Being a pharmacist in today’s healthcare landscape is both exciting and challenging. The demands and complexities faced by the NHS and the pharmacy workforce, necessitate robust, prominent, and active utilisation of clinical leaders to be addressed effectively.

As experts at the forefront of optimising medications, pharmacists continuously seek to elevate their skills to make profound impacts on patient care. Yet, within the expansive realm of the NHS decision-making tables, the profession finds itself relatively underrepresented.

However, amid the ongoing evolution of healthcare and the NHS workforce, we are gradually seeing change and the emergence of pharmacists and pharmacy professionals as valued and visible leaders. It’s inspiring to witness the pharmacy workforce reshaping roles and workstreams beyond traditional confines. Prominent examples of diverse paths and initiatives include multidisciplinary fellowships, NHS England Inclusive Pharmacy Practice, steering healthcare as directors, and leading research institutes at renowned Universities. The diversity of accessible paths has never looked as promising.

The 2022/2023 cohort of the NHS Regional Clinical Leadership Fellow scheme included five pharmacists from diverse practice backgrounds. The collective enthusiasm and shared drive to excellence in clinical leadership and patient care, has involved a transformative journey that has deftly bridged the juncture between clinical and leadership roles.

As we approached a year since the ending of our fellowship, we have carried with us a wealth of knowledge and experience. With gratitude, we share our reflections from this journey of growth, impact, and evolution.

Highlights of the Fellowship Scheme

1. Developing as leaders: The immersive leadership development program cultivated our abilities, equipping us with indispensable skills to lead and, hopefully, inspire. Through workshops, lunch time seminars, mentorship, and coaching, we honed our communication, problem-solving, and decision-making abilities. We gained valuable knowledge and experience in strategic planning and project management, redefined our views of leadership in the NHS, as going beyond clinical management and extending into transformative change and all-encompassing principles to deliver high-quality care.
2. Fostering interdisciplinary synergy and collaboration: Undoubtedly a significant benefit of this scheme has been integration and collaboration with healthcare professionals from an array of backgrounds. The connections formed allowed us to exchange ideas, knowledge, and expertise, fostering an ecosystem of collaboration – ranging from support on clinical subject expertise to projects on improving workforce culture, as well as mutual respect and understanding of other professional and directorate roles. Professional diversity is crucial for advances in care and the scheme provided extensive networking opportunities, connecting us with influential figures in the healthcare sector. Building these professional relationships has unlocked opportunities for potential collaborations and career advancements, as well as forging lasting friendships.
3. Understanding health, policy, and systems: The fellowship exposed us to the wider domains that impact the healthcare landscape, enabling engagement in policy and dialogues at the Houses of Parliament. It also facilitated direct interactions with stakeholders, policymakers, and esteemed NHS and global leaders. We applied skills in advocating for the development and enhancements of policies and practices, using our unique experiences to amplify patient and workforce voices. Our insights deepened as we delved into the intricacies and challenges faced by policymakers, and how to broaden our own personal influence in these (perceived as ‘hard-to-reach’) spaces.

Overcoming challenges

1. Managing competing demands: balancing the conflicting demands of the fellowship, clinical duties whilst also providing knowledge to colleagues on the fellowship was a challenge at times. Our cohort was during the COVID recovery period and a time where Pharmacists selected for leadership fellowships, let alone outside of pharmacy, was uncommon. Nevertheless, with adept time management, sharing of education and resources alongside support from peers, mentors, and family we navigated the hurdle, whilst learning there is no such thing as the perfect balance. The dynamic of remaining clinical and applying on-the-ground learning into leadership roles was beneficial.
2. Adaptive Leadership: The experience undoubtedly required flexibility and openness to change. Our receptiveness to new ideas and practices grew, along with our self-development and resilience – skills that are much needed in continually evolving healthcare contexts.
3. Working remotely: An initial challenge that for some hindered assimilation in new teams and heightened ‘imposter phenomenon’. However, through collaborative efforts such as peer led drop-in sessions, where sharing how to overcome barriers was held. Also, the introduction of engaging virtual platforms to replicate the communication and brainstorming, that you would so easily access in person, achieved via virtual networks being set up such as the Clinical Fellow led Female Healthcare Leaders Network and MS Teams Forums. Alongside the inclusion of hybrid approaches, a mixture of options allowed barriers to be overcome.
4. Stakeholder Engagement: Ensuring active involvement and communication with relevant individuals whilst managing the ever-changing NHS dynamics, influence and expectations and the crucial and delicate balance the political world has on health systems. Whilst recognising there is no ‘perfect’ fit or approach, appreciating the advice of mentors and senior leaders that road of learning and development always stay together, and your professional background can open doors outside of traditional roles and teams.

