Chief pharmacist at Argyle Health Group Graham Stretch announced on Monday (13 May) that he had been elected as co-clinical director of his primary care network. Costanza Pearce chats to him about why he applied for the role and what he’s expecting


How do you feel to have been appointed as clinical director?

Hopeful, optimistic and excited.


What made you apply for the role?

One of the reasons I applied to the post was that I felt I had experience in recruitment and mobilisation of pharmacists into general practice across multiple practices.

There is a shortage of suitably-trained pharmacists and having recognised that, it’s important to then recognise that there’s a huge training need. While the classroom-based activity provided via the NHS England scheme is helpful, I think, in the end, mentorship at a local level is where very often an individual practitioner might thrive or fail.

It’s there that I felt I had something to contribute.

That’s what I’ve been doing for several years now. I did quite a lot of work with the whole pharmacy workforce – pharmacy technicians, students, pre-registration pharmacists and foundation pharmacists, among others. Right across the board we’ve tried to bring in that skillset to general practice and I think largely speaking we’ve been successful.

A big criticism of GP pharmacy of course is that we steal people from hospital and community, so we’ve invested a fair amount into training our own people. We hope now to do that in the primary care network (PCN) and we’ve got ten pre-registration students starting in July. We are training our own.

Also, 15 years in community pharmacy taught me that pharmacists can do an awful lot of this work and naturally I hope to collaborate in that area.


What was the application process like?

It was a rather hard-fought election campaign that went on for two weeks. There was a proper election with four candidates that involved practices [in the network] casting votes for their preferred director.

There were various conversations that were had and I was fortunate enough to be appointed as a joint clinical director with a responsibility for the additional workforce. A GP from within the PCN is going to join me [in the role] and we’ve roughly demarcated the workload.

There was some controversy but I think in the end, people are happy with the selection. We’re only just starting so I can’t claim any credit yet, but we’ve got to start somewhere.


What will the clinical directorship include for you?

In the practice I’m involved with, we have pharmacists and technicians working but in the first year a single pharmacist will be recruited by the PCN and funded for a maximum of £37,000. In addition, we get funding towards the cost of a social prescriber in the first year and then in subsequent years we get more freedom to choose which professionals we need from a specified list that now includes physios, paramedics, physician associates and discussions are ongoing around including pharmacy technicians and others.

My role will be to engage with those various professions and the needs of the population. Social prescribing in particular is a very interesting agenda.


Do you have any plans for your PCN?

Collaboration is the key and we’re not even at the stage where I’ve started to discuss [plans] with my partners or with our wider workforce in the area.

What I am doing is looking around elsewhere to see what work is being done, specifically with community pharmacy. We’re hoping to include pharmacy in our workforce and also collaborate with community pharmacy and so there are already conversations with LPCs that have started. It’s very exciting.

Let’s not reinvent the wheel but then also let’s see if we can do anything innovative locally and make full use of the pharmacy network. I’m sure that our community pharmacists would be very keen to get involved in that as well.

Until we’ve actually got some outcomes to share, it’s better that we just keep our heads down and get on with the work. In the end it’s what we deliver that counts.


When and why did you decide to go into practice pharmacy in the first place?

That was a very slow evolution. I realised that to be involved in the very start of the prescribing process, I had to be where the prescription is initiated and so gradually I went from medication reviews to helping with prescribing in general practices, towards doing single sessions and then onto managing the whole prescribing process. Then the NHS England [practice pharmacist] scheme came along.

It’s hard to say because there wasn’t a day when I stopped being a community pharmacist and starting being a GP pharmacist, it was a gradual thing. I can no longer claim to be a community pharmacist and haven’t been able to do so for probably four or five years.