Abstract/Summary

Background: There has recently been a drive to integrate pharmacists into UK general practices to tackle workload pressures and enhance patient access to healthcare. Although not a new role, it is the first time that pharmacist presence in general practice is being formally funded and tested. Therefore, little is known about how pharmacists in general practices impact the wider healthcare system. Aim: To build evidence on the impact of pharmacists in general practice, via in-depth elicitation of stakeholder experiences. Methods: A multi-method, ‘realistic’ approach was followed, including qualitative focus groups with general practice-based staff to identify impact measurement problems for pharmacists in general practice; an e-Delphi study to reach consensus, amongst experts, on what pharmacist activities are important to record as part of impact identification; and qualitative interviews with community pharmacy teams and patients to explore their experiences of general practice-based pharmacists. Focus groups and interviews were audio-recorded and transcribed verbatim. Qualitative data was analysed thematically and quantitative data via descriptive statistics. Results: Pharmacists carry out various valuable services in general practice, however, the majority of existing national measures are not fit for purpose in targeting pharmacist work and capturing the whole spectrum and quality of services. There was agreement on recording primarily funding-related activities, which included medication reviews, high-risk drug monitoring and medicines reconciliations. Pharmacy colleagues in general practices and community pharmacies are willing to develop mutual relationships, which could result in stronger links between the two settings and streamlined workloads. Patients are satisfied with easy access to a pharmacist in general practice who is able to interact with them at a high standard. Lack of awareness, however, limits uptake of pharmacist-led services. Conclusions: General practice-based pharmacists could better link different healthcare teams and enhance accessibility to, and quality of, primary care services. Ways to effectively capture pharmacist impact are still needed. Findings will inform policy attempting to frame pharmacist services in general practice as per needs and expectations of stakeholders.