Integration of a clinical pharmacist workforce into newly forming primary care networks: a qualitatively driven, complex systems analysis

Journal article


Mills, T., Madden, M., Stewart, D., Gough, B. and McCambridge, J. (2022). Integration of a clinical pharmacist workforce into newly forming primary care networks: a qualitatively driven, complex systems analysis. BMJ Open. 12 (11). https://doi.org/10.1136/bmjopen-2022-066025
AuthorsMills, T., Madden, M., Stewart, D., Gough, B. and McCambridge, J.
Abstract

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.

Year2022
JournalBMJ Open
Journal citation12 (11)
PublisherBMJ
ISSN2044-6055
Digital Object Identifier (DOI)https://doi.org/10.1136/bmjopen-2022-066025
Web address (URL)https://bmjopen.bmj.com/content/bmjopen/12/11/e066025.full.pdf
Publication dates
Print03 Nov 2022
Publication process dates
Accepted05 Oct 2022
Deposited09 Nov 2022
Publisher's version
License
File Access Level
Open
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