A qualitative exploration of barriers and enablers to providing autonomous independent pharmacist prescribing for common clinical conditions in community pharmacy.

INTRODUCTION: In 2020, a national Pharmacy First Plus (PF+) service was introduced in Scotland to enhance healthcare access by enabling community pharmacists with an independent prescribing qualification to diagnose, manage and autonomously prescribe for a wider range of common clinical conditions. Data demonstrated service delivery is variable. OBJECTIVES: This study aimed to explore the barriers and enablers to delivering PF+ by community pharmacies within National Health Service Greater Glasgow & Clyde (NHSGGC), the largest health board in Scotland. METHOD: Between July and December 2023, 12 one-to-one semi-structured interviews with NHSGGC community pharmacist prescribers offering the PF+ service were conducted face to face or virtually. Audio recordings of the interviews were transcribed verbatim and underwent thematic analysis using normalization process theory. KEY FINDINGS: Analysis generated three overarching themes of individual, organizational and contractual factors. Subthemes were pharmacy logistics, clinical skills and training, staffing/skill mix, competing priorities, time challenges and external stakeholder relationships. Many of these were interdependent and had the potential to be a barrier or an enabler to PF+ provision, depending on context. CONCLUSION: The barriers and enablers to community pharmacists working as autonomous prescribing pharmacists and delivering a standardized service are multifaceted. With growing opportunities to expand the PF+ service, it is important to address and influence the barriers that currently exist.