Exploring community pharmacy professionals and general practitioners' views on primary care communication and pathways to access antibiotics in England

Background With most antimicrobials in England being prescribed in primary care, collaboration on antimicrobial stewardship (AMS) between general practitioners (GPs) and community pharmacists (CPs) is important. Previous research identified barriers to communication between GPs and CPs across England. Objectives To explore experiences of communication between GPs and CPs in relation to AMS and the pathways to access antibiotics in primary care. Methods Five qualitative focus groups and nine semi-structured interviews were conducted with GP and community pharmacy professionals (CPPs) independently. Two reconvened focus groups with GPs and CPPs present together provided a holistic discussion on initial findings and practical solutions. Data were analysed thematically. Results Nine CPs, three pharmacy technicians and 12 GPs participated. Four themes emerged: nature of GP-CP interactions, role recognition, barriers to AMS and overcoming barriers. Many CPs, particularly those not co-located with a GP surgery, reported challenges in contacting GPs. Proximity of location between CPs and GPs influences ease of communication and relationship management. GPs highlighted having limited or no awareness of the availability of medicines at the point of prescription. Suggested solutions to optimize collaborative working on AMS included providing functionality to share topline patient notes with prescriptions, a system that tracks and summarizes stock levels and having central points of contact between CPs and GPs. Conclusion The challenges reported have implications on the collaborative relationship between GPs and CPs and solutions are needed to optimize AMS between primary care health professionals. The appetite for digital transformation suggests that strategic conversations with senior stakeholders are needed.