Section 2 Relationship with local general

Section 2 of the interview schedules asked the pharmacists and general practitioners about the nature of their interprofessional relationships and the extent and nature of any social contact.

2.3.4.1 The nature o f the interprofessional relationship

The community pharmacists were asked to describe their relationship with each local general practitioner and the general practitioners were asked to describe their relationship with each local community pharmacist. The responses were categorised into positive, neutral and negative, as shown in Table 2.4.

Table 2.4: The community pharmacists (CPs) and general practitioners (GPs) responses, when asked to describe their relationships with the local general practitioners and community pharmacists respectively.

No. of positive responses given by:

CPs GPs

No. of neutral responses given by:

CPs GPs

No. of negative responses given by:

CPs GPs

11 17 4 3 5 0

The majority of the community pharmacists and general practitioners described their relationships in positive terms; no general practitioners initially responded

negatively. The positive responses given included: 'excellent', 'extremely good' 'very friendly'. The neutral responses included: 'OK', 'not bad' and 'reasonable '.

Chapter 2 - Interviews with CPs and GPs

The negative responses included: fairly poor 'very minimaV and 'no relationship

The probes following the main question asked the community pharmacists and general practitioners to elaborate on their responses. Four of the community

pharmacists, who had described their relationships with the local general practitioners in positive terms, qualified their responses by describing the way that their local general practitioners handled queries:

'Dealing with problems on prescriptions, any queries, are very happily dealt with \

One pharmacist described a reciprocal relationship:

'They are always asking fo r information and they are always willing to share any information that I need'.

Good communication was mentioned by another pharmacist: 'We can talk about everything'.

One community pharmacist had been instrumental in helping to set up three of the local general practices and was involved in the provision of patient orientated

services, including oxygen therapy and domiciliary visits, which he felt contributed to his 'excellent ' relationships.

Two community pharmacists who had initially described their relationships in positive terms, added that they felt the positive descriptions only applied to local single handed general practitioners and not to larger local practices:

'With the group practice we don't get much chance I think they are a long established practice and simply cope by themselves pretty well. They seem to be self sufficient '.

One community pharmacist, who initially described his relationships with the local general practitioners in positive terms, added that he felt there was 'scope fo r improvement ’ and that there needed to be greater understanding of each other’s roles.

The general practitioners, who had described their relationships with the local community pharmacists in positive terms, generally qualified their responses by further describing the local community pharmacists as: ‘helpfiiV, 'obliging' and

'understanding'. Two way communication was also mentioned: 'They ring me up; I can ring them up '.

The provision of supportive patient services by the community pharmacists, including prescription collection, medicine delivery, ordering items for particular patients and the provision of emergency supplies of medication, were also given as reasons to explain why the general practitioners had described their relationships in positive terms.

The four community pharmacists who gave a neutral response to the main question qualified their responses by saying that they did not really have a relationship with the local general practitioners and only had contact with them regarding prescription queries. Two of the general practitioners who responded in a neutral manner, expanded their responses when probed:

Chapter 2 - Interviews with CPs and GPs

'There is no personal relationship \

One of the five community pharmacists, who described his relationships with the local general practitioners in negative terms, had only been working at the pharmacy where he was interviewed for a period of a month and he hoped that he would be able to establish relationships with time. Negative responses were qualified by the other four community pharmacists by the following additional comments:

'The relationship...seems to he very one sided. She won't help u s’. 'They are not really interested in any kind o f communication \ 'The practices are not overly keen on getting involved at all \ 7 don't think the doctors appreciate what the pharmacist can do '.

Four general practitioners who had initially responded positively to the main question, added negative comments in response to the probes. The comments made by three of the general practitioners specifically applied to one or two local pharmacists:

'It is difficîdt to have a good relationship with people that you don't know. Sometimes some o f the advice that has been given is perhaps not the advice that I would have chosen fo r patients to have or the right sort o f approach '.

'We have some worries about one [o f the local community pharmacists] '. 'Sometimes you think that he would like to be a doctor and you have to remind him that he is a pharmacist \

'One or two you do get worries with sometimes because you fin d that they are defrauding the patients \

2.3.4,2 Social contact

Section 2 continued by asking the community pharmacists and the general

practitioners whether they had any social contact with their local general practitioners and community pharmacists respectively. Seventeen community pharmacists said that they did not have any social contact with the local general practitioners. Three

pharmacists said that they did have social contact with one local general practitioner; two reporting that the social contact took place at the pharmacy:

‘[One o f the local general practitioners] comes to the shop quite often; once or twice a week'.

‘Sometimes on a Saturday the doctor opposite will come down and have a chat

Reasons given by the pharmacists to explain why they did not have any social contact with the local general practitioners included: lack of time; not living in the area where they worked; lack of interest on behalf of the general practitioners; the fact that some general practitioners did have or may have established relationships with other local pharmacists and having only been in practice in the area for a short period of time.

Seventeen general practitioners said that they had no social contact with any of the local community pharmacists. The three general practitioners who said that they did have social contact, reported that they invited the local community pharmacists to the practice Christmas party. Two general practitioners gave reasons to explain the lack of social contact:

‘Chances are very limited'. ‘They are busy and we are busy '.

Chapter 2 - Interviews with CPs and GPs