From 2006 to 2022, Keith was chief pharmaceutical officer for England, the NHS’s and Government’s principal adviser on pharmacy and medicines use, and head of the pharmacy professions in England. During that time he led fundamental reforms that led to pharmacy professionals delivering more clinical services to patients. He was centrally involved in a number of policy areas including antimicrobial resistance, introducing a more patient focused approach to medicines use (known as “medicines optimisation”) into the NHS, the introduction of biosimilars, and the response to the Covid pandemic. Keith led a number of Government reviews, including the National Overprescribing Review which identified the scale and causes of overuse of medicines and made recommendations for improvement.

Prior to becoming chief pharmaceutical officer, Keith was chief pharmacist at University Hospitals Birmingham, and North Glasgow University Hospitals. During the 1990s, Keith worked at the Department of Health during which he was involved in the establishment of NICE.

Since stepping down as chief pharmaceutical officer, Keith has advised a number of organisations on subjects including digital therapeutics and pharmacy automation. Keith is a member of the European Board of Icon Group, a cancer care service provided based in Australia. Whilst a pharmacist by background, Keith left the pharmaceutical register in 2022.