A Survey of the Provision of Clinical Pharmacy Services in Relation to Existing Published Standards

Abstract

Objective– To investigate the provision of clinical pharmacy services in hospitals in one NHS region in UK, and to measure the delivery of these services against published standards. Method– The study comprised two phases. Phase 1 was a postal questionnaire to hospital chief pharmacists seeking information on the provision of clinical pharmacy in their hospital. Phase 2 involved a semi-structured interview with hospital chief pharmacists to obtain a detailed understanding of clinical pharmacy services in their hospital and factors influencing the provision of these services. Results– Ninety-four percent of all hospitals surveyed were providing a clinical pharmacy service. However, only two thirds provided a service to all wards, and the main reason given for not doing so, was lack of resources. There was a divergence of opinion amongst chief pharmacists whether it was better to provide a limited service to all wards or a good service to some wards. Thirty-seven percent of hospitals did not meet the minimum standard of frequency for visiting acute wards, whereas, 58 were meeting the optimal standard of frequency of visits for non-acute short stay wards and 67 for long stay wards, primarily because the latter required less frequent visiting. The study showed that hospital pharmacies were influencing prescribing decisions in a variety of ways other than ward visiting. Conclusion– Although hospital chief pharmacists see clinical pharmacy as a core service, published standards for these services are not being met. As a result of staff shortages, managers are using a variety of approaches to maintain clinical pharmacy services. There is scope for further devolvement of duties to pharmacy technicians in order to release valuable pharmacist time.