Advocacy Leader of the Week Sandra Hanna: ‘Every single one of us is an advocate’

SnapshotEducation: BSc Pharm, Leslie Dan Faculty of Pharmacy, University of TorontoLLM, Masters of Health Law, Osgoode HallICD.D, Institute of Corporate Directors, RotmanRole/Title: Chief Executive Officer, Neighbourhood Pharmacy Association of Canada Describe your journey into the field of pharmacy and what inspired you to take on a leadership role in advocacy.I began my career as a community pharmacist and soon transitioned into pharmacy ownership. I quickly discovered that what excited me most was the business operations side of the pharmacy. I was constantly refining processes to make high-value patient interactions more efficient, balancing patient demands with running a sustainable and successful business. Simultaneously, I became passionate about exploring creative business development opportunities to grow my business and offer added value to both my patients and the healthcare providers I worked with.By collaborating closely with vendors to create and roll out various demonstration projects in my pharmacy, I embraced a “win-win-win” principle. Every project was designed to prioritize patients' needs and improve their experience beyond the usual care, while also ensuring financial viability and value for both the pharmacy and the vendor. In my experience there was always an area where these three intersected – and if there wasn’t, I wasn’t interested!As I continued to implement these projects, I transitioned to spending most of my time with vendors and retailers, offering business development and strategic consulting services. In 2017, my consulting work led me to the Neighbourhood Pharmacy Association of Canada, where I supported several projects as a subject matter expert. Although I had no prior advocacy or government experience, the prospect of learning about this space excited me. I quickly realized that advocacy and government relations, while seemingly different, fundamentally involved the same principle I had been applying all along: finding the win-win-win. In this context, it meant developing solutions that met public needs, were financially viable for the government as the payer, and beneficial for the pharmacies delivering the services.What are some of the most significant challenges you have faced in your advocacy efforts, and how have you overcome them?Solutions often require extensive due diligence, and decisions, progress, and timelines must consider a much broader set of stakeholders. The control I was used to having over my plans, goals, and deliverables was effectively gone. However, I also learned that when alignment is found between problems and solutions, actionable steps toward change can still happen quickly.This was especially clear during the pandemic – while discussions of expanding pharmacists’ scope to prescribe and immunize were underway for years in some jurisdictions, the lack of access to other primary care providers during the pandemic made action in this area a no-brainer.This experience taught me an important lesson: it’s easy to think that our suggestions make perfect sense – because they do – but there are many other demands on the government’s agenda that also make sense. Timing is everything, and drawing a clear connection between a problem and a solution we can offer is the best path to success!How do you envision the future of pharmacy practice, and what role do you see advocacy playing in shaping that future?I think we are already seeing a clear vision of where pharmacy practice is going. With Canadians visiting their pharmacists up to 10 times more frequently than any other healthcare provider, and with a growing shortage of primary care practitioners due to retirements and fewer new practitioners entering the field, we can expect to see pharmacies continue to own their place as community health hubs.Pharmacy will continue to evolve to play a greater role in initiating and managing chronic disease therapy; continuing to be the destination for the assessment and management of common, self-limiting ailments; and being the immunization hub for preventive care and wellness. Looking beyond our borders, we're also seeing a clear expansion of pharmacies into the wellness space, through supplements, and even nutrition – especially in pharmacies tied to grocery stores.Overall, we can expect to see pharmacies continue to grow as health and wellness destinations. However, to fully realize this potential, we must push the needle on regulatory barriers that limit our ability to innovate and efficiently operationalize our expanded roles. We need to work with regulators and governments to encourage innovation in pharmacy design, operations, staffing, technology use, and funding. Only then can we truly capitalize on the full potential of pharmacy!Can you share a success story where your advocacy efforts led to a tangible improvement in pharmacy practice?We at Neighbourhood Pharmacies have been very busy lately and have lots to share in this regard! One of our notable successes was leveraging our much-anticipated annual Pharmacy EXPO to advance our key priorities. EXPO featured a panel discussion with Nova Scotia Premier Tim Houston and Pharmacy Association of Nova Scotia (PANS) CEO Allison Bodnar. We focused on the lessons learned from the rollout of primary care clinics in the province, which culminated in a successful call to action encouraging other jurisdictions to invest in similar pharmacy-led primary care services.We also made significant strides by engaging early with Health Canada and Canada Health Infoway on proposed changes to the funding model for PrescribeIT. We issued a public statement emphasizing that pharmacy should not be the sole contributor to funding this tool, which provides benefit to patients, the health system, and all pharmacy stakeholders. This led to significant federal engagement with the health minister's office on possible solutions.Furthermore, we continue to raise awareness and spark critical conversations about the growing influence of Pharmacy Benefit Managers (PBMs) in Canada. Our efforts have included releasing a position statement, forming key alliances with new stakeholders, and attracting media attention, all of which have been crucial in bringing greater focus to this important issue. How do you balance the interests and needs of different stakeholders within your advocacy work? How do you foster collaboration and unity among diverse