SACM - United Kingdom
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Item Restricted The role of independent pharmacist prescribers in primary care settings in Wales: a mixed-methods evaluation(Cardiff University, 2024) Alghamdi, Saeed Saad A; Karen Hodson, Rhian DeslandesIn Wales, the role of independent prescribing pharmacists (IPPs) has developed over time, particularly since 2015, when the Welsh Government implemented its primary care plan and primary care clusters. The aim of this PhD was to explore the development of the role of IPPs within the primary care setting with a focus on the role of IPPs in general practitioner (GP) practices and community pharmacies. The study adopted a mixed-methods approach in which a quantitative stage involved analysis of prescribing data related to IPPs and other nonmedical prescribers, and the qualitative studies utilised semi-structured interviews with IPPs in GP practices and community pharmacies, and community pharmacy leads in different Health Boards (HBs) in Wales. The findings show that the number of non-medical independent prescribers and the volume of prescribing in GP practices in Wales increased over the study period, particularly since the implementation of primary care clusters. Thematic analysis of the interviews revealed that this increase, as perceived by participants, may have helped reduce the pressure on GPs, enhanced IPPs’ skill sets across various therapeutic areas, and increased their job satisfaction and motivation. Moreover, the role of IPPs in community pharmacies was more related to acute conditions, whereas their involvement with chronic conditions was more evident in GP practices. Some challenges to the role of IPPs were identified in this study, such as the lack of funding and support, the lack of access to GP records in community pharmacies, unclear indemnity insurance in GP practices, an unclear strategy and plan to develop the role, and a high workload. However, most of these challenges were resolved over time with the progression of the role, except for the high workload issue that needs more support. Some of the enablers for their roles were the Welsh Pharmaceutical Committee’s (2030) vision, which included a strategy to increase the number of IPPs in community pharmacies, and support from other healthcare professionals, GP practices, and HBs in Wales. The vision and the new Pharmacy Workforce Plan published by Health Education and Improvement Wales (HEIW) may help develop the role of IPPs and allow them to use their skills more effectively. This eventually may help in improving patient care and relieving the increased pressure on primary care settings. However, these plans need to be monitored to ensure the successful development of this role and its effective integration into the future healthcare service and workforce in Wales. Future research should focus on further understanding the prescribing patterns of IPPs in both GP practices and community pharmacies in Wales, patients’ satisfaction with the role of IPPs in these areas, clinical outcomes of patients managed by IPPs, and different stakeholders' and other healthcare professionals’ views on the role.10 0Item Restricted Measuring patient experience of primary care and capturing patients’ perceptions of the primary care reforms in Saudi Arabia(University of Exeter, 2024) Mubarky, Abdullah; Pitchforth, Emma; Hulme, Claire; Valderas, Jose MBackground: Primary care (PC) is the backbone of most health systems around the world. In Saudi Arabia, the health system is reforming as part of the country Vision 2030 and Health Transformation Strategy. One of the principal objectives of this reform is to build a new, strong PC system to attract patients and enhance preventive care. PC will play a significant role within this transformation strategy, which calls for PC improvement in terms of facilities, services, and technology. The patient is a primary recipient and profoundly impacted by these reforms. Therefore, patient experience is essential for guiding and improving the health reform plans in Saudi primary care. Aim: This study aims to assess patient experience with PC and capture patients’ perceptions of the PC reforms in Saudi Arabia. Methods: Three pieces of work were conducted sequentially and integrated to answer the research question and achieve the study's objectives. The first was a scoping review conducted in January 2021 and updated in September 2023 that reviewed the existing instruments designed to measure patient experience in primary care globally for identifying the main domains of patients’ experiences with PC, and factors affecting those experiences. Eighty five papers were extracted and synthesised. The second piece of work was a series of eleven focus groups conducted in January/February 2022 with 44 PC patients to develop an in-depth understanding of the key issues related to PC reform in Saudi Arabia. The final piece of work was the development and implementation of a patient survey to measure patient experience with primary care and capture patients’ perceptions of the primary care reform in Saudi Arabia. The survey then distributed to PC patients. Five hundred and ninety nine individuals responded between December 2022 and February 2023. 2 Findings: Overall, there was a positive experience of accessibility to Primary Care Centres (PCCs) in Saudi Arabia. The majority of respondents expressed positive continuity of care, as they were able to receive care from their preferred primary care clinician, albeit with less continuity in their relationship with the same physician. Regarding coordination, the general quality of referrals to other healthcare providers seems to be commendable. Nevertheless, there is room for improvement in the feedback provided by other healthcare providers to PCC's physicians. Moreover, patients perceive the comprehensiveness of services provided to them in a positive manner, whereas the availability of services received a comparatively less positive rating from the respondents. The digital appointment system, known as Mawid, and the Wasfaty platform appear to be functioning effectively, resulting in a positive outcome. Two areas that warrant further attention are dental services and digital literacy, specifically in regards to Mawid. Conclusion: The study indicates that overall patient have positive experiences of primary care centres in Saudi Arabia but key areas for improvement remain. The methods developed and findings can inform future monitoring of patient experience as part of ongoing healthcare reforms.26 0Item Restricted Elevating Primary Healthcare in Saudi Arabia: A Strategic Implementation of National Standards(University College London, 2025) Alsoqair, Yara; John, PreethiPurpose This comprehensive exploration enables the identification of gaps, trends, and seminal works that shape the discourse within the health sector. Moreover, the analysis of diverse strategies for issues identified by the client adds a pragmatic layer to the project, bridging theoretical insights with real-world applicability. Methodology Balancing the need for transparency with confidentiality and ensuring that research outcomes were used responsibly and for the benefit of the public were integral to this consultancy project’s approach. Findings The study identifies several determinants, including the essence of primary care accessibility, elevating primary care quality, nurturing the primary care workforce, harnessing Health Information Technology (HIT), regulatory compliance, diverse stakeholder perspectives, and crisis preparedness and response.28 0