Empowering Opportunities and Interactions

3. Breath of exposure: We were privileged to lead several innovative workstreams, utilising our skills as pharmacists across a breadth of projects. Some examples include; the transition of Covid Medicines Delivery Units (CMDUs) into routine clinical practice, The Midlands Pharmacy Charter, Inclusive Pharmacy Practice, Dental eRS Pilot Scheme, Pharmacogenetic Testing in Adult Acute Lymphoblastic Leukaemia and Evaluation of Pharmacy Impact in Virtual Wards. This range and breadth of exposure shows the varied role that pharmacists can play in the MDT leadership setting, allowing us to both, develop our skillset whilst learning how widely it can be transferred and utilised in an interdisciplinary way.
4. Appreciating the power of public speaking: Regular opportunities to present ideas and projects before esteemed audiences and senior leaders improved our public speaking and ability to articulate our opinions effectively. As a cohort of clinicians on our leadership journey, moving away from the patient setting and conversing in national discussions was a positive challenge but steep and beneficial learning curve. We absorbed concepts, such as the power of storytelling when communicating ideas, gaining sustainable skills in engaging with stakeholders and supporting our cohort develop skills for painting a positive picture for change, as we progress into life post-fellowship.
5. Support and mentorship: Having access to experienced mentors and coaches was invaluable to our growth. Navigating the fellowship felt isolating at times, with fellows spread across the country, adapting into new organisations, and understanding the landscape of systems and leaders. However, the unwavering support, sponsorship, and feedback significantly enriched our experience. We are especially grateful to Rachael Moses (Head of Clinical Leadership Development Leadership & Lifelong Learning) and Emma Marrison-Taylor (Acting Project Manager – Clinical Leadership Development Leadership and Lifelong Learning) in this regard. Their regular leadership sessions were an excellent opportunity to connect with inspirational leaders across healthcare in an informal setting, hearing of their career journeys, challenges, and lessons learned, which provided food for thought about potential career paths. The sessions also provided a psychologically safe space to ask questions and discuss issues transparently.

Conclusion

The fellowship has proved transformative for us. We have honed our leadership skills, fostered interprofessional collaborations and gained valuable insights across directorates and system layers. The benefits are far-reaching, enabling us to become more effective advocates for patient care, the workforce and driving positive change in the healthcare sector. Although it has been a rollercoaster experience at times, with both ups and downs, the accrued experiences and development outweighs the challenges laid out above. It has redefined our purpose and abilities as dynamic, inclusive, and compassionate clinical leaders.

As parting words, we encourage pharmacists and the pharmacy workforce, to continue to transcend the confines of traditional roles and perceptions by applying for schemes such as this. The profession must continue to exemplify the flexibility of our diverse pharmacy workforce, the skills we encompass and that our commitment to patient care expands beyond being the experts in medicines. The pharmacy profession holds a vital decision-making seat and front row leadership role, in the rapidly changing and diverse systems we are witnessing.

This fellowship led us through uncharted waters, nurturing us as holistic and dynamic healthcare leaders. With humility, resolve and unity, our cohort carry our growth with a commitment to shaping the ever-changing healthcare systems to meet the needs of patients, workforce and the communities we serve.

Authors

Aiysha Raoof

A former NHS England and Faculty of Medical Management and Leadership (FMLM) Clinical Leadership Fellow, Aiysha is a multisectoral clinician, with experiences across the NHS and wider landscape. Post fellowship she maintains a portfolio role as Head of Medicines Optimisation, Governance & Medicines Safety Officer and Deputy Chief Pharmacist at East Midlands Ambulance Service NHS Trust and an Associate Lead in an ICS.  An avid advocate for tackling health inequities, she is a CORE20PLUS Ambassador for The National Healthcare Inequalities Improvement Programme.

During her fellowship she worked across systems and directorates, formally represented the cohort and engaged with stakeholders in developing the alumni scheme. Alongside this, she engaged and contributed to her professional background, nationally with the NHS England Chief Pharmaceutical Officers team and regionally with NHS Midlands, Regional Chief Pharmacist and Assistant Director of Clinical Delivery.

A diverse leader with a portfolio career, she encompasses the core values to ensure effective and compassionate leadership, is a champion for healthcare, patients and workforce equity and values the importance of clinical leadership in driving improvement.

Twitter:@_araoof

LinkedIn: https://uk.linkedin.com/in/aiysha-raoof

Declaration of interests

I have read and understood the BMJ Group policy on declaration of interests and declare the following interests: Royal Pharmaceutical Society – Primary Care Expert Advisor

Onyinye Ndefo

Onyinye has a passion for improving patient outcomes through clinical leadership. As a 2022/23 NHS England Regional Clinical Leadership Fellow in the East of England, she worked on several key projects within the office of the Regional Chief Pharmacist, including the transition of the Covid Medicines Delivery Units (CMDUs) into routine clinical practice.

Onyinye secured her current role as the Academic Research Manager for Northamptonshire Integrated Care Board (ICB) during her fellowship, a testament to her leadership skills and ambition. In this capacity, she continues to use her expertise to drive evidence-based projects that improve patient care, facilitate interdisciplinary research collaborations, and contribute to the advancement of health and care research in her Integrated Care System.

She envisions a healthcare landscape where clinical leadership is an integral part of every healthcare professional’s journey. Her career journey from a Clinical Leadership fellow to a Research Manager exemplifies her unwavering commitment to improving healthcare outcomes through innovation, leadership, and research.

Linkedin: Onyinye Ndefo | LinkedIn

Declaration of interests

I have read and understood the BMJ Group policy on declaration of interests and declare the following interests: None.