Applying a whole systems lens to the general practice crisis: cross-sectional survey looking at usage of community pharmacy services in England by patients with long-term respiratory conditions

Abstract

ObjectiveUK policy initiatives aiming to extend community pharmacy services to moderate patient demands and to reduce general practitioners’ (GPs) workload have had limited success. This study used marketing theory to identify factors that could influence patients to make better use of community pharmacies within the primary care pathway.DesignCross-sectional postal survey design applying the ‘7Ps marketing mix’ (‘product’, ‘price’, ‘place’, ‘promotion’, ‘people’, ‘process’ and ‘physical evidence’).SettingGreater Manchester, England.ParticipantsPatients with asthma or chronic obstructive pulmonary disease registered at two GP practices.Primary outcomePatient preference for community pharmacy services.ResultsThe response rate was 29% (289/1003). Most respondents preferred to use GP practices for invasive/diagnostic services (product) while preferring using community pharmacy for medicines supply and minor ailments (place). Stronger preference for using GP practices over community pharmacy was significantly associated with gender (male>female), age group (≥65 years) and healthcare services previously accessed at the pharmacy. Respondents perceived they would be more likely to use community pharmacy services if pharmacists offered them enough time to discuss any concerns (73.3%) (price), if community pharmacies had private/clean consultation rooms (70%–73%) (physical evidence) and if pharmacy staff had strong interpersonal skills (68%–70%) (people). Respondents were divided on likelihood of using community pharmacy services if pharmacists could access their whole medical record but wanted pharmacists to add information about their visit (59.6%) (process). Respondents would be encouraged to use community pharmacy for healthcare services if they were offered services by pharmacy staff or recommended/referred to services by their GP (44%) (promotion).ConclusionsUsing the 7Ps marketing mix highlighted that community pharmacies having staff with strong interpersonal skills, good quality consultation rooms and integrated information systems could positively influence patients to use community pharmacies for management of long-term conditions. There are opportunities for community pharmacies to alleviate GP workload, but a whole system approach will be necessary.

Understanding the impact of a new Pharmacy Sore throat Test and Treat service on patient experience: A quantitative study

“…However, patient and public attitudes were influenced by frequency of service usage and the perceived impact or benefit from using these services, which is what we observed in our study. A recent cross-sectional survey looking at usage of community pharmacy services in England by patients with long-term respiratory conditions further reiterates our findings: most patients in the survey preferred to use GP practices for diagnostic services, but preference was associated with services previously accessed at the pharmacy [24]. Both studies identified professionalism of the whole pharmacy team and timeliness of consultations as features that enhance patient and public use of pharmacy services, in addition to convenience and ease of access, which were also identified by patients in our study.…”

“…Despite patients overall being broadly positive for pharmacists providing extended services, awareness is low [4,[24][25]. Increased collaboration between GPs and pharmacists has been identified as key to successful implementation and integration of new pharmacy services, with studies reporting these services not always perceived as beneficial or useful from the GPs' point of view [26][27].…”

Understanding the impact of a new pharmacy sore throat test and treat service on patient experience: A survey study

“…A recent crosssectional survey looking at usage of community pharmacy services in England by patients with long-term respiratory conditions further reiterates our findings: most patients in the survey preferred to use GP practices for diagnostic services, but preference was associated with services previously accessed at the pharmacy. 24 Both studies identified professionalism of the whole pharmacy team and timeliness of consultations as features that enhance patient and public use of pharmacy services, in addition to convenience and ease of access, which were also identified by patients in our study.…”

“…Despite patients overall being broadly positive for pharmacists providing extended services, awareness is low. 4,[24][25] Increased collaboration between GPs and pharmacists has been identified as key to successful implementation and integration of new pharmacy services, with studies reporting these services not always perceived as beneficial or useful from the GPs' point of view. [26][27] This study was part of a larger evaluation of the STTT service and findings need to be interpreted within this context.…”

On the frontline against COVID-19: Community pharmacists’ contribution during a public health crisis

“…45 In order to maximise community pharmacists' contribution to the health service and potential to alleviate GP workload, a whole system-level approach will be required. 46 As the pharmacy profession responds to COVID-19, innovative and extended methods of practice will be needed. For example, in order to promote social distancing and facilitate self-isolation while ensuring that patients continue to have access to vital pharmacy services, new methods of service delivery will play an increasing role.…”