| Description | Prof CHRISTINE BOND interview on Wednesday February 1, 2023. Interviewer Eric Crockart. Summary by Eric Crockart.
(0:00:00) CHRISTINE MARGARET BOND (née NEWNHAM), born on 25th of June, 1946 in Chingford, near London E4. Retired from Aberdeen University in 2016 and became an Emeritus Professor, but has continued working, full time hours, as a freelance researcher, explains in detail the many things she does; definitely not retired. Went to Oaklands primary school in Loughton in Essex; passed 11-Plus exam and went to Loughton High School. Interested in Sport and Science, but actually loved everything, bemoans having to give up French and History in English school system. Did Physics, Chemistry and Biology at A-Level. Her father was a graduate chemist, quite unusual at that time. Studied Pharmacy; had got a place in medical school, but was not liking the dissection; explains about her decision. (0:05:05) Studied at London University, then called the Chelsea School of Pharmacy - a London University degree, now part of King’s College. Talks about being a Pharmacy undergraduate in the 1960s; not dissimilar to Medicine in some ways, explains in detail, missed a whole term because of illness. Really worked hard, not affected by 1960s culture, explains. Graduated in 1967 with a First Class B Pharm (Bachelor of Pharmacy) degree. Explains having got the degree you had to do so many years in practice [on later review of this summary Christine corrected this to just one year] before you could be registered as a Pharmacist; had to work for a year under the supervision of a pharmacist, but Christine explains she did her year’s registration at Glaxo Laboratories [Christine later added this explanatory note: The difference was that at that time the supervision had to be by another registered pharmacist but the sector was not specified, so after a year in industry under a pharmacist's supervision, I could then take on a role as a fully registered pharmacist in a patient facing role (ie community or hospital ) without ever having had any relevant experience! This is no longer the case- you need at least 6 months supervised practice in a patient facing role as part of the year under supervision]. Then became a Member of the Pharmaceutical Society (MPS - now MRPharmS; explains in detail the complications in 2012 when society split into two organisations following the Dr Harold Shipman case). Talks about working in the research laboratories at Glaxo; looking at novel ways of protecting drugs that were sensitive to light; that work became a PhD, but then had her first child. Talks of animosity of male colleagues who felt she should not be going back to work when she had a child, so went to Norway when her husband got a job there. Came back to a small market town near the Barrow shipyard where her husband was working, Christine did locums with a small community pharmacy, who were very innovative and already delivering some of the roles we now see universally, explains. (0:10:44) In Norway from 1973-76, had two children. Was then in the North of England for three or four years, then husband got a job in Aberdeen. Christine started looking for pharmacy locums, by then had three children. Became friendly with a neighbour who was a GP, she was also trying to get a research contract with Aberdeen University, working with then acting head of the General Practice department Ross Taylor; neighbour told Christine they were looking for another researcher on a drug-related project, Christine got the post. Her husband came to Aberdeen in 1979, she came in 1980. Continued doing locums till 1996, when she was asked to take a secondment to the health board as Chief Pharmaceutical Officer. Explains this was for 50% of her time; made sense in terms of the medics she was working with [later added: because they all had combined clinical and academic roles in various contractual models]; explains she was by then a senior lecturer and head of teaching, they also had clinical interests. In 1984 took up a Research Assistant post with University of Aberdeen, just nine hours a week, explains had turned down full-time post with the School of Pharmacy at Robert Gordon’s (RGIT, Robert Gordon’s Institute of Technology) for child care reasons. Post she took up was with the Dept of General Practice, it was in a bit of a doldrums, very small; most senior person was Dr Ross Taylor, department under wing then of Dept of Community Medicine, headed by Roy Weir, also mentions Elizabeth Russell; explains how this changed as Ross Taylor built up the department and was given the title of Head of General Practice. Christine then became a Research Fellow, and then Lecturer by 1989. Explains that as she worked with Ross Taylor to bring in grants she was named as a Research Fellow; Ross Taylor believed in her, explains (0:16:38) Ross Taylor was her PhD supervisor; this was another PhD, not the one she started at Glaxo, which she did not finish, explains in detail; prescribing in community pharmacy, at the time unheard of, explains. Talks in detail about her involvement with Prof Elizabeth Russell; she was in Community Medicine, and Christine was in General Practice; very influential in blurring the boundaries between the professions, not just looking at things from a medical perspective. Speaks about her hopes for the future, but very concerned about all the current strikes in the NHS, explains. Personally thinks we do not pay enough