Development of consensus guidance to facilitate service redesign around pharmacist prescribing in UK hospital practice
- 326 Downloads
Background The last decade has seen a drive towards non-medical prescribing in the United Kingdom (UK). However, there is a dearth of any published literature on applying the principles of service redesign to support pharmacist prescribing in any sphere of practice. Objective To develop consensus guidance to facilitate service redesign around pharmacist prescribing. Setting UK hospital practice. Methods The Delphi technique was used to measure consensus of a panel of expert opinion holders in Scotland. Individuals with key strategic and operational roles in implementing initiatives of pharmacy practice and medicines management were recruited as experts. An electronic questionnaire consisting of 30 statements related to pharmacist prescribing service redesign was developed. These were presented as five-point Likert scales with illustrative quotes. Main outcome measures Consensus, defined as 70 % of panel members agreeing (ranked strongly agree/agree) with each statement. Results Responses were obtained from 35/40 (87.5 %) experts in round one and 29 (72.5 %) in round two. Consensus in round one was achieved for 27/30 of statements relating to aspects of generic ‘service development’ (e.g. succession planning, multidisciplinary working, quality evaluation, practice development and outcome measures) and ‘pharmacist prescribing role development’ (e.g. education and future orientation of service). Issues of disagreement were around targeting of pharmacist prescribing to clinical specialities and financial remuneration for prescribing in the hospital setting. Conclusion Consensus guidance has been developed to facilitate service redesign around hospital pharmacist prescribing.
KeywordsConsensus guidance Pharmacist prescribing Secondary care Service redesign United Kingdom
The authors would like to acknowledge the participation of all external opinion holders.
The research was funded by Robert Gordon University.
Conflicts of interest
There are no conflicts of interest to declare.
- 2.Latter S, Blenkinsopp A, Smith A, Chapman S, Tinelli M, Gerard K, Little P, Celino N, Granby T, Nicholls P, Dorer G. Evaluation of nurse and pharmacist independent prescribing. London: Department of Health; 2010.Google Scholar
- 3.Department of Health (2014) Non-medical prescribing programme. http://www.dhsspsni.gov.uk/non-medical-prescribing. Accessed Jul 2014.
- 6.General Pharmaceutical Council (2014) Indicative curriculum for the education and training of pharmacist independent prescribers, London. http://www.pharmacyregulation.org/sites/default/files/Pharmacist%20Independent%20Prescribing%20-%20Learning%20Outcomes%20and%20Indicative%20Content.pdf. Accessed Jul 2014.
- 7.George J, McCaig D, Bond C, Cunningham S, Diack L, Watson A, Stewart D. Supplementary prescribing: early experiences of pharmacists in Great Britain. Ann Pharmacother. 2006;40:843–1850.Google Scholar
- 8.Smalley L. Patients’ experiences of pharmacist-led supplementary prescribing in primary care. Pharm J. 2006;276:567–9.Google Scholar
- 17.NHS Institute for Innovation and Improvement (2014) Quality and service improvement tools. http://www.institute.nhs.uk/quality_and_service_improvement_tools/quality_and_service_improvement_tools/role_redesign.html. Accessed Jul 2014.
- 23.McDermott JH, Caiola SM, Kuhn KF, Stritter FT, Beza J. A Delphi survey to identify the components of a community pharmacy clerkship. Am J Pharm Ed. 1995;59:334–41.Google Scholar
- 31.NHS Health Development Agency. Clarifying health impact assessment, integrated impact assessment and health needs assessment. London: Health Development Agency; 2003. ISBN 1-84279-242-3.Google Scholar
- 32.Tolson D, West B. An exploration of role development in nursing and midwifery. Edinburgh: NHS Health Scotland; 2002.Google Scholar