Past and current involvement in

In order to explore the extent and nature of past and current interprofessional collaboration, the community pharmacists and general practitioners were asked if: they had ever attended any joint meetings, workshops or study days; whether they were invited to attend meetings by local general practitioners/community pharmacists respectively; whether they invited local general practitioners/community pharmacists to attend meetings and whether they were currently or had been involved in any joint projects.

Meetings, workshops and study days.

Thirteen community pharmacists had never been to any joint meetings, workshops or study days; seven had. Four of the seven pharmacists were pharmacy managers at

Chapter 2 - Interviews with CPs and GPs

branches of a multiple or a small chain, two were independent proprietor pharmacists and one was the second pharmacist at the branch of a multiple. The seven

pharmacists reported attending a total of 17 such events, ranging from two to four per pharmacist. The majority of the joint events were organised by the FHSAs. One pharmacist reported attending a joint event organised by a drug company. The format of the events varied; some were whole study days with guest speakers in the morning and workshops in the afternoon and others were afternoon or evening

meetings. Six of the seven pharmacists, who had attended these events, felt that more pharmacists than general practitioners had attended. Subjects covered at the meetings and study days included: PACT data interpretation; pharmacy audit; liaison between general practitioners and community pharmacists and health promotion. Some of the joint events attended had been clinical meetings and topics covered had included:

cardiology, oral health, diabetes, dermatology and arthritis. On the whole the pharmacists felt that the benefits of such events were educational. One pharmacist reported:

'There is really no social aspect; there could be but everyone is very pushed fo r time \

Time, funding and finding locum cover were reported as the barriers to attending such events by the community pharmacists who had never attended.

Fifteen general practitioners reported that they had never attended any joint meetings, workshops or study days; five had. Three of the five general practitioners were single handed, one was the senior partner in a two general practitioner practice and the fifth

was a general practitioner partner in a practice with six general practitioners. Two general practitioners reported that they had attended only one such event, organised by the FHS A. The joint meeting attended by one general practitioner had focused on prescribing practice. The second general practitioner had been to a joint workshop on formulary development. Two general practitioners had each attended one joint promotional event organised by a drug company. The fifth general practitioner had attended a joint clinical course organised by the medical audit advisory group (MAAG) looking at heart disease prevention, lipid monitoring and contraception.

Invited to meetings

Sixteen community pharmacists reported that they had never been invited to a

meeting at any of the local general practices; four pharmacists reported that they had. Two of the pharmacists were independent pharmacist proprietors, one was a

pharmacy manager at a branch of a small chain and the fourth was a pharmacy manager at a branch of a multiple. The two pharmacist managers each reported that they had attended monthly meetings at a local general practice where they had previously worked. One reported that the meetings had involved discussions centred around prescribing issues; the other reported educational monthly meetings for the whole of the primary health care team. One independent pharmacist proprietor had attended a single meeting at a local general practice together with other local pharmacists, nurses and midwives to discuss nurse prescribing. The second

independent pharmacist proprietor reported currently attending regular meetings at two of his local general practices, at which they discussed:

Chapter 2 - Interviews with CPs and GPs

'All and sundry from the business plan to staffing \

Although no other pharmacists reported attending meetings in person, the second pharmacist at an independent pharmacy reported that the proprietor pharmacist had attended a meeting at a local general practice to discuss asthma medication and inhalation devices.

None of the general practitioners reported having ever been invited to attend a meeting by a local pharmacist.

Invited a general practitioner/community pharmacist to a meeting

Eighteen pharmacists reported that they had never organised a meeting and invited a local general practitioner or practitioners to attend; two pharmacists had. One pharmacist, a manager at a branch of a multiple, had invited local general

practitioners, their receptionists and all the staff from the nursing homes where they provided a pharmaceutical service to come to the pharmacy one evening. The visitors were given an explanation and demonstration of the monitored dosage system used in the nursing homes and a tour of the dispensary. The second pharmacist had invited local general practitioners to the pharmacy where he had previously worked. He had shown them around and they had discussed over the counter prescribing.

Although no other pharmacists reported having organised such meetings for local general practitioners, one pharmacist had invited the receptionists from one local

practice to the pharmacy where he had worked previously, to show them the monitored dosage system that he supplied to the local nursing home. Another pharmacist, the second pharmacist at a branch of a multiple, reported that she was involved in an informal scheme whereby the general practitioner trainee at the local practice attended the pharmacy for up to a week during his/her training period and the pre-registration pharmacy graduate at the pharmacy spent time at the local practice.

Three general practitioners reported that they had invited local community pharmacists to the general practice for a single meeting in the past. One of those general practitioners also reported that a local community pharmacist had, in the past, been invited to attend a few practice meetings when the development of drug

protocols was discussed.

Projects

The community pharmacists and general practitioners were asked if they were currently involved in a project with any local general practitioners/community

pharmacists respectively or if they had been in the past. Two independent proprietor pharmacists replied that they were currently involved in a joint project. The second pharmacist at a branch of a multiple was also supposed to be involved in a joint project but it had foundered. One single handed general practitioner reported

involvement in a joint project and another general practitioner, the senior partner in a two general practitioner practice, was intending to set up a joint project.

Chapter 2 - Interviews with CPs and GPs

One independent proprietor pharmacist reported being involved in an FHSA project concerned with primary health care team work. The ‘team’ consisted of all primary health care professionals who would visit a housebound patient at home, plus any others who could provide a service that a housebound patient might need and, therefore, could join the team as and when required. In order to fulfil his role in the team, the pharmacist had attended a domiciliary care training programme. The project involved improving communication between all the team members by the use of a file kept at the patient’s home. Any team member who visited the patient had access to the file and could make notes in it for future reference. The pharmacist explained that this was a pilot project and if successful could be implemented throughout the FHSA.

The second independent proprietor pharmacist was involved in a formulary

development project, organised jointly by the practice and pharmacist. Discussions were often opportunistic, but a more formal structure would be adopted for the writing stage of the project.

The failed joint project reported by the third community pharmacist was a formulary development project, organised by the FHSA. Six meetings had been held at the FHSA for the participating pharmacists (approximately 20) to facilitate their involvement in formulary development, followed by two joint meetings for the community pharmacists and their partner general practitioners. However, the pharmacist had heard nothing further from the general practitioner or his practice,

despite a clear agenda set out by the FHSA and apparent enthusiasm from both parties.

One general practitioner reported that he was involved in a formulary development project with one local community pharmacist and together they had attended a

formulary development meeting at the FHSA. A second general practitioner reported that he was intending to set up a formulary development project, currently at the planning stage.