taxes, explains in detail; mentions situation in America and Obamacare. Thinks people over-medicalise and go to the doctor too much; talks about problem of changing demography and there not being enough working young people in future to look after the old. (0:22:50) In 1993 Christine became Senior Lecturer, about the time she became Head of Teaching and developed the General Practice teaching curriculum (1991). Overlapping roles, in 1992 she began studying for a degree at Aberdeen University, Masters in Education, because she thought she needed to understand teaching theory better, explains. At a time when it was realised that there needed to be more teaching of General Practice as an academic discipline, explains she was trying to build the body of GP tutors. Talks about how she coped with all her different roles at that time, plus studying for a PhD, all while coping with a young family; her husband was not able to help as he was working in Azerbaijan; he is a chemical engineer, worked in the oil industry till he retired. In 1996 Christine was seconded to NHS Grampian; before that she had persuaded the university to change the name of the department from the Dept of General Practice to the Dept of General Practice and Primary Care, reflected national moves, explains; subsequently became just Primary Care. Explains difference between General Practice and Primary Care. Addresses again her secondment to NHS Grampian; at some point the previous Chief Pharmaceutical Officer, Arthur Williams, had asked Christine to help with a few small research projects; had also done work for him on Shetland, explains. (0:29:35) Interviewer clarifies he had misread her CV and she was first seconded in 1986, not 1996; a consultant staff pharmacist who travelled to Shetland, explains in detail, very rewarding experience. In 1996 Christine becomes the Chief Administrative Pharmaceutical Officer for NHS Grampian, 50% of her time, other half with Aberdeen University, animosity from the other pharmacists, explains. Both got more than 50% of her time, but symbiotic, explains in detail. Got smoking cessation service up and running in Grampian with community pharmacists leading it. Under her leadership Grampian one of the earliest health boards to put pharmacists into General Practice, explains, mentions Hamish Wilson, Head of Primary Care at the health board. Explains in detail what these pharmacists were doing in General Practice; gradually started seeing patients, started running their own clinics, looking particularly at the prescribing. (0:34:57) Explains how pharmacists in theory have a better understanding of how all drugs work; don’t diagnose, that’s medical, but can prescribe. Says that in 2025 or 2026 pharmacists will all come out with prescribing rights, explains; a dramatic change. Harks back to her working in the community pharmacy at Ulverston in the North of England, issued repeat prescriptions to regular customers, explains significance, doctors would retrospectively sign the prescriptions. Explains about Emergency Supply, which was part of the regulations. Things like that gradually became custom and practice; it was decided this had better be regulated, Crown Report came out in the late 1990s, explains how role of pharmacists developed as a result. Built on some of the research Christine had done in the late 1990s as well, explains; reduced the amount of medicines prescribed, and reduced prevalence of side effects. In 2000 Christine becomes, as part of her secondment to NHS Grampian, a Consultant in Pharmaceutical Public Health; she explains about this in detail; became a Fellow of the Faculty of Public Health as well. (0:41:36) In 2001, as part of her university career, Christine became a Professor and Head of the Dept of General Practice and Primary Care. Talks about this in detail, Ross (Taylor) as head of the department never given the Chair, Christine upset about this. Lewis Ritchie was given the Chair; he came in full of energy and entrepreneurial ideas, he really built the department up [Later added: Make clear whilst I felt at the time Ross should have been recognised, Lewis and I immediately got on, he was a great supporter of my work and we had a great partnership for many years with him as Head and myself as deputy]. Round that time we established a Clinical Trials Unit in the department, which Christine headed; explains how this operated. Thinks that after that she became the head of department they took over the Centre for Rural Health, in Inverness. By that time they had over a hundred people on the books, so gradually expanded. Clarifies that she became head of the department in 2008 [later corrected to 2007- and in 2008 renamed to Centre of Academic Primary Care]. Talks about what she did then, and how the previous head Lewis Ritchie was still there, just stood down as head of the department. (0:46:35) Thinks she was the first non-medic to head a medical department in the UK, explains. How was she treated? The other heads of department in Scotland - Glasgow, Edinburgh and Dundee - were all people she had known a long time, so she was just accepted. Slightly harder within UK group, explains in detail; mentions Sandra Eldridge, a statistician who was co-head of a department at Queen Mary’s, used to speak with her, still do projects with her. Talks about her contributions at the Scottish and UK level with her professional body, the Royal Pharmaceutical Society. Can’t quite remember why she did