Alison Tennant: My Working Life as a Chief Pharmacist

 

Did you always want to be a pharmacist? 

No, as a child, I wanted to be an actor, but I chickened out because the career path seemed so uncertain. I liked biology and chemistry and working with people but did not want to be a doctor, then I got chatting to our local pharmacist one day and looked at the syllabus for the course, which seemed interesting.

I love being a pharmacist, my career has given me so many opportunities and I feel I can help improve people’s lives.  

 

Can you describe your work in 1 sentence? 

Think of anything to do with medicines in a hospital and I will be involved in some way! From research, procurement, education, storage, information, administration, destruction – the whole pathway.

 

What qualities do you think you need to do your job well? 

My trust’s values are ambition, bravery and compassion and those are the qualities I try to use daily. You also need patience and curiosity. A lot of my time is spent asking questions to work out what the actual issue is and what the potential solutions might be.

Pharmacists are very focused on detail, but a chief pharmacist also needs to take a big picture approach. We have to step back and look across the whole trust, as well as looking forwards into the future so we can plan the services accordingly.  

 

Have any unusual career opportunities led you to where you are today? 

I worked for an innovative chief pharmacist who gave me my first senior job. I led the set up of new services – a clinical and supply service to a local private hospital – and one day he asked whether I would be interested in working for GPs.

It turned out that he drank in the same pub as some GPs who had asked him if he could help them with a new thing called ePACT – an online application which gives authorised users access to prescription data. He sold me two days a week to the practice to review their prescribing. That got me into primary care and eventually into heading up a pharmacy team in a PCT.  

 

What are the main 3 factors that make you frustrated at work? 

1. Not enough managers, there is a lot I do that could be done by a non clinical manager – and probably better! 

2. Not being able to get the whole team together for staff development and engagement. In primary care and commissioning I could get everyone together, but in an acute trust you have patients 24/7. Even opening 15 minutes late one morning a week results in a couple of people waiting outside the pharmacy. 

3. Multiple IT systems that don’t talk to each other. I deal with patients across the UK and trying to communicate information about medicines across organisations and compare data takes up so much time.

 

Why would you recommend your career to a young person? 

Pharmacy is a fabulous degree that gives you so many options for a career path. You can become a specialist or a generalist, do research, you can work in industry or run your own business, you can work at population health level or with individual patients, and you can have a portfolio career with lots of different strands.

Within the NHS I describe pharmacy as the “thin green line.” Look at any NHS service and you will find a pharmacist working somewhere in that service.   

 

What has been your biggest career disappointment or challenge and why, and how did you overcome it? 

My biggest challenge was becoming a chief pharmacist of an acute trust after 17 years out of secondary care. While I had a good range of the core skills needed, I rapidly realised that my knowledge gap was much greater than I had expected.

My saving grace was the fabulous West Midlands Chief Pharmacists Network. They were so patient with my questions and sometimes, slightly panicky, phone calls when I encountered another gap – the day I was told I was responsible for medical gases was a heart stopping moment!

I learnt afterwards there was some discussion among the network on whether I would stay in the role once I realised exactly how much a chief pharmacist is responsible for. Thanks to their support I am still here – they even voted me in as chair of the network.

 

What was your best career move?

Job sharing – I took up a joint post as a specialist in pharmaceutical public health at Dudley PCT. A colleague had suggested I talk to another pharmacist, whomI did not know at the time, since both of us didn’t want full time posts and colleagues thought we’d be a good match.

We applied together and had a fantastic 10 years at the PCT achieving some great changes, such as establishing a directly commissioned pharmacy on a sinkhole estate delivering public health and community services.

The job share enabled me to be there for my children while still having a senior role and being able to develop. It had lots of other advantages like being able to talk through issues with someone who understood the problem, plus being able to cover two meetings that clashed.

 

What 3 factors make you skip into work?

1. The people. I have a great team, both within pharmacy and in the wider trust. My role brings me into contact with all parts of the trust and I have some amazing colleagues who have become good friends. 

2. The patients and families. Whether we are helping children with cystic fibrosis get a new medicine that will change their lives or talking to a teenager with mental health issues worried about the side effects of their medication, seeing how they benefit makes the frustrations worth it. 

3. The variety. My medical director and I laugh about our continuing professional development (CPD) records – the people who read them must wonder what on earth comes through our doors. From how to source a rare medication from Belgium at short notice to how our services need to change to include pharmacogenomics, no two days are ever the same.  

What’s the best advice you’ve ever got from a patient or work colleague? 

The best leaders have the best teams – and that’s not by accident. I have learnt that no one person has all the skills and knowledge needed to lead a service like ours.

Having a great team means you can use the skills you have while letting others shine for their abilities. It makes for great job satisfaction for all of you.    

If you could go back in time and give one piece of career advice to your younger self, what would it be? 

