What free services do pharmacists offer? Investigating the provision of unfunded pharmacy services in community pharmacies.

Abstract

Globally, pharmacists report to be providing free or partially subsidised patient-focused services in order to meet healthcare needs of their communities. Budget cuts to pharmacy contracts are reported to challenge the provision of such services. Limited information exists identifying the types of unfunded services provided in community pharmacies. To identify the types of services which pharmacists report to provide that are not reimbursed by the government, insurance companies or paid for by the patient. Semi-structured focus group discussions with pharmacists were conducted stimulating narratives from community pharmacists across New Zealand about the types of unfunded pharmacy services they provide. Discussions were audio recorded and transcribed verbatim. Inductive coding of the data was carried out using QSR International Nvivo 11 for Windows. A semantic thematic analysis was carried out. Twenty-four pharmacists took part in the focus groups across five regions in both the North and South Islands of New Zealand. Key themes identified from focus groups were: 'Standalone unfunded services', 'Services funded elsewhere' and 'Leakages from the current funding model'. Pharmacists reported that unfunded patient-focused services accounted for 15%-50% of their daily activities. Pharmacists stated that they believed these services often led to reduction of disease progression, hospitalisations and improved quality of life. Pharmacists also stated that given budget cuts, these services are not sustainable. Pharmacists report to offer many professional services without remuneration. In some cases, these services make up a substantial part of the pharmacist's time. Further budgetary constraints and increased competition may put these services at risk of being lost. Findings from this study can be applied to unfunded pharmacy services elsewhere, as worldwide pharmacy faces many similar challenges, particularly where there are budget cuts and decreasing revenue in other jurisdictions.