Negotiating new roles in general practice: a qualitative study of clinical pharmacists.

Background: To address general practice workforce shortages, policy in England has supported the recruitment of 'non-medical' roles through reimbursement funding. As one of the first to receive funding, the clinical pharmacist role offers insight into the process of new role negotiation at general practice level.

Aim: To identify factors influencing clinical pharmacist role negotiation at practice level, comparing the process under two different funding and employment models.

Developing consensus on the principles and key actions for collaborative working between general practices and community pharmacies: a modified eDelphi study.

Objectives: To develop consensus on the principles and key actions for collaborative working in practice between general practice, community pharmacy and patients and their carers.

Design: Three-round modified eDelphi study, starting from an established conceptual model of collaboration between general practitioners (GPs) and community pharmacists.

Setting: Community pharmacies and general practices in England, UK.

The use and impact of digital COVID-19 tracking in adult social care: a prospective cohort study of care homes in Greater Manchester.

Background: To support proactive care during the coronavirus pandemic, a digital COVID-19 symptom tracker was deployed in Greater Manchester (UK) care homes. This study aimed to understand what factors were associated with the post-uptake use of the tracker and whether the tracker had any effects in controlling the spread of COVID-19.

Methods: Daily data on COVID-19, tracker uptake and use, and other key indicators such as staffing levels, the number of staff self-isolating, availability of personal protective equipment, bed occupancy levels, and any problems in accepting new residents were analysed for 547 care homes across Greater Manchester for the period April 2020 to April 2021.

Implementation, uptake and use of a digital COVID-19 symptom tracker in English care homes in the coronavirus pandemic: a mixed-methods, multi-locality case study.

Background: COVID-19 spread rapidly in UK care homes for older people in the early pandemic. National infection control recommendations included remote resident assessment. A region in North-West England introduced a digital COVID-19 symptom tracker for homes to identify early signs of resident deterioration to facilitate care responses.

Evaluating the impact of a health hackathon on collaborative team science: a Social Network Analysis (SNA).

The Mount Sinai Health Hackathon is designed to provide a novel forum to foster experiential team science training. Utilizing a Social Network Analysis survey, we studied the impact of the Mount Sinai Health Hackathon on the nature of collaborative relationships of hackathon participants. After the event, the number of links between participants from different disciplines increased and network density overall increased, suggesting a more interconnected network with greater interdisciplinary communication.

Organisational factors associated with safety climate, patient satisfaction and self-reported medicines adherence in community pharmacies.

Background: Evidence suggests that community pharmacy service quality varies, and that this may relate to pharmacy ownership. However little is known about wider organisational factors associated with quality.

Objective: To investigate organisational factors associated with variation in safety climate, patient satisfaction and self-reported medicines adherence in English community pharmacies.

Skill-mix change in general practice: a qualitative comparison of three 'new' non-medical roles in English primary care.

Background: General practice is currently facing a significant workforce challenge. Changing the general practice skill mix by introducing new non-medical roles is recommended as one solution; the literature highlights that organisational and/or operational difficulties are associated with skill-mix changes.

Aim: To compare how three non-medical roles were being established in general practice, understand common implementation barriers, and identify measurable impacts or unintended consequences.

How do organisational configuration and context influence the quantity and quality of NHS services provided by English community pharmacies? A qualitative investigation.

Community pharmacies are expanding their role into medicines-related healthcare and public health services, previously the domain of physicians and nurses, driven by policies to improve healthcare access for patients and to address problems of increasing demands and rising costs in primary and urgent care services. Understanding the organisational context into which this expansion is taking place is necessary given concerns over the extent to which pharmacies prioritise service volume over the quality of service provision. As part of a larger programme of work, this paper aims to explore stakeholder perceptions of the organisational and extra-organisational factors associated with service quality and quantity in community pharmacy as an established exemplar of private sector organisations providing publicly-funded healthcare.

Evolution of the general practice pharmacist's role in England: a longitudinal study.

Background: To address the growing GP workforce crisis, NHS England (NHSE) launched the Clinical Pharmacists in General Practice scheme in 2015. The NHSE scheme promotes a newer, patient-facing role for pharmacists and, currently, there is little insight into the role and activities undertaken. All scheme pharmacists are enrolled on the general practice pharmacist training pathway (GPPTP).

Negotiating inter-professional interaction: playing the general practitioner-pharmacist game.

