Table 6 Quotes related to theme 4: Practical considerations for pharmacy based interventions

1

“We have to do CPD, professionals we have to do CPD don’t we and also I did a community pharmacy diploma about three or four years ago and they have a section in that that you cover on arthritis and on pain management.” P07, Pharmacist

2

“Yes, absolutely. I think really for us the reason that I probably feel more confident and know a bit more is just because I've come out of university and we studied it. But I couldn't say confidently that five years down the line I'd know as much as I did now.” P16, Pre-registration pharmacist

3

“Yeah, obviously, I love training but I think it’s tricky … I’ve got three kids and I work 43 h a week. It’s tricky to fit it in.” P01, pharmacist

4

“I mean the dispensers or the healthcare counter staff are not really trained or aware of things that they should be picking up so they do refer to us”, P06, Pre-registration pharmacist

5

“If healthcare counter staff are just sending them away with pain relief and then they leave it there's always that downfall that they're not getting treated”, P06, Pre-registration pharmacist

6

“I think it's really good because it's like with the inhaler technique with us, once that came out about 10% of patients actually knowing how to use their inhaler and then pharmacists didn’t really know so then where is the knowledge coming from when they're prescribed it? So that was a big thing, I think things like this need to happen” P06, Pre-registration pharmacist

7

“A lot of other people would have the same situation where they can’t always attend. An e-learning course, promoted by CPPE, would be my preference, or something like that, because they promote emails and everybody uses those on a daily basis. That would be something to highlight this e-learning package. It’s got to be simple and it’s not very long.” P04, Pharmacist

8

“I would think a more face-to-face kind of approach. It’s a lot more useful. I mean you would need to do some preliminary work first and in the face-to-face interaction you might not cover all the ground at that stage but I think face-to-face is needed to consolidate it.” P19, Pre-registration pharmacist

9

“CCGs have a good, important role as well and so they could roll that out across the area; whether it’s in GP practices or community pharmacies. I’m sure they could. I don’t know whether they can promote that.” P04, Pharmacist

10

“Yes, we see people on a regular basis. We can see deterioration in some people and that goes for lots of other medical issues going on as well.” P05, Pharmacist

11

“We’re a village pharmacy, I’ve been there 25 years and so have half my staff, so we know the individual people that walk in, so we might initiate a conversation with somebody… You’ve initiated the conversation and given them the opportunity to speak to somebody about something that is occurring with them.” P05, Pharmacist

12

“If you're a locum and you're only in there for a day it’s very difficult to even get an idea of how often this patient comes in so it can be missed” P15, Pre-registration pharmacist

13

“I tend to do formal referrals when I think it’s urgent and so it helps to ease people through the system because sometimes, a letter from a pharmacist actually does carry a little bit of clout that would get you past Reception. When I’ve felt that someone needs to be seen quite urgently, I have given people referral letters to take to the Walk-In Centre.” P01, Pharmacist

14

“Sometimes if it’s like a medication review, so like an MUR … that we’ve done, we can do a referral letter … or normally it’s just, ‘Oh, you just need to make an appointment […] with your GP so they can’, you know, we leave that with the patient to do themselves […] arrange themselves. Or if we find it an emergency or often not an emergency, if it’s something that we can do for them that they feel involved, ‘Actually I know your surgery quite well or I know the girls at XXX and that’s our local doctor’s surgery, we can just pass them a message or we can just give them a call’, especially the times if it’s elderly patients or housebound patients maybe that have popped in on the off chance. I will give them a call, say, ‘You know, a doctor probably wants to […] his patient’, we’ve done that in the past as well.” P09, Pharmacist