Few research projects are completed without the support of many and this one is no exception. We are grateful to the Leverhulme Trade Charities Trust who provided the funding which made this research investigation possible. We would also wish to acknowledge all the support provided by the University of Ulster and the Queen's University of Belfast (QUB) throughout the two years of the research. In particular we would like to acknowledge the help received from the following staff of the University of Ulster at Jordanstown: Alastair Gilmore, Chief Technician of the Faculty of Social and Health Sciences, for all his help and advice on technical matters; Joe O'Neill for his technical assistance and enduring good nature during the many hours spent videorecording in pharmacies; Philip Burch for his time, skill and patience in producing, often at short notice, the necessary graphic materials; and the staff of the Education and Technical Unit for all their assistance during the long days of video editing. We owe a very real debt of gratitude to Fidelma Haffey, research assistant in the Department of Communication at UUJ, who devoted a great deal of time and expertise to the video editing and who also contributed ideas about the research project itself and always with such infectious good humour. Thanks are also due to Mary Duffy, research assistant in the Department of Communication at UUJ, for her help at the stage of analysis of videotapes. We are equally appreciative of all the support received from the staff of the School of Pharmacy, QUB, especially that from Mr Alan Robinson for his goodwill during the stages of data analysis and write up, and Ms Lesley Crawford for her constant and invaluable help during the second phase of the project. Finally, we are indebted to the 15 community pharmacists who participated in the study. They not only gave so generously of their time and hospitality during the long hours of recording, but shared their wisdom and experience during the sometimes exhausting evening periods of tape analysis and skill categorisation. An essential part of this research was that all pharmacists and patients would remain anonymous, so to all these unsung individuals we here express our sincere gratitude. 4 Chapter 1: Background to the Study Communication and Health Care The last decade has witnessed an ever increasing appreciation of the role of communication in the delivery of health care and of the importance of the interpersonal skills of health professionals. The former reliance upon a medical model of care has been replaced by a more patient-centred approach in which the relationship with patients is seen as an important part of treatment (Stewart and Roter, 1989). The impetus to improve communication has also been stimulated by a more consumerist attitude on the part of patients who are increasingly prepared to question services and indeed treatments (Armstrong, 1991; Skipper, 1992). Furthermore, within the U.K. the recently published Patients' Charter (Department of Health, 1991) now officially de...