Abstract
BackgroundThe expansion of community pharmacy services is one solution to relieve pressure on general practice in the United Kingdom (UK). There is a paucity of research of general practitioners’ (GPs’) perspectives of quality of care in the community pharmacy sector.The purpose of this study was to explore GPs’:Conceptualisation of quality for community pharmacy services, including the management of acute (low acuity) conditions and defining indispensable aspects of the patient experience (‘always events’)Opinions regarding whether and how to measure quality in the community pharmacy sectorMethodSemi-structured interviews were conducted with GPs in the UK. GPs were recruited using the snowballing technique and professional networks. Interviews were audio-recorded, transcribed and analysed using an interpretive approach.ResultsInterviews were completed with 20 GPs from Scotland (n = 8) and England (n = 12). Multidimensional and inter-related concepts of quality were identified; most dimensions related to patient benefit, as well as impact on GP workload or other health service provision. Interviewees cautioned that “what counts can’t always be measured”. GPs’ expectations of quality often mirrored those of their own sector, but were ambivalent about the adoption of a quality outcome framework-type approach. Pharmacist involvement was expected to ensure quality in the management of ‘acute consultations’, however, GPs lacked awareness of community pharmacy personnel type, roles and training. Interviewees’ perceptions of quality varied by pharmacy type; independent pharmacies were sometimes associated with higher quality service delivery than larger chain organisations.ConclusionsQuality frameworks for community pharmacy services could be partly informed by GP experience and expectations, but need to be contextual to reflect differences between both settings. The importance of person-centred care, consistency and continuity was emphasised together with the need for competent personnel and privacy of interactions.
Highlights
The expansion of community pharmacy services is one solution to relieve pressure on general practice in the United Kingdom (UK)
Interviews were completed with 20 general practitioner (GP) from Scotland (n = 8) and England (n = 12)
Multidimensional and inter-related concepts of quality were identified; most dimensions related to patient benefit, as well as impact on GP workload or other health service provision
Summary
The expansion of community pharmacy services is one solution to relieve pressure on general practice in the United Kingdom (UK). The purpose of this study was to explore GPs’: Conceptualisation of quality for community pharmacy services, including the management of acute (low acuity) conditions and defining indispensable aspects of the patient experience (‘always events’). Each year in the United Kingdom (UK), an estimated 18 million general practitioner (GP) appointments (~ 13% of all consultations) are used for conditions suitable for treatment by community pharmacy personnel, either with non-prescription medicines and/or advice [1]. The suitability of community pharmacies for managing these conditions (hereafter referred to as acute consultations) is gaining recognition and support from primary care organisations and through national policies [2,3,4]. Many patients prefer to manage acute illness and ailments using self-care [8] with support from community pharmacy personnel. National quality indicators were introduced for community pharmacy in 2017 and have recently been updated in the new 5-year Community Pharmacy Contractual Framework [3], but none refer to the management of acute consultations despite these being regarded as the “shop window” of community pharmacy [15]
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