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How do pharmacists in English general practices identify their impact? An exploratory qualitative study of measurement problems
Background: In England, there is an ongoing national pilot to expand pharmacistsâ presence in general practice. Evaluation of the pilot includes numerical and survey-based Key Performance Indicators (KPIs) and requires pharmacists to electronically record their activities, possibly by using activity codes. At the time of the study (2016), no national evaluation of pharmacistsâ impact in this environment had been formally announced. The aim of this qualitative study was to identify problems that English pharmacists face when
measuring and recording their impact in general practice.
Methods: All pharmacists, general practitioners (GPs) and practice managers working
across two West London pilot sites were invited, via e-mail, to participate in a focus group study. Appropriately trained facilitators conducted two audio-recorded, semi-structured
focus groups, each lasting approximately one hour, to explore experiences and
perceptions associated with the KPIs. Audio-recordings were transcribed verbatim and
the data analysed thematically. Results: In total, 13 pharmacists, one GP and one practice manager took part in the study. Four major themes were discerned: inappropriateness of the numerical national KPIs (âwhether or not we actually have positive impact on KPIs is beyond our controlâ); depth and breadth of pharmacistsâ activity (âwe see a huge plethora of different patients and go through this holistic approach - everything is looked atâ); awareness of practice based pharmacistsâ roles (âI think the really important [thing] is that everyone knows what pharmacists in general practice are doingâ); and central evaluation versus local initiatives (âthe KPIs will be measured by National Health Service England regardless of what we thinkâ versus âwhat I think is more pertinent, are there some local things weâre going to measure?â). Conclusions: Measures that will effectively capture pharmacistsâ impact in general practice should be developed, along with a set of codes reflecting the whole spectrum of pharmacistsâ activities. Our study also points out the significance of a transparent, robust national evaluation, including exploring the needs/expectations of practice staff and patients regarding pharmacistsâ presence in general practice