Examination of England's New Medicine Service (NMS) of complex health care interventions in community pharmacy

Abstract

Background

Public views of different sources of health advice:pharmacists, social media and mobile health applications

“…While few had used any pharmacy PH services, many were willing to use them once they became aware of what was offered. This echoes other studies that have shown that pharmacy services are not fully utilised and are not well advertised …”

Solidarity or dissonance? A systematic review of pharmacist and GP views on community pharmacy services in the UK

“…Pharmacists commonly voiced concerns over the lack of awareness of extended services particularly by patients and members of the public, but also among GPs. Studies reporting GP views confirmed their low awareness of extended services (Agomo, Portlock, & Ogunleye, ; Bradley, Ashcroft, & Noyce, ; Latif et al., ; Saramunee et al., ). Pharmacists believed that a lack of well‐defined roles made their responsibilities unclear to patients and GPs and led to services being perceived as crossing GP boundaries (Butterworth et al., ; Horsfield, Sheridan, & Anderson, ; Mantzourani, Richards, & Hughes, ; Morton, Pattison, Langley, & Powell, ).

The public doesn't fully understand what the pharmacy has to offer.

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“…GPs were generally less positive about extended pharmacy services (Atkins et al., ; Latif et al., ; Porteous & Bond, ; Wilcock & Harding, ). Some GPs did not see extended pharmacy services as a priority for them (Wilcock & Harding, ), were not convinced that these services reduced their workload (Atkins et al., ; Latif et al., ; Porteous & Bond, ) and preferred services to be simplified (Porteous & Bond, ; Wilcock & Harding, ). Even when GPs were supportive of community pharmacy services (Blenkinsopp, Tann, Evans, & Grime, ; Michie, Cameron, Glasier, & Greed, ; Morecroft et al., ; Wilcock & Harding, ), this was associated with suggestions that they supervised and authorised pharmacists’ activities (Blenkinsopp et al., ; Bradley et al., ; Maddox, Halsall, Hall, & Tully, ; Michie et al., ).

I guess we need to educate them, but I don't feel that's my responsibility…we're going to have to chase it up and make sure they are doing it properly.

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“…They acknowledged the need for community pharmacies to employ sufficient pharmacy staff to be able to manage and distribute responsibilities to provide a range of extended services. At times, pharmacists were reluctant to approach patients/provide extended services due to high workload (Evans, Wood, & Carter, ; Horsfield et al., ; Michie et al., ; Sohanpal et al., ) which was mainly linked to dispensing duties (Latif et al., ; Ogunbayo et al., ; Saramunee et al., ; Tucker & Stewart, ). Some reconfigured service delivery (Latif et al., ; Morton et al., ; Sohanpal et al., ) or prioritised information provided due to high workload (Sturrock, Preshaw, Hayes, & Wilkes, ).

There's just not enough pharmacist hours in branch to do everything that pharmacists need to do … because we are busy you kind of don't drive it as much as you could (Pharmacist, Evans et al., )

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“…Despite both pharmacists and GPs acknowledging the importance of collaboration to optimise the provision of extended services, they commonly perceived collaboration to be poor. This perception was influenced by GPs’ negative attitudes towards pharmacists (Agomo, Ogunleye, & Portlock, 2016b; Campion et al., ; Evans et al., ; George et al., 2006b; Latif et al., ; Urban et al., ; Wilcock & Harding, ), GPs being suspicious of pharmacists’ financial motives (Urban et al., ) and competition for services (Agomo et al., 2016b; Evans et al., ; Latif et al., ; Wilcock & Harding, ). Examples of poor engagement included lack of GP availability (Mackridge, Beynon, McVeigh, Whitfield, & Chandler, ; Savage et al., ), patient referrals (Latif et al., ; Lucas & Blenkinsopp, ; Pumtong et al., ) and feedback (Akram et al., ; Urban et al., ).

The only way I think everything could improve would be to have some way of getting the GPs back into the loop and stressing to them how important it is that patients know about any new medications they've been put on… For any service to work you need to have everybody engaged with the actual service and it's just this problem that the lack of responses from GPs.

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