Exploring the impact of pharmacist prescribers in secondary care

Non-medical prescribers are healthcare professionals who are not doctors or dentists but who, after attaining an advanced qualification in prescribing, are legally permitted to prescribe medicines, dressings and appliances. In the United Kingdom, there are approximately 4000 pharmacist prescribers working in secondary care, primary care and the community pharmacy settings. Pharmacist prescribing in secondary care is increasing and changing in the type of prescribing being done. Initially, pharmacist prescribers were specialist pharmacists but more recently, they are being introduced into a much more generalist role, such as prescribing all medication on hospital admission or discharge. This change has occurred, in many cases, as a response to the Carter report. Lord Carter was commissioned by the government to review efficiency opportunities in the NHS. In his report, issued in February 2016, there are a range of recommendations made relating to hospital pharmacy and medicines optimisation, and this has resulted in a national programme of hospital pharmacy transformation. In response to the recommendations set out in the Carter Report, Lancashire Teaching Hospitals has developed a Hospital Pharmacy Transformation Plan, including nine key actions. This studentship will focus on evaluating the second of these actions: increasing the utilisation of pharmacists as prescribers, particularly increased use of pharmacist prescribers in generalist roles. The study will take a mixed methods approach, combining qualitative and quantitative methodologies. In the first year of the PhD, the student will undertake a review of the literature describing the development of pharmacist prescribers, their roles and responsibilities, and the impact of these roles. This will inform the fine tuning of the subsequent research methods employed which could include qualitative interviews with pharmacist prescribers, pharmacy technicians, nursing and medical staff at the Trust; observational methods; documentary analysis; the secondary analysis of administrative data; and primary outcome data collection.

Candidates will have opportunities to undertake appropriate training to support their development of skills in research methods (including qualitative [interviews, focus groups, observation] and quantitative [survey, experimental] research techniques). In addition, all PhD students in the Division of Pharmacy and Optometry can take part in training and development provided by the Faculty, with networking with peers actively encouraged to support career and professional development.

The Division of Pharmacy and Optometry hosts a thriving community of researchers from postgraduate students up to professorial level in both the pharmaceutical sciences and pharmacy practice. Within the Drug Usage and Pharmacy Practice (DUPP) group, there are currently over 20 postgraduate students and postdoctoral researchers from a variety of disciplinary backgrounds including pharmacists, organisational psychologists, and sociologists undertaking studies in prescribing, workforce behaviour, patient safety, and pharmacoepidemiology. This PhD project will be supervised by Drs Mary Tully and Sally Jacobs, with additional input from the chief pharmacist at Lancashire Teaching Hospitals. Our current research programme includes investigations of the process and outcomes of prescribing in secondary care, clinical productivity in community pharmacy, stress and well-being in the pharmacy workforce and the training and development of pharmacy professionals.