A qualitative exploration of the enablers and barriers to the provision of outpatient clinics by hospital pharmacists.

Abstract Background: With increasing demands on the National Health Service (NHS), Scottish Government-led pharmacy strategy has prioritised the development and expansion of modern outpatient services. Pharmacist-led outpatient clinics have been shown to reduce hospital admissions and improve patient outcomes. However, expanding these contemporary models of care has proved challenging, and there are few qualitative data about the factors affecting the provision of these.Aim: This study aimed to explore the enablers and barriers to hospital pharmacists providing outpatient clinics within the largest health authority in Scotland, NHS Greater Glasgow & Clyde (NHSGGC). Method: Between August and October 2020, one-to-one semi-structured interviews were conducted virtually using the videoconferencing platform Microsoft Teams®, with NHSGGC hospital pharmacists. Audio- and video-recordings of the interviews were transcribed in verbatim and underwent thematic analysis.Results: 16 hospital pharmacists were interviewed; 50% were clinic providers and 50% were not. Analysis generated seven themes: clinical or service need, individual psychological factors, clinic structure and processes, additional clinical skills and training, competing priorities, macro-level pharmacy working, and external stakeholder relationships.Conclusion: The enablers and barriers to hospital pharmacists providing outpatient clinics are multifaceted. Changes are required at the micro- and macro-level, with distributed leadership and system transformation remaining crucial. The forthcoming implementation of new professional curricula, should reconfirm whose role it is to develop such services and may enable pharmacists to overcome the individual and systematic barriers that prevent them from currently progressing the development of modern outpatient services; prospective research needs to accompany this vision.