Improving pharmaceutical care within the A&E setting (WRIGHTU15UEA)

The aim of this PhD studentship is to identify the opportunities for improving pharmaceutical care in the Accident and Emergency setting (A&E). Hospital pharmacists in England routinely provide medicines information advice, undertake medicines reconciliation, review prescribed therapy for effectiveness and safety, provide education and training to other healthcare professionals, support medicines self-administration, enforce local prescribing guidelines and policies whilst also being responsible for all medicines procurement, supply and storage. With increasing demand A&E departments in the UK, where the pharmacists has traditionally been relatively limited, are currently reviewing how they can better meet government targets. A new role in triage and response to minor ailments and medicines related attendance has already been identified and reported. We hypothesise that the pharmacists can become an integral member of the A&E team and that there are a wide range of opportunities for improving pharmaceutical care within this setting.

This PhD studentship will consist of a number of phases which are designed to test our hypothesis and develop a model for the provision of pharmaceutical care in the A&E setting. Each phase will be co-dependent and as with all PhDs exact content and nature will be decided by the successful applicant as the PhD progresses.

The successful candidate will be expected to develop a deep understanding of pharmaceutical care and to review the literature systematically in order to identify different pharmacist roles in the A&E setting, the impact of electronic prescribing systems and the quality of evidence underpinning these.

The PhD student may then undertake some observational research, shadowing different healthcare professionals and looking at prescribing errors and the interplay with electronic prescribing systems in A&E to identify the areas where pharmaceutical care could be enhanced or the pharmacist could undertake roles to improve the use of skill mix in this setting. Qualitative research methods may also be employed to understand the perspectives of different employees within the A&E setting with respect to the future integration of the pharmacist and enhancement of pharmaceutical care. Estimation of the quantitative impact of an A&E pharmacist on length of stay and admission avoidance may also be included.

The effectiveness of the current service provided to A&E may be evaluated and if identified as appropriate to test new models of working may be employed, piloted and evaluated using traditional quantitative and qualitative research methodologies.

The evidence from the literature review, qualitative research, local piloting and service evaluation will then be used to propose a new model of pharmaceutical care with A&E.

A PhD in health services research is seen as providing training in research and as such the successful applicant will be expected to attend basic and advanced courses in health services research, undertake bespoke courses dependant on their identified training needs and attend conferences to ensure that their research and methodological approaches are current.

We are seeking a UK registered pharmacist, preferably with hospital pharmacy experience.