Pharmacists' and mentors' views on the introduction of pharmacist supplementary prescribing: a qualitative evaluation of views and context

Abstract

Abstract Objective Supplementary prescribing has been a major policy initiative in the UK, which has seen pharmacists and nurses assume greater responsibility for prescribing in collaboration with doctors. This study explored the views and professional context of pharmacists and physicians (who acted as their training mentors), prior to the start of supplementary prescribing training. Setting Primary and secondary healthcare settings in Northern Ireland. Method All pharmacists (n = 63) from the first four cohorts enrolled for supplementary prescribing training in Northern Ireland were invited to participate in a series of focus groups, while mentors (n = 54) were asked to participate in face-to-face semi-structured interviews; the research took place between September 2003 and April 2005. All discussions/interviews were audiotaped and transcribed, and analysed using constant comparison. Key findings Nine pharmacist focus groups were convened (number per group ranging from 4 to 8; total n = 47) and 35 semi-structured interviews with mentors were conducted. The four main themes that emerged were internal drivers, benefits and concerns, relationships, and beyond the current professional comfort zone. Supplementary prescribing was broadly welcomed by both professional groups and was anticipated to produce improvements in patient care and interprofessional relationships, but there were some concerns about loss of diversity, deskilling of junior doctors, safety and professional encroachment. Caution was expressed with regard to a further extension of prescribing rights, particularly in relation to the role of pharmacists in diagnosis and independent prescribing decision making. Conclusion Although supplementary prescribing was viewed positively, these findings should be considered in the light of more recent developments in prescribing rights for other health professionals, including pharmacists.