Published: 16/06/2005, Volume II5, No. 5960 Page 40 41

Primary care is ideal for aspiring managers, offering diverse, hands-on work. Adrian O'Dowd reports

The pharmacy profession could be about to lose a valued member, but managers need not worry - the pharmacist in question is now a committed and successful manager herself.

Portia Omo-Bare has carved herself a successful and varied career that has taken her to primary care - the area she recommends for aspiring managers of tomorrow who want to be where the real action lies.

Portia moved from a senior job at a strategic health authority to a primary care trust because she wanted to get back in touch with hands-on health services and because the opportunities are so plentiful. 'I know primary care is the place where it is all happening at the moment, ' says Portia, associate director of primary care for Waltham Forest PCT in London.

A pharmacist by background, Portia is now resolved to being primarily a manager at heart, although the pharmacist in her will always exist.

'People always think I am a glutton for punishment because I always have a lot on, ' she admits, but foresees dropping her pharmacy registration in a couple of years to concentrate on being a manager.

In all of her management roles so far, Portia remained lead for all prescribingand medicines-related issues - something that made sense and, she adds: 'I did not want to lose my professional background.' She registered as a pharmacist in 1981 and after a short spell working at Barts and the London trust, took off to West Africa for a five-year spell working in a community pharmacy role.

It was not long after her return to the UK in 1987 that she got a job as a drug information pharmacist at Homerton Hospital.

From there, she worked her way up to acting chief pharmacist before moving on to being deputy chief pharmacist for Newham Healthcare trust in 1990 - which she considers as her first real management role.

'What was different about it was understanding accountability and responsibility - that the buck stopped with you, that you need to make decisions you will be accountable for at a later stage and think about planning.' An opportunity for a secondment as pharmaceutical adviser to the then family health services authority for City and East London health authority presented itself soon after she moved to the HA in 1996 as head of prescribing and medicines management.

She prospered at the health authority and later became head of primary care performance and development - a role in which she developed local performance indicators for GPs, the implementation of a local support process for poorly performing GPs and primary care indicators.

'Coming from hospital pharmacies, I tended to think, like many in hospitals, that the world ended at the hospital gates, ' says Portia. 'There was this whole new primary care world I had never even heard of. That is where I really spread my wings as a manager and developed my management skills in pharmacy. I began to see there was a bigger world out there.

'When I got into primary care, the ironic thing was that primary care thought the world stopped at GP surgeries. You have to try to make both sides realise the world is bigger than both of them.' In 2002, Portia took up another challenge and moved to North East London SHA as assistant director for the national service frameworks for older people, chronic-heart disease and critical care.

In 2003 she decided it was time for a change again in the form of a move to Waltham Forest PCT as associate director of primary care in 2003.

'When the SHAs were formed, I wasn't convinced it was the right place for me. I am quite a practical person and I like the hands-on delivery rather than arm'slength performance management.

'The NHS is a place of change, and in some ways It is fantastic for careers because things are always changing, and if you have got your eye on the ball you can think what is going to happen in two years' time and where would you like to be then.' Portia is also keen to progress to director-level positions, and gaining operational experience is crucial.

Her current job demonstrates just how diverse such a post can be. She is the lead in areas including new GP contracts, pharmacists and dentists, premises, integrated walk-in centres, out of hours, older people, complementary therapies and access. She is also responsible for implementing practice-based commissioning in Chingford, east London.

Developing expertise 'Practice-based commissioning is going to be huge, ' says Portia. 'Commissioning has taken place in an narrow, controlled way.

If we are going to have it, we will need to develop commissioning expertise, particularly in primary care. There is also a lot of service development that needs to go on.' Waltham Forest PCT has chosen four areas to focus on initially - orthopaedics, diabetes, dermatology and chronic-heart disease. All practices are expected to take part in practice-based commissioning, unless some choose to opt out.

Portia has other interests, including mental health. She is a trustee on mental health charity MIND's national council of management and a member of its policy committee.

'I do have an interest in this, partly for personal reasons - I have a family member who has chronic schizophrenia - and because It is such a rewarding area to work in.' The barriers of being a woman and being black have not held Portia back in her career as a health service manager, she believes, but she is aware of their existence.

'When I was first at what I would call a senior level in the NHS, I would often turn up to meetings and be the only black person. That has changed over the years.

'I got to where I am today by being flexible, wanting a challenge and making sure I am clear about where I want to work and where I do not.' And with primary care offering a healthy range of career opportunities, Portia believes this is where her future lies: 'Primary care is excellent because it covers such a broad spectrum of what PCTs are responsible for - service development, managing contracts, premises, whole system working and partnership working. There is lots of choice around.'

Portia Omo-Bare CV

1980-90 - various pharmacy posts in London acute trusts and in the community in Africa

1990-96 - deputy chief pharmacist, Newham Healthcare trust

1996-2002 - head of prescribing and medicines management for East london and City health authority until june 2001, and then its head of primary care performance and development

1999 - trustee on the national council of mental health charity MIND and policy committee member

2002-03 - assistant director of national service framework priorities, North East London strategic health authority

2003 - associate director of primary care, Waltham Forest primary care trust