Development of consensus guidance to facilitate service redesign around pharmacist prescribing in UK hospital practice

Antonella Tonna, Dorothy McCaig, Lesley Diack, Bernice West, Derek Stewart
International Journal of Clinical Pharmacy 2014, 36 (5): 1069-76

BACKGROUND: The last decade has seen a drive towards non-medical prescribing in the United Kingdom (UK). However, there is a dearth of any published literature on applying the principles of service redesign to support pharmacist prescribing in any sphere of practice.

OBJECTIVE: To develop consensus guidance to facilitate service redesign around pharmacist prescribing.

SETTING: UK hospital practice.

METHODS: The Delphi technique was used to measure consensus of a panel of expert opinion holders in Scotland. Individuals with key strategic and operational roles in implementing initiatives of pharmacy practice and medicines management were recruited as experts. An electronic questionnaire consisting of 30 statements related to pharmacist prescribing service redesign was developed. These were presented as five-point Likert scales with illustrative quotes.

MAIN OUTCOME MEASURES: Consensus, defined as 70 % of panel members agreeing (ranked strongly agree/agree) with each statement.

RESULTS: Responses were obtained from 35/40 (87.5 %) experts in round one and 29 (72.5 %) in round two. Consensus in round one was achieved for 27/30 of statements relating to aspects of generic 'service development' (e.g. succession planning, multidisciplinary working, quality evaluation, practice development and outcome measures) and 'pharmacist prescribing role development' (e.g. education and future orientation of service). Issues of disagreement were around targeting of pharmacist prescribing to clinical specialities and financial remuneration for prescribing in the hospital setting.

CONCLUSION: Consensus guidance has been developed to facilitate service redesign around hospital pharmacist prescribing.

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