How does the public conceptualise the quality of care and its measurement in community pharmacies in the UK : a qualitative interview study

Watson, Margaret C and Silver, Karin and Watkins, Ross (2019) How does the public conceptualise the quality of care and its measurement in community pharmacies in the UK : a qualitative interview study. BMJ Open, 9 (3). e027198. ISSN 2044-6055

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    Abstract

    Objectives This study explored citizens’ perspectives about the quality of community pharmacy services in the UK and whether and how the quality of community pharmacy services should be measured.Design Semistructured interviews and focus groups were conducted and were audio recorded, transcribed and analysed systematically using an interpretive approach.Participants Members of the public were approached via networks, such as Health and Social Care Alliance Scotland, as well as community groups and personal networks.Setting Scotland, England and Wales.Results Data were collected from 20 participants: 11 interviews and 2 focus groups (in community settings, with five and four participants). Quality was conceptualised as multidimensional with inter-related overarching themes of person-centredness, professionalism and privacy. The importance of relational aspects with pharmacy personnel was emphasised including the need for a ‘friendly’ caring service, continuity of care, being known to personnel, including their awareness of individual’s health conditions: ‘it’s quite a personal service I would say…I think it means that they care about your welfare’. Participants discussed the importance of a professional approach to customer interactions including staff behaviour and appearance. Pharmacy design influenced perceptions of privacy, including having sufficient space or a separate consultation room to promote confidential consultations with a pharmacist. Participants suggested that quality assurance is needed to improve quality and to inspire confidence in the public ‘it would drive up quality standards overall’ but suggested that quality ratings were unlikely to influence their use of specific pharmacies. They emphasised the need for multidimensional quality ratings and for transparency with their derivation.Conclusions The public conceptualises quality of community pharmacy services as multidimensional and value relational aspects of care provided by personnel in this setting. While the development and application of quality indicators may drive improvement, it seems unlikely to influence the public’s use of individual pharmacies.