could have a part-time role that adds a glittering touch to your CV, boosts your profession's profile and local fortunes and improves patient care. So what are you waiting for? PEC tenures vary, as will the roles the PCT will need to fill when vacancies arise. These should be advertised to local healthcare professionals through channels such as NHS.net. But if you're interested, it doesn't hurt to say so early on, says Mr Soni.
He advises contacting your PCT to find out when PEC positions are likely to come up - and to start accumulating the knowledge you'll need to get the job and do it well. If you're an employee pharmacist, Mr Ramsden advises, earn your boss's support to use your time this way by pointing out the benefits for pharmacy locally. But Mr Soni's main advice? “Go for it. Believe that you can make a difference.”
What's it like to be a PEC pharmacist?
Ash Soni, PEC pharmacist for Lambeth PCT and Kurt Ramsden, PEC pharmacist at Middlesbrough and Redcar & Cleveland PCT, answer your questions.
Q How much time does the role take up?
A This will vary from PCT to PCT, and according to the roles and portfolios to be taken on within them, but you're looking at a few days in total spread out over the month. But bear in mind this doesn't include reading emails and papers in preparation for upcoming meetings. And Ash Soni, who does three and a half days a month, says you have to be very careful to manage your workload to prevent it escalating beyond the allotted time. “You have to be careful you don't spend six days a week doing PEC business because you don't get paid for it,” he says. Mr Soni tries to allocate a couple of full days a week to working in his pharmacy, when he doesn't do any PEC work at all.
Q What's the pay like?
A “It's not the best paid job in the world and you have to accept that,” Mr Soni says, choosing to focus on the non-financial benefits of the role.
But the pay's not awful, either, says Kurt Ramsden. “It compares favourably with your average employee wage.” And, he adds: “If it's something you're interested in, it doesn't feel like work.”
Do you have a career-related question for C+D? Email jrichardson@cmpmedica. com and we'll ask the experts