A policy analysis of the pharmacy in a New Age initiative
This thesis is a policy analysis of the Pharmacy In A New Age (PIANA) initiative
launched by the Royal Pharmaceutical Society of Great Britain (RPSGB) in 1995.
It leads to an understanding of how pharmacy services develop as a part of the
Welfare State. The chosen interpretation was to explore the pharmacy policy
sub-system using the Advocacy Coalition Framework (ACF), the Systems
Approach and the dimensions of power associated with decision-making.
The PIANA initiative identified five areas where pharmacists' input into future
healthcare systems would be valued:
o the management of prescribed medicines;
e the management of long-term conditions;
the management of common ailments;
the promotion and support of healthy lifestyles; and,
advice and support for other healthcare professionals.
Research was conducted using both qualitative and quantitative methods to
ascertain pharmacists' perceptions towards the implementation of the PIANA
From the interviews it was determined that isolation, remuneration, skill mix and
competitive retail environment were factors thought to impede the implementation
of new pharmacy services in the community setting.
Hypotheses were generated and subsequent questionnaire based research
explored pharmacists' views relating to the development of the extended
pharmacy services and which organisations were trusted to influence the policy
process. The study group comprised 2359 pharmacists living in Great Britain
who were registered With the RPSGB on March 12 th 1999. The response rate
was 50.1 % (n= 1182).
Statistical analysis demonstrated that the management of prescribed medicines
was ranked most important role and that pharmacists employed in GP surgeries
were thought best placed to carry out this role. The author suggests that clinicallytrained pharmacists based in GP surgeries would be best placed to manage
Community pharmacists ranked the management of common ailments as their
second most important role and were perceived to be best located by all
pharmacists. Hospital ranked the advice and support of health care professionals
as the second most important; community pharmacists ranked this as the fifth
The conclusionsd raw on the literaturea ssociatedw ith implementationT. he
author considers that the methods employed, were appropriate to analyse the
pharmacy policy process. The analysis identified that the RPSGB was unable to
unilaterally influence the policy process and that the plethora of pharmacy
organisationsm ay be detrimentatl o policy implementationT. he authorc oncludes
that local leadersw ho are associatedw ith severalp harmacyo rganisationsfu rther
compromise the situation.
Employees of Primary Care Organisations were found to possess the triple
dimensions of power associated with decision-making and are key policy brokers
for emerging pharmacy services. Future policy implementation research should
focus upon this group.
The majority of pharmacists were unable to identify a legitimate organisation to
support the local implementation of pharmacists' non-dispensing roles, this may
impede the implementation process.
The majority of pharmacists agreed that they would have to change the skills that
they used in order to survive. Educators and trainers should ensure that
pharmacists develop competencies to the expected professional standards
required to develop and deliver new roles.