stakeholders with varying priorities and goals?For me, again I go back to the principle of finding the wins here. Balancing the interests and needs of different stakeholders in our advocacy work can certainly create challenges, but I am of the belief that the broader the perspectives informing an issue, the better the proposed solutions will be, the more informed the discussion will be and the better the likelihood of success will be. Collaborating to find solutions is vitally important – not only for relationship building, but also as a reminder to all parties involved that we are working towards the same end goal: a healthier population and a sustainable and thriving pharmacy sector.In my role as CEO at Neighbourhood Pharmacies I always try to examine solutions and positions from different lenses – as a practising pharmacist, a pharmacy owner, my own experience consulting with vendors using different pharmacy business models, and even as a taxpayer, and indirect payer! Ultimately, there’s always an intersection where the goals of different stakeholders can align. As a trade association representing a diverse membership, I always try to operate in this win-win-win “zone,” and the engagement of all our members and partners is so critical to ensuring that our advocacy as an association is well informed and well balanced! What advice would you give to young pharmacy professionals who are passionate about advocacy and want to make a difference in the field?Advocacy happens at both the macro and micro levels, meaning that every single one of us is an advocate. Whether you’re comfortable being an ‘official’ voice for the profession or prefer to advocate more subtly in your community, every patient interaction creates an experience and a story that can drive the sector forward. Politicians and decision-makers are patients too, and their experiences directly impact their perceptions when evaluating solutions or proposals.Additionally, get involved with your associations. Associations can only be as strong as their members are engaged! Active participation by stakeholders not only strengthens our collective voice but also enhances our ability to advocate effectively on key issues. Grassroots advocacy is particularly vital. When pharmacy stakeholders representing the full gamut of pharmacy sector (from manufacturers to distributors to pharmacies and pharmacists on the frontline) come together to support initiatives, such as our recent pharmacare advocacy efforts, we amplify our impact and drive meaningful change. Your involvement, at whatever level you’re comfortable with, makes a difference.Can you highlight any current or upcoming initiatives that you are particularly excited about in your advocacy work?Our advocacy efforts focus on safeguarding existing pharmacy funding from erosion while exploring new, sustainable funding models to ensure the ongoing viability and future success of community pharmacy. We are committed to developing solutions that meet the needs of all stakeholders across the pharmacy sector.I’m particularly excited about the growing recognition of the vital role pharmacies and their teams can play in enhancing the primary care system. We’re seeing numerous pilot projects in various jurisdictions that are evaluating pharmacy-led clinic models in areas with a high need for primary care services. The early results are promising, showing significant popularity, high satisfaction, and positive outcomes. However, these projects also highlight a clear gap between the available funding and the actual costs of delivering these services. This evidence is crucial as we advocate for sustainable funding models and continue to push for broader adoption of these innovative pharmacy-led solutions. But the most exciting part is that all eyes are on pharmacy to deliver solutions, and with sustainable funding and modernization of the policies that sometimes bog us down in administration rather than valued patient care and interactions, deliver we will!What personal qualities or experiences do you believe have been most instrumental in your success as an advocacy leader?An ability to listen and eagerness to learn different perspectives has been key to both my front-line pharmacy work and my advocacy efforts. A general curiosity to better understand different perspectives, how they differ, and where they align is essential, as well as an ability to ask the (sometimes tricky) questions that foster collaboration and ultimately drive towards finding alignment – that is the sweet spot!Looking back on your career, is there anything you would do differently, or any key lessons you have learned along the way?Honestly, I don’t think I would change anything. I've been fortunate to take on various roles across the pharmacy sector, which has given me a broad understanding of different perspectives, motivations, priorities, and approaches. I've discovered that being open to learning and engaging with different stakeholders opens many doors and opportunities, exposing me to possibilities I never knew existed.If you had asked me in pharmacy school where I thought I would be at this stage of my career, I wouldn’t have guessed leading a trade association. However, I made learning a priority from day one, and this has led to new opportunities and unexpected, incredibly rewarding paths. I've been fortunate to meet many incredible colleagues, who have now become friends, along the way.What advice would you give to colleagues who want to participate in advocacy efforts or initiatives? Be open to new opportunities and put yourself out there if you’re looking for new experiences. You might not always know what you're looking for or how you'll get there at the outset, but make connections, learn from them, and keep the door open to new opportunities and challenges. I’ve always told myself that if there is an opportunity to learn new skills and work with new people, it will be worthwhile, and this has proven true for me!If you do have a clear vision of what you want to do and how you’d like to be involved in advocacy but don’t know where to start, reach out – to me, other advocates, or associations. We’d love to work with you! When it comes to spreading the word about the potential of pharmacy, we are always stronger together.Sherif Guorgui - FIP-Community Pharmacy Section | LinkedIn

Advocacy Leader of the Week Sandra Hanna: ‘Every single one of us is an advocate’

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