Community Pharmacists' Views on the Early Stages of Implementation of a National Pilot Independent Prescribing Service in Wales: A Qualitative Study

Efi Mantzourani; Rhian Deslandes; Karen Hodson; Andrew Evans; Lydia Taylor; Cherie Lucas

doi:10.2147/IPRP.S395322

Community Pharmacists' Views on the Early Stages of Implementation of a National Pilot Independent Prescribing Service in Wales: A Qualitative Study

Integr Pharm Res Pract. 2023 Jan 27:12:11-23. doi: 10.2147/IPRP.S395322. eCollection 2023.

Authors

Efi Mantzourani^#^{1

2}, Rhian Deslandes^#¹, Karen Hodson^#¹, Andrew Evans³, Lydia Taylor¹, Cherie Lucas⁴

Affiliations

¹ Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, Wales, UK.
² Primary Care, Digital Health and Care Wales, NHS Wales, Cardiff, Wales, UK.
³ Primary Care Services, Welsh Government, Cardiff, Wales, UK.
⁴ Graduate School of Health (Pharmacy Discipline), University of Technology Sydney, Sydney, New South Wales, Australia.

^# Contributed equally.

Abstract

Background: A pilot Independent Prescribers' Service (IPS) was introduced in 13 community pharmacies across Wales in June 2020. Independent Pharmacist Prescribers (IPPs) could prescribe in the areas of management of acute conditions, contraception, or opioid withdrawal, as agreed with local commissioners. Access to the patients' medical records was provided via Choose Pharmacy, the national community pharmacy IT platform.

Objective: To explore the experiences of IPPs delivering the service and commissioners responsible for financial resources regarding the IPS in Wales.

Methods: A qualitative methodology was employed, with purposive sampling, semi-structured interviews, and inductive thematic analysis.

Results: Five themes were constructed from 13 interviews (n=9 IPPs; n=4 commissioners): (i) patient experience and safety; (ii) professional enablement and rebalancing workload of GPs; (iii) role and limitations of remote consultations; (iv) funding and business model; (v) functionality on Choose Pharmacy to support patient care. The design of the service allowed pharmacists to determine how best to deliver the IPS, maximizing access for patients and promoting a sense of professional value amongst pharmacists.

Conclusion: This study builds on the body of evidence on enhanced patient experience with prescribing services in the community, reinforcing that IPPs have a key role in rebalancing management of common conditions from GP surgeries to community pharmacies. Several considerations need to be addressed to ensure future success of the service implementation, delivery and enhanced sustainability, such as formal referral pathways and access to medical records. These can be used by other commissioning bodies in the UK and internationally to build a network of suitably supported IPPs, confident to appropriately deal with uncomplicated acute and chronic conditions; and liaise with primary and/or secondary care when referrals are needed.

Keywords: Choose Pharmacy; independent pharmacist prescribing; non-medical prescribing; patient experience; patient safety.