New models of care in the NHS: exploring the role of community pharmacy

In 2014 NHS England published the Five Year Forward View (1). This sets out the problems and challenges facing the NHS, highlighting aging populations, rapid technological change, increasing patient expectations and a funding shortfall. The proposed solutions include what are called ‘new models’ of care, encouraging local commissioners and providers to work together to break down barriers between organisations and deliver seamless care to patients. A number of new models of care have been established, with 50 sites designated as pilots or ‘Vanguards’. Three of these models (multispecialty community providers, primary and acute care systems and extended services in care homes) focus upon developing collaborations between primary, secondary, community and social care, aiming to increase quality of care, reduce costs and increase the proportion of care provided outside hospitals. The role of community pharmacy will be vital in delivering this agenda, with many community pharmacists already supporting GP practices in rationalising their prescribing, working in care homes to reduce polypharmacy and delivering services such as contraception and self-care for minor illnesses in the community.

These developments give rise to a number of areas for research:
• Evaluating the role of community pharmacies and of employed pharmacists in new models of care, including analysis of outcomes
• Exploring the changing commissioning landscape for pharmacy services, including contracting and payment models for standard pharmacy services, as well as the commissioning of extended services
• Exploring the interactions within local health economies. How do pharmacists from different organisations engage with colleagues across organisational boundaries, and what are the factors influencing this?
• Investigating the implications for pharmacist identity and professionalism of engaging with different forms of service provision
• Research focusing upon organisational issues – how do factors such as employment model (eg salaried or business owner) impact upon the role played by pharmacists?

In the first year of the project, the successful student will be supported to refine their research topic, reviewing relevant literature, refining their research questions, designing their project and getting the research underway. Training will be provided consonant with the student’s previous training and skills. This will involve a mix of generic training around research design, as well as bespoke research methods training specific to the project as it develops.

In year two the focus will be upon supporting the student to prepare outputs for publication, as well as generic skills in preparing and delivering presentations. There will be ongoing support in acquiring skills necessary for project delivery.

In year three the focus will be upon thesis preparation and in preparing for employment post-PhD. Relevant training will be available depending upon the student’s needs.

Candidates are expected to hold, or about to obtain, a minimum upper-second (or equivalent) undergraduate degree in pharmacy, medicine, the social sciences or related areas. A related Masters qualification with a significant element of social research training methods and/or substantial (>2 years) research experience would be desirable.

The successful candidate will be expected to have a passion for working in research and a keen interest in policy and organisational issues in healthcare. A good understanding of UK NHS, community pharmacy or other health disciplines is welcome but not essential.

This project may be suitable for a pharmacist or academic clinical fellow interested in applying for an NIHR, ESRC or PRUK studentship.