Insight: Soar Beyond x Shailen Rao

The path I travelled to become Managing Director and Owner of Soar Beyond, a pharmaceutical consultancy and provider of clinical pharmacist services, has been an interesting one.  

After studying pharmacy at Aston and a stint in community pharmacy, I started to get twitchy. Feeling like I probably couldn’t imagine another 40 years or so in this environment.

Back in 1995, I took a leap into a career path which now is a little more known -working in GP Practices and supporting them to make savings, efficiencies and patient care improvements through providing prescribing advice. I realised that I really enjoyed supporting general practice to make the best out of their investment in medicines and soon moved into a Head of Medicines Management role in Health Authority which became a Primary Care Trust (PCT) which then became a Clinical Commissioning Group, (CCG) but the acronym isn’t important.

My main function was to effectively and safely manage a budget of £30M+ to serve a population of 250,000 people. I found myself both fascinated and challenged by the constant dilemma of making commissioning decisions to serve a large patient population whilst needing to invest in the most cost-effective medicines and devices within this finite budget. It was clear to me that medicines underpin so much of healthcare and their successful utilisation has a wider impact on the healthcare service and patient care. However, in a traditional medicines management role, so much is focussed on the silo budget and acquisition costs of the drugs that it doesn’t take into account the broader cost and patient implications. To a greater or lesser extent, this has moved on now, with a focus on ‘medicines optimisation’ over ‘medicines management’ but the budgetary challenges and annual budgets do make this a more difficult cultural shift.

One of my key achievements was becoming the Diabetes Service Lead alongside my medicines management role. I became accountable for driving a whole pathway re-design for Diabetes care to provide a community and intermediate care service- between 2000- 2007, this was one of the first of such services and the NHS continues to grapple with this.

This posed a number of obstacles:

  • The perception of the pharmacist as a systems leader was quite unusual (it is still a work in progress, IMHO) and I had to really build trust to break down pre-conceptions about what Medicines Management Pharmacists were interested in and could influence.
  • The resistance to change by NHS colleagues and managing the various competing agendas – much of which stemmed from protectionism. I needed to fully understand their roles, priorities and the wider NHS in order to overcome this and it took time and required a great deal of facilitation and negotiation skills to ensure that people could own a mutually shared vision.
  • Being able to harness the existing investment in medicines and diabetes patient care to be utilised in a more efficient and focussed way. I realised that pharmaceutical and device companies were already investing in training and education with HCPs, but this was adhoc, not standardised nor organised. In this role, therefore, I was able to cohesively work in partnership across Industry to apply their funding and skills to better meet the needs of the clinicians and patients of Hillingdon.

All of these roles have culminated in me setting up Soar Beyond and applying my personal experiences and expertise to develop a high-quality team to meet the unmet needs of:

  • Driving effective pathway redesign in recognition of the pivotal role of medicines and to overcome resistance to change – we have developed a simplified and proprietary approach to doing so- 4D
  • Upskilling of the pharmacist as a leader and change agent- we do this through our strategic support to commissioning and provider organisations as well as our training programmes through the i2i Network
  • Supporting the Pharmaceutical Industry and NHS to better work in alignment to meet the NHS, patient and Industry needs. These initiatives are always so rewarding – delivering improved patient care through true partnership.

I gained great value and challenge from my career working in commissioning and particularly understanding the complexities of NHS decision-making.

I would strongly recommend this career route for pharmacists seeking to stretch their clinical knowledge and apply it to a cross-section of medicines and clinical pathways; it will provide a broader understanding and application of your skills. In order to break into this career, I would strongly advocate that you spend time understanding the wider NHS and transformation as this underpins all decisions.

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