A Pilot Study to Establish the Leadership Development Needs of Community Pharmacist Leads in Lambeth, South East London.

Primary care networks (PCNs) are geographical networks consisting of 30,000 to 50,000 patients and groups of general practices working in a multidisciplinary team, including community pharmacists. Community pharmacy (CP) neighbourhood leads act as a conduit between pharmacy contractors and general practitioners (GPs) in these networks, sharing information and providing a voice for the community pharmacy locally. The Lambeth medicines team (NHS South East London Integrated Care Board) recognised the need to continue funding these leadership roles to address barriers to relationship-building between community pharmacies and general practices, the consistency of service delivery and effective communication. The aim of this study was to understand the current experience of CP neighbourhood leads to inform their further development. All eight CP neighbourhood leads individually completed a semi-structured interview over Microsoft Teams, which was then reviewed using content analysis. Ethical approval was received. Leads reported the use of common communication methods such as emails, text messaging applications and telephone calls to engage GPs and pharmacies in their neighbourhoods. Barriers to undertaking their roles included time constraints, delays in responses, high workloads and competing pressures. Other factors impacting their effectiveness and ability to undertake their roles included the scheduling of meetings outside of working hours, finding time during busy working days and organising locum cover on an ad hoc basis. The leads also reported they spent more time focussed on building relationships with their peers and less time focussed on general practice colleagues. Support for CP neighbourhood leads could include ensuring that funded time is protected; communication and technology training; and the provision of more structural support for communication with GPs. The findings of this study can be used to inform future work.

General practice pharmacists in England: Integration, mediation and professional dynamics.

BACKGROUND: A number of key publications in recent years have advocated a more integrated vision of UK primary care involving increased multi-professional communication and understanding. This has resulted in a marked change in the roles being undertaken by pharmacists. Community pharmacists have traditionally provided a medicine supply function and treated minor ailments in addition to delivering a suite of locally commissioned services; however these functions have not necessarily been part of a programme of care involving the other clinicians associated with the patient. An integrated model of care would see much closer working between pharmacy and general practice but also with pharmacists not only working with, but in the practice, in an enhanced patient-facing role, trained as independent prescribers. This has implications for the dynamics amongst professionals in this environment. OBJECTIVES: This exploratory multiple case study attempts to explore these changing dynamics across ten GP surgeries throughout the South-East of England. METHODS: Semi-structured, in-depth interviews were conducted with one nurse, one pharmacist and one physician from each clinic, and survey data was collected from 38 patients who had appointments with a pharmacist. RESULTS: The data suggested that the pharmacists who had enhanced roles perceived some uncertainty about their professional role and identity, which resulted in instability and insecurity and that this uncertainty led to both professional and interprofessional tension with their primary care colleagues. The survey data revealed that n = 35 (92%) patients stated they were 'very satisfied' or 'satisfied' with their appointment. And n = 37 (97%) were 'very comfortable' or 'comfortable' discussing their medications with the pharmacist. In addition, 36 patients (95%) reported that they strongly agreed or agreed with the clinical recommendations made by the pharmacist. CONCLUSIONS: These findings are discussed in relation to role expansion and professional/interprofessional relations before key practical suggestions are offered.

Asthma-Targeted MURs: How Confident are Community Pharmacists in Delivering Different Interventions?

This study aimed to identify and determine the confidence level of community pharmacists in providing different interventions during asthma-targeted medicine use reviews (MURs). A self-administered questionnaire was posted to 487 pharmacies accredited to provide the service, across Greater London, Southampton, Cornwall, Sheffield and Norwich. A total of 122 responses were obtained, giving a response rate of 25% (122/487). Around half of the community pharmacists (51.6%) were providing more than 60 asthma-targeted MURs annually with inhaler technique being the most offered intervention and stepping up/down therapy being the least. The majority of community pharmacists (94.3%) were confident in providing inhaler technique advice, followed by smoking cessation (91%). However, confidence was less with relevant vaccination (61.5%) and stepping up/down patients' therapy (56.6%). Confidence level can vary between community pharmacists regarding different interventions provided during respiratory MURs. The results stress the need to promote community pharmacists' confidence in providing interventions such as stepping up/down therapy during asthma-targeted MURs. Additional research in this field is highly recommended in order to evaluate community pharmacists' confidence level on a national scale and to determine the factors influencing it. The study also suggests that provision of different interventions during respiratory MURs can be related to how community pharmacists perceive their role.