Despite a mutual interest in optimising the benefits of medication for patients, the general practitioner (GP) and community pharmacist (CP) often work in isolation from one another, both physically and figuratively. Sources of tension include pharmacy's 'shopkeeper' image, traditional medical hierarchies and potential encroachment on professional boundaries. This article examines GP and CP perceptions of their interactions and negotiations and, drawing on the works of Stein and Goffman, identifies a set of 'unwritten' rules, termed the 'GP-pharmacist game', which involves the concept of 'face-work'.

Organisational and extraorganisational determinants of volume of service delivery by English community pharmacies: a cross-sectional survey and secondary data analysis.

Objectives: This study aimed to identify the organisational and extraorganisational factors associated with existing variation in the volume of services delivered by community pharmacies.

Design And Setting: Linear and ordered logistic regression of linked national data from secondary sources-community pharmacy activity, socioeconomic and health need datasets-and primary data from a questionnaire survey of community pharmacies in nine diverse geographical areas in England.

Outcome Measures: Annual dispensing volume; annual volume of medicines use reviews (MURs).

Restructuring supervision and reconfiguration of skill mix in community pharmacy: Classification of perceived safety and risk.

Background: Broadening the range of services provided through community pharmacy increases workloads for pharmacists that could be alleviated by reconfiguring roles within the pharmacy team.

Objectives: To examine pharmacists' and pharmacy technicians (PTs)' perceptions of how safe it would be for support staff to undertake a range of pharmacy activities during a pharmacist's absence. Views on supervision, support staff roles, competency and responsibility were also sought.

Patient safety in healthcare preregistration educational curricula: multiple case study-based investigations of eight medicine, nursing, pharmacy and physiotherapy university courses.

Background: We sought to investigate the formal and informal ways preregistration students from medicine, nursing, pharmacy and the allied healthcare professions learn about patient safety.

Methods: We drew on Eraut's framework on formal and informal acquisition of professional knowledge to undertake a series of phased theoretically informed, in-depth comparative qualitative case studies of eight university courses. We collected policy and course documentation; interviews and focus groups with educators, students, health service staff, patients and policy makers; and course and work placement observations.

Changes to supervision in community pharmacy: pharmacist and pharmacy support staff views.

Pharmacists now offer increasing levels and ranges of clinical, diagnostic and public health services, which may require a pharmacist to be absent from the pharmacy premises. Currently, in the UK, many pharmacy activities legally require the direct supervision and physical presence of the pharmacist. This study aimed to explore the potential for changes to supervision, allowing pharmacist absence, and greater utilisation of pharmacy support staff.

The role of hidden curriculum in teaching pharmacy students about patient safety.

Objective: To examine how hidden and informal curricula shaped pharmacy students' learning about patient safety.

Methods: A preliminary study exploring planned patient safety content in pharmacy curricula at 3 UK schools of pharmacy was conducted. In-depth case studies were then carried out at 2 schools of pharmacy to examine patient safety education as delivered.

Integration and differentiation: a conceptual model of general practitioner and community pharmacist collaboration.

Background: The drive for integrative systems and collaboration across organizations and professions involved in the provision of health and social care has led to the development of a number of scales and models that conceptualize collaborative behavior. Few models have captured the dynamics of the collaboration between community pharmacy and general medicine, 2 professional groups that are increasingly being encouraged to adopt more collaborative practices to improve patient care.

Objectives: This article presents a new model of collaboration derived from interviews with general practitioners (GPs) and community pharmacists in England involved in service provision that required some form of collaboration.

The challenge of integrating community pharmacists into the primary health care team: a case study of local pharmaceutical services (LPS) pilots and interprofessional collaboration.

The aim of this paper is to investigate interprofessional collaboration between general practitioners (GPs) and pharmacists involved in the delivery of enhanced pharmacy services under the local pharmaceutical services (LPS) contract in England. Previous research suggests that a number of interprofessional barriers exist between community pharmacists and GPs which hinders the integration of community pharmacists into the primary health care team (PHCT). One of the aims of the LPS contract, introduced in England in 2002 as an alternative to national contractual arrangements, was to enable pharmacists to work more closely with other health care professionals.

Determinants of the uptake of medicines use reviews (MURs) by community pharmacies in England: a multi-method study.

Objectives: To explore and identify the key determinants influencing the uptake of medicines use reviews (MURs), a new community pharmacy service in England.

Methods: Survey of all primary care organisations (PCOs) in England (n=303, response rate=74%) and case study investigations of 10 PCOs, involving interviews with a purposive sample of 43 key stakeholders, including PCO, Local Pharmaceutical Committee and community pharmacy representatives. National data on MUR activity were also analysed and multiple linear regression was used to test determinants of MUR uptake.