Negotiating New Roles in General Practice: a qualitative study of Clinical Pharmacists

Fay Bradley, Pauline Nelson, Christopher Cutts, Damian Hodgson

Research output: Contribution to journalArticlepeer-review


BACKGROUND: To address general practice workforce shortages, policy in England has supported the recruitment of 'non-medical' roles through reimbursement funding. As one of the first to receive funding, the clinical pharmacist role offers insight into the process of new role negotiation at general practice level. AIM: To identify factors influencing clinical pharmacist role negotiation at practice level, comparing the process under two different funding and employment models. DESIGN AND SETTING: Qualitative interview study with staff involved in the following schemes: 1) the national NHS England (NHSE) Clinical Pharmacists in General Practice scheme; and 2) a local clinical commissioning group-funded scheme, providing clinical pharmacist support to general practices in one area of Greater Manchester in the UK. METHOD: Semi-structured interviews with purposive and snowball sampling of pharmacists, GPs, and practice staff took place. The interviews were analysed using template analysis. RESULTS: In total, 41 interviews were conducted. The following four factors were found to influence role negotiation: role ambiguity; competing demands and priorities; potential for (in)appropriate utilisation of clinical skills; and level of general practice control over the role. Key differences between the two funding and employment models were the level of influence GPs had in shaping the role and how adaptable pharmacists could be to practice needs. The potential for inappropriate utilisation was reported under both schemes, but most apparent under the role reimbursement, direct employment model of the NHSE scheme. CONCLUSION: This study has highlighted lessons applicable for the introduction of non-medical roles more widely in general practice. It has provided insight into the factors that can influence role negotiation at practice level and how different funding and/or employment models can impact on this process.

Original languageEnglish
Pages (from-to)e27-e33
JournalBritish Journal of General Practice
Issue number738
Early online date28 Dec 2023
Publication statusPublished - 1 Jan 2024


  • clinical skills
  • general practice
  • pharmacists
  • professional role
  • qualitative research
  • workforce
  • Attitude of Health Personnel
  • Humans
  • General Practice
  • Negotiating
  • Qualitative Research
  • Pharmacists


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