Background

Recent legislation provides the framework for the development of Local Pharmaceutical Services (LPS).¹The government's strategy for pharmacy intends that LPS will allow pharmaceutical services to be provided under locally tailored arrangements, free from the restriction of the national remuneration system and terms of service.² The successful development and implementation of LPS requires the provision of services that meet the health needs of local populations. To plan such services, the opinions of stakeholders must be gathered. The key stakeholders in these services are patients, local health and social care personnel, and community pharmacists themselves. The objective of this study was to seek the opinions of these stakeholders in order to inform the LPS planning process.

Methods

The setting was a small town in the North West Region of the NHS. For each stakeholder group, an appropriate method was selected to reflect the level of engagement of each group in the process. Four hundred and fifty six pharmacy customers in 11 community pharmacies undertook a self-completion survey over 4 weeks between 16^th July and 14^th August 2001. Semi-structured telephone interviews with 28 primary health and social care professionals were conducted in July 2001. A two-round Delphi consultation was conducted with 18 community pharmacists between May and July 2001.³ Quantitative data from the patient survey were entered into a SPSS database, and descriptive and comparative statistical tests were employed. Interviewer notes from the stakeholder interviews were analysed qualitatively to identify common and contrasting themes. Responses to the first round of the Delphi survey were ranked and re-circulated to participants, resulting in a prioritised list of possible pharmacy services for development.

Results

The methods employed provided key stakeholders with a "voice" in the planning process. The patients were introduced to the idea that pharmacy services may change and were asked to give their opinion on the direction of change. An information leaflet included with the survey also provided patients with background information to the changes proposed. The other professionals were asked to consider their priorities for local health improvement and then engaged to consider how pharmacists might help them to meet their targets. From these interviews their priorities were mapped to a matrix of potential services. The pharmacists, who were already engaged with the planning process, were able to discriminate between proposed new services in a structured manner, with regard to three criteria: perceived patient benefit, professional satisfaction and feasibility.

Conclusion

The use of qualitative and quantitative methods with all relevant stakeholder groups has provided local pharmacists with a combined dataset that is being used to develop priorities in LPS planning.

References

1. House of Commons. Health & Social Care Act. HMSO: London 2001.
2. Department of Health. Pharmacy in the Future - Implementing the NHS Plan. London: DoH 2000
3. Jones J, Hunter D. Consensus methods for medical and health services research. BMJ 1995;311:376- 80.