it, took any opportunity that looked interesting. Applied to be a member of the Scottish Pharmacy Board, sub group of the UK-wide pharmacies organisations, explains. Wanted to bring academic rigour, some very unpleasant encounters at the board when she wanted to push community pharmacies to do more, explains in detail. Things have changed. (0:51:31) Explains the concept of Community Pharmacy; long history of providing advice and recommending treatment to people, as separate service from the GP. Explains what happened after creation of the NHS. Explains how much pharmacists can do as part of the Primary Care team; talks about challenges of cascading care down, workforce reconfiguration so everyone’s skills are used appropriately. Education of pharmacists has changed to prepare them for that role, also General Practice now dealing with things that would once have been more the medical speciality. Comments on how well pharmacy is working within the multi-disciplinary team; change always takes time, a big paradigm shift, explains. (0:56:09) Comments on the public reaction to Community Pharmacy. Talks about her research interests; ensuring medicines are used appropriately and safely, explains in detail. Did some work in the management of pain, explains how those patients monitored by pharmacists were doing better after six months than those monitored by GPs. Gives other examples. (1:01:40) Talks in detail about Pain being the most horrendous thing to manage, no easy answer; chronic pain. Christine did a European project looking across nine countries at the use of the extended healthcare team in healthcare, explains what they found; patient outcome depended on trust between the team members. Explains pharmacists and doctors are trained differently; consequences of this; doctors more cliquey. If you want to delegate, doctor will say "Do I know him?", pharmacist will say "I’ve got the qualification". When they were first putting pharmacists into the Health Board, also did research project trying to look at the benefit, same attitude displayed; trust needs to be built up, not at a personal level, but a professional level. Thinks that is happening, the Pharmaceutical Society and the Royal College of General Practitioners now work quite closely together. (1:06:21) Talks about her career highlights; helping improve the quality of research that’s done in the context of pharmacy, only been able to do that because she’s been at Aberdeen in a research university, explains. One of the things she’s now trying to do with the Chief Pharmaceutical Officer of England is to try to instil a greater research culture within the pharmacy profession, explains. Journal editing work. Another thing is she is pleased she has brought the professions closer together; she’s a Fellow of the Royal College of General Practitioners, wonderful letter to receive. Two of her late 1990s projects on repeat prescribing by pharmacists, and smoking cessation, now accepted as established roles for pharmacists, explains. Compares how things are now with how they were when she started out. Had to fight a lot of small battles, explains in detail how perceptions of GPs, hospital pharmacists and community pharmacists have changed. Talks of how getting a PhD benefitted her, as she then had the title Doctor; although still found herself sometimes saying she was not a doctor! Need for change, takes time to happen. (1:11:57) Talks of benefit of Medical School in Aberdeen being all on one site, but says biggest thing for her was Ross (Taylor) and Lewis (Ritchie) believing in her, pays tribute [And later Phil Hannaford whose appointment greatly strengthened the Department and the research database he brought with him]. Achievements of the department which continued after she took over as head from Lewis (Ritchie) they were at their largest in terms of establishment numbers, had very big research portfolio, did well in the REF (Research Excellence Framework) (and ranked highly in UK); but change as people move on. One of her key (staff) supporters who was Head of Research (Neil Campbell) went back into General Practice, the Head of Teaching (Blair Smith) moved to Dundee; so quite suddenly things started to fall apart, [also coinciding with wider University cuts and freeze on posts so another three midrange/senior research team leaders left]. Now a very small department, very sad. She had over a hundred people on the books, now ten or something. But points out that all the departments in Aberdeen have reduced in size, explains. [As University cuts in staff more generally and posts frozen, so four people whom she would have expected to move on to tenured posts/stay on, left, as saw no future/were not continued. Three of these now doing well in senior/professorial posts and one happily retired]. Under current head they are beginning to build again, good to see. Another factor, UK decision to professionalise teaching, which is good; but took all the primarily teaching staff out of departments and put them into teaching institutes or whatever. So all their General Practice teachers, who had all been involved in doing some research, taken away; gradually lost contact with them. Talks about why she stood down as head of the department in 2014, but stayed as a member of staff till 2016. Thinks she has been very privileged to have been accepted as a Pharmacist in a medical school, explains. (ENDS 1:18:22)
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