Learn how to manage upwards. Everyone learns about managing people in their teams but it is rare for someone to tell you how to feed the right information at the right time upwards.

I was lucky to work for a manager who taught me these skills so that the senior team knew the key things but were not overwhelmed with emails. She also taught me how to feed enough information upwards for people to leave you alone to get on with the job.

 

If there was one thing you could change about your role or the physical or policy environment you work in, what would it be and why? 

Big data – can we find ways to use it please! The NHS has so much data and I look with envy at what Ben Goldacre’s team at the University of Oxford has been able to develop with primary care medicines data for OpenPrescribing.

In paediatrics there is so much being done, but the data is not being captured or analysed. I understand why drug companies won’t do trials in children, but we are using the drugs anyway so why can’t we use real world data, like the European Health Data and Evidence Network (EHDEN) project in Europe, to stop use of ineffective treatments and to move to interventions that work better. 

 

What advance in medical/pharmaceutical technology would have the greatest impact in your field? 

I am part of a pilot using pharmacogenomics in mental health. It’s still not clear what the full impact of this technology will be, and where it is best focused, but there is a lot of promise.

The ability to add another piece to the jigsaw when deciding which medication to prescribe is exciting – especially when that piece tells us how that individual will metabolise the medication – a step further towards personalised medicine.

 

What do you hope will be your legacy to your profession and colleagues? 

I hope that I have managed to give colleagues the opportunities I had. The significant steps in my career were often due to people opening doors for me or suggesting things that I would never have thought of going for.

I feel a responsibility to give others that same helping hand up I had. I am a mentor in our #ByYourSide equality, diversity and inclusion programme and really enjoy helping people access opportunities they might not otherwise have taken.

 

How do you balance work and family life?

Badly at the moment, I’ll be honest. I did better when I had to be home for the children, and I had to put work to one side for them. I do try to switch off and deliberately leave my phone in another room.

I have learnt that if I try to stay in contact all the time I don’t give my team a chance to build their experience and they think I don’t trust them – which I do!  

 

What do you do to relax/de-stress?

Walk. I love being by the sea and I am working my way round the South West Coast Path with a group of friends called the Walkie Talkies – because we walk and we talk!

 

Do you have a morning routine – something you always start your working day doing? 

I get into work early and spend the first half hour having my coffee, doing the Wordle (my son and I compete on who can get it first), checking that I know what the priorities are for the day and not talking to anyone. If I don’t have that space, then I feel I’m behind the whole day.

 

Who has been your biggest inspiration?

My mother. She was one of the first female business leaders in Northern Ireland in the 70s. She always wore bright colours and knew how to work a room. She was the brightest of her siblings, but my grandfather had said that there was only enough money to send her brother to university.

She made sure that my sisters and I had every opportunity and made us leave Northern Ireland so we could experience a world outside of the Troubles.

 

Where are you happiest and why?

In a room full of people trying to make a change, whether it be improving a service or solving an issue. I love the energy in the room, people all focused on a single outcome, but with lots of different views. I love being at the front of change, if you do it first, no-one can tell you what you are doing is wrong.   

 

If you could be invisible for a day what would you do?

Walk around listening to people on Teams calls and magic up cups of tea and coffee when they don’t have time to make them. I wish we could cut all Teams calls to 50 minutes and allow 10 minutes between each meeting to adjust your brain, get a drink and a comfort break.  

 

Biography:

Alison Tennant studied pharmacy at Aston University and then completed her pre-registration year at St Bartholomew's Hospital in London in 1987, where she had an early introduction to emergency response working as it was the year of the Kings’ Cross tube fire and the “great storm”.

She enjoyed the variety of challenges in secondary care and working within a team of other pharmacists, so in 1988 she began her NHS career as a hospital pharmacist and worked in various Midlands hospitals before being appointed one of the first pharmacists in a GP practice in 1997. She progressed within primary care to become a specialist in pharmaceutical public health at Dudley PCT (as one half of a male/female job share).

Her role there included leading the primary care pharmacy team and managing the primary care drug expenditure as well as the provider medicines costs through the newly introduced payment by results (PBR) tariff. She was also the pharmacist advisor for the framework of West Midlands Ethical Commissioning Policies, operated by the West Midlands Specialised Commissioning Group. 

Following the 2012 health reforms, Alison moved into broader NHS management as a clinical commissioning group (CCG) board member leading on service development and quality. This led to a role as part of the NHS England (NHSE) specialised commissioning team and then on to leading on pharmacy services for the West Midlands Regional NHSE team. 

In 2016 she decided on a move back to hospital-based work and took up the post of director of pharmacy at the Royal Wolverhampton NHS Trust just as it was taking on responsibility for a group of GP practices. In 2019 Alison moved to be chief pharmacist at Birmingham Women’s and Children’s NHS Trust, where her knowledge of medicines’ funding flows and commissioning pathways has been well utilised. She is currently chair of the Chief Paediatrics Pharmacists Group.