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Pharmacists in general practice: a qualitative interview case study of stakeholders’ experiences in a West London GP federation

BACKGROUND: Increased patient demand for healthcare services coupled with a shortage of general practitioners necessitates changes in professional roles and service delivery. In 2016, NHS England began a 3-year- pilot study of pharmacists in general practice, however, this is not an entirely new ini...

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Autores principales: Ryan, Kath, Patel, Nilesh, Lau, Wing Man, Abu-Elmagd, Hamza, Stretch, Graham, Pinney, Helen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5879559/
https://www.ncbi.nlm.nih.gov/pubmed/29609603
http://dx.doi.org/10.1186/s12913-018-3056-3
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author Ryan, Kath
Patel, Nilesh
Lau, Wing Man
Abu-Elmagd, Hamza
Stretch, Graham
Pinney, Helen
author_facet Ryan, Kath
Patel, Nilesh
Lau, Wing Man
Abu-Elmagd, Hamza
Stretch, Graham
Pinney, Helen
author_sort Ryan, Kath
collection PubMed
description BACKGROUND: Increased patient demand for healthcare services coupled with a shortage of general practitioners necessitates changes in professional roles and service delivery. In 2016, NHS England began a 3-year- pilot study of pharmacists in general practice, however, this is not an entirely new initiative. There is limited, current, evidence-based, UK research to inform the pilot so studies of pre-existing services must suffice until findings from a formal national evaluation are available. METHODS: The aim of this exploratory, descriptive interview study was to explore the experiences of stakeholders in eight general practices in the Ealing GP Federation, West London, where pharmacy services have been provided for several years. Forty-seven participants, including pharmacy team members (pre-registration and clinical pharmacists, independent prescribers and pharmacy technicians), general practitioners, patients, practice managers, practice nurses and receptionists took part in semi-structured, audio-recorded qualitative interviews which were transcribed verbatim, coded and analysed thematically to extract the issues raised by participants and the practicalities of providing pharmacy services in general practice. RESULTS: Findings are reported under the themes of Complementarity (incorporating roles, skills, education and workloads); Integration (incorporating relationships, trust and communication) and Practicalities (incorporating location and space, access, and costs). Participants reported the need for time to develop and understand the various roles, develop communication processes and build inter-professional trust. Once these were established, however, experiences were positive and included decreased workloads, increased patient safety, improved job satisfaction, improved patient relationships, and enhanced cost savings. Areas for improvement included patients’ awareness of services; pharmacists’ training; and regular, onsite access for practice staff to the pharmacy team. CONCLUSIONS: Recommendations are made for the development of clear role definitions, identification of training needs, dedication of time for team building, production of educational materials for practice staff members and patients, and provision of on-site, full-time pharmacy services. Future work should focus on evaluation of various models of employing pharmacy teams in general practice; integration of pharmacists and pharmacy technicians into multidisciplinary general practice teams; relationships between local community pharmacy and general practice personnel; and patients’ service and information needs. A formal national evaluation of the pilot scheme is overdue. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12913-018-3056-3) contains supplementary material, which is available to authorized users.
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spelling pubmed-58795592018-04-04 Pharmacists in general practice: a qualitative interview case study of stakeholders’ experiences in a West London GP federation Ryan, Kath Patel, Nilesh Lau, Wing Man Abu-Elmagd, Hamza Stretch, Graham Pinney, Helen BMC Health Serv Res Research Article BACKGROUND: Increased patient demand for healthcare services coupled with a shortage of general practitioners necessitates changes in professional roles and service delivery. In 2016, NHS England began a 3-year- pilot study of pharmacists in general practice, however, this is not an entirely new initiative. There is limited, current, evidence-based, UK research to inform the pilot so studies of pre-existing services must suffice until findings from a formal national evaluation are available. METHODS: The aim of this exploratory, descriptive interview study was to explore the experiences of stakeholders in eight general practices in the Ealing GP Federation, West London, where pharmacy services have been provided for several years. Forty-seven participants, including pharmacy team members (pre-registration and clinical pharmacists, independent prescribers and pharmacy technicians), general practitioners, patients, practice managers, practice nurses and receptionists took part in semi-structured, audio-recorded qualitative interviews which were transcribed verbatim, coded and analysed thematically to extract the issues raised by participants and the practicalities of providing pharmacy services in general practice. RESULTS: Findings are reported under the themes of Complementarity (incorporating roles, skills, education and workloads); Integration (incorporating relationships, trust and communication) and Practicalities (incorporating location and space, access, and costs). Participants reported the need for time to develop and understand the various roles, develop communication processes and build inter-professional trust. Once these were established, however, experiences were positive and included decreased workloads, increased patient safety, improved job satisfaction, improved patient relationships, and enhanced cost savings. Areas for improvement included patients’ awareness of services; pharmacists’ training; and regular, onsite access for practice staff to the pharmacy team. CONCLUSIONS: Recommendations are made for the development of clear role definitions, identification of training needs, dedication of time for team building, production of educational materials for practice staff members and patients, and provision of on-site, full-time pharmacy services. Future work should focus on evaluation of various models of employing pharmacy teams in general practice; integration of pharmacists and pharmacy technicians into multidisciplinary general practice teams; relationships between local community pharmacy and general practice personnel; and patients’ service and information needs. A formal national evaluation of the pilot scheme is overdue. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12913-018-3056-3) contains supplementary material, which is available to authorized users. BioMed Central 2018-04-02 /pmc/articles/PMC5879559/ /pubmed/29609603 http://dx.doi.org/10.1186/s12913-018-3056-3 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Ryan, Kath
Patel, Nilesh
Lau, Wing Man
Abu-Elmagd, Hamza
Stretch, Graham
Pinney, Helen
Pharmacists in general practice: a qualitative interview case study of stakeholders’ experiences in a West London GP federation
title Pharmacists in general practice: a qualitative interview case study of stakeholders’ experiences in a West London GP federation
title_full Pharmacists in general practice: a qualitative interview case study of stakeholders’ experiences in a West London GP federation
title_fullStr Pharmacists in general practice: a qualitative interview case study of stakeholders’ experiences in a West London GP federation
title_full_unstemmed Pharmacists in general practice: a qualitative interview case study of stakeholders’ experiences in a West London GP federation
title_short Pharmacists in general practice: a qualitative interview case study of stakeholders’ experiences in a West London GP federation
title_sort pharmacists in general practice: a qualitative interview case study of stakeholders’ experiences in a west london gp federation
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5879559/
https://www.ncbi.nlm.nih.gov/pubmed/29609603
http://dx.doi.org/10.1186/s12913-018-3056-3
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