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Integration of a clinical pharmacist workforce into newly forming primary care networks: a qualitatively driven, complex systems analysis
OBJECTIVE: The introduction of a new clinical pharmacist workforce via Primary Care Networks (PCNs) is a recent national policy development in the National Health Service in England. This study elicits the perspectives of people with responsibility for local implementation of this national policy pa...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9639102/ https://www.ncbi.nlm.nih.gov/pubmed/36328385 http://dx.doi.org/10.1136/bmjopen-2022-066025 |
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author | Mills, Thomas Madden, Mary Stewart, Duncan Gough, Brendan McCambridge, Jim |
author_facet | Mills, Thomas Madden, Mary Stewart, Duncan Gough, Brendan McCambridge, Jim |
author_sort | Mills, Thomas |
collection | PubMed |
description | OBJECTIVE: The introduction of a new clinical pharmacist workforce via Primary Care Networks (PCNs) is a recent national policy development in the National Health Service in England. This study elicits the perspectives of people with responsibility for local implementation of this national policy package. Attention to local delivery is necessary to understand the contextual factors shaping the integration of the new clinical pharmacy workforce, and thus can be expected to influence future role development. DESIGN: A qualitative, interview study SETTING AND PARTICIPANTS: PCN Clinical Directors and senior pharmacists across 17 PCNs in England (n=28) ANALYSIS: Interviews were transcribed, coded and organised using the framework method. Thematic analysis and complex systems modelling were then undertaken iteratively to develop the themes. RESULTS: Findings were organised into two overarching themes: (1) local organisational innovations of a national policy under conditions of uncertainty; and (2) local multiprofessional decision-making on clinical pharmacy workforce integration and initial task assignment. Although a phased implementation of the PCN package was planned, the findings suggest that processes of PCN formation and clinical pharmacist workforce integration were closely intertwined, with underpinning decisions taking place under conditions of considerable uncertainty and workforce pressures. CONCLUSIONS: National policy decisions that required General Practitioners to form PCNs at the same time as they integrated a new workforce risked undermining the potential of both PCNs and the new workforce. PCNs require time and support to fully form and integrate clinical pharmacists if successful role development is to occur. Efforts to incentivise delivery of PCN pharmacy services in future must be responsive to local capacity. |
format | Online Article Text |
id | pubmed-9639102 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-96391022022-11-08 Integration of a clinical pharmacist workforce into newly forming primary care networks: a qualitatively driven, complex systems analysis Mills, Thomas Madden, Mary Stewart, Duncan Gough, Brendan McCambridge, Jim BMJ Open Health Policy OBJECTIVE: The introduction of a new clinical pharmacist workforce via Primary Care Networks (PCNs) is a recent national policy development in the National Health Service in England. This study elicits the perspectives of people with responsibility for local implementation of this national policy package. Attention to local delivery is necessary to understand the contextual factors shaping the integration of the new clinical pharmacy workforce, and thus can be expected to influence future role development. DESIGN: A qualitative, interview study SETTING AND PARTICIPANTS: PCN Clinical Directors and senior pharmacists across 17 PCNs in England (n=28) ANALYSIS: Interviews were transcribed, coded and organised using the framework method. Thematic analysis and complex systems modelling were then undertaken iteratively to develop the themes. RESULTS: Findings were organised into two overarching themes: (1) local organisational innovations of a national policy under conditions of uncertainty; and (2) local multiprofessional decision-making on clinical pharmacy workforce integration and initial task assignment. Although a phased implementation of the PCN package was planned, the findings suggest that processes of PCN formation and clinical pharmacist workforce integration were closely intertwined, with underpinning decisions taking place under conditions of considerable uncertainty and workforce pressures. CONCLUSIONS: National policy decisions that required General Practitioners to form PCNs at the same time as they integrated a new workforce risked undermining the potential of both PCNs and the new workforce. PCNs require time and support to fully form and integrate clinical pharmacists if successful role development is to occur. Efforts to incentivise delivery of PCN pharmacy services in future must be responsive to local capacity. BMJ Publishing Group 2022-11-03 /pmc/articles/PMC9639102/ /pubmed/36328385 http://dx.doi.org/10.1136/bmjopen-2022-066025 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Health Policy Mills, Thomas Madden, Mary Stewart, Duncan Gough, Brendan McCambridge, Jim Integration of a clinical pharmacist workforce into newly forming primary care networks: a qualitatively driven, complex systems analysis |
title | Integration of a clinical pharmacist workforce into newly forming primary care networks: a qualitatively driven, complex systems analysis |
title_full | Integration of a clinical pharmacist workforce into newly forming primary care networks: a qualitatively driven, complex systems analysis |
title_fullStr | Integration of a clinical pharmacist workforce into newly forming primary care networks: a qualitatively driven, complex systems analysis |
title_full_unstemmed | Integration of a clinical pharmacist workforce into newly forming primary care networks: a qualitatively driven, complex systems analysis |
title_short | Integration of a clinical pharmacist workforce into newly forming primary care networks: a qualitatively driven, complex systems analysis |
title_sort | integration of a clinical pharmacist workforce into newly forming primary care networks: a qualitatively driven, complex systems analysis |
topic | Health Policy |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9639102/ https://www.ncbi.nlm.nih.gov/pubmed/36328385 http://dx.doi.org/10.1136/bmjopen-2022-066025 |
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