Integration of a clinical pharmacist workforce into newly forming primary care networks: a qualitatively driven, complex systems analysis
Objective The introduction of a new clinical pharmacist workforce via Primary Care Networks (PCNs) is a recent national policy development in the National Health Service in England. This study elicits the perspectives of people with responsibility for local implementation of this national policy pac...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-11-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/11/e066025.full |
| _version_ | 1811223838100291584 |
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| author | Jim McCambridge Duncan Stewart Thomas Mills Mary Madden Brendan Gough |
| author_facet | Jim McCambridge Duncan Stewart Thomas Mills Mary Madden Brendan Gough |
| author_sort | Jim McCambridge |
| collection | DOAJ |
| description | Objective The introduction of a new clinical pharmacist workforce via Primary Care Networks (PCNs) is a recent national policy development in the National Health Service in England. This study elicits the perspectives of people with responsibility for local implementation of this national policy package. Attention to local delivery is necessary to understand the contextual factors shaping the integration of the new clinical pharmacy workforce, and thus can be expected to influence future role development.Design A qualitative, interview studySetting and participants PCN Clinical Directors and senior pharmacists across 17 PCNs in England (n=28)Analysis Interviews were transcribed, coded and organised using the framework method. Thematic analysis and complex systems modelling were then undertaken iteratively to develop the themes.Results Findings were organised into two overarching themes: (1) local organisational innovations of a national policy under conditions of uncertainty; and (2) local multiprofessional decision-making on clinical pharmacy workforce integration and initial task assignment. Although a phased implementation of the PCN package was planned, the findings suggest that processes of PCN formation and clinical pharmacist workforce integration were closely intertwined, with underpinning decisions taking place under conditions of considerable uncertainty and workforce pressures.Conclusions National policy decisions that required General Practitioners to form PCNs at the same time as they integrated a new workforce risked undermining the potential of both PCNs and the new workforce. PCNs require time and support to fully form and integrate clinical pharmacists if successful role development is to occur. Efforts to incentivise delivery of PCN pharmacy services in future must be responsive to local capacity. |
| first_indexed | 2024-04-12T08:40:27Z |
| format | Article |
| id | doaj.art-305bd1c35a56451b9bf30ab73eb337fd |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-12T08:40:27Z |
| publishDate | 2022-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-305bd1c35a56451b9bf30ab73eb337fd2022-12-22T03:39:55ZengBMJ Publishing GroupBMJ Open2044-60552022-11-01121110.1136/bmjopen-2022-066025Integration of a clinical pharmacist workforce into newly forming primary care networks: a qualitatively driven, complex systems analysisJim McCambridge0Duncan Stewart1Thomas Mills2Mary Madden3Brendan Gough4Department of Health Sciences, University of York, York, UKCentre for Primary Health and Social Care, London Metropolitan University, London, UKDepartment of Health Sciences, University of York, York, UKDepartment of Health Sciences, University of York, York, UKLeeds Beckett University, Leeds, UKObjective The introduction of a new clinical pharmacist workforce via Primary Care Networks (PCNs) is a recent national policy development in the National Health Service in England. This study elicits the perspectives of people with responsibility for local implementation of this national policy package. Attention to local delivery is necessary to understand the contextual factors shaping the integration of the new clinical pharmacy workforce, and thus can be expected to influence future role development.Design A qualitative, interview studySetting and participants PCN Clinical Directors and senior pharmacists across 17 PCNs in England (n=28)Analysis Interviews were transcribed, coded and organised using the framework method. Thematic analysis and complex systems modelling were then undertaken iteratively to develop the themes.Results Findings were organised into two overarching themes: (1) local organisational innovations of a national policy under conditions of uncertainty; and (2) local multiprofessional decision-making on clinical pharmacy workforce integration and initial task assignment. Although a phased implementation of the PCN package was planned, the findings suggest that processes of PCN formation and clinical pharmacist workforce integration were closely intertwined, with underpinning decisions taking place under conditions of considerable uncertainty and workforce pressures.Conclusions National policy decisions that required General Practitioners to form PCNs at the same time as they integrated a new workforce risked undermining the potential of both PCNs and the new workforce. PCNs require time and support to fully form and integrate clinical pharmacists if successful role development is to occur. Efforts to incentivise delivery of PCN pharmacy services in future must be responsive to local capacity.https://bmjopen.bmj.com/content/12/11/e066025.full |
| spellingShingle | Jim McCambridge Duncan Stewart Thomas Mills Mary Madden Brendan Gough Integration of a clinical pharmacist workforce into newly forming primary care networks: a qualitatively driven, complex systems analysis BMJ Open |
| title | Integration of a clinical pharmacist workforce into newly forming primary care networks: a qualitatively driven, complex systems analysis |
| title_full | Integration of a clinical pharmacist workforce into newly forming primary care networks: a qualitatively driven, complex systems analysis |
| title_fullStr | Integration of a clinical pharmacist workforce into newly forming primary care networks: a qualitatively driven, complex systems analysis |
| title_full_unstemmed | Integration of a clinical pharmacist workforce into newly forming primary care networks: a qualitatively driven, complex systems analysis |
| title_short | Integration of a clinical pharmacist workforce into newly forming primary care networks: a qualitatively driven, complex systems analysis |
| title_sort | integration of a clinical pharmacist workforce into newly forming primary care networks a qualitatively driven complex systems analysis |
| url | https://bmjopen.bmj.com/content/12/11/e066025.full |
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