The clinical autonomy of community pharmacists in England. 2. Key findings

Objective: To investigate the perceived autonomy of community pharmacists in clinical settings and any differences between subgroups of pharmacists. Method: A specially designed instrument, a central feature of which was 12 scenarios, was distributed by post to a systematic random sample of 2000 community pharmacists in England selected from the Royal Pharmaceutical Society of Great Britain database. Data were analysed using techniques including contingency tables, main effects binary logistic modelling and Cronbach's alpha scores. Key findings: The response rate was 31 % (626 community pharmacists). Comparison with a regional survey confirmed that the respondents were representative of the community pharmacy work-force. 'Reality checks' indicated that, notwithstanding variations, the scenarios were perceived as being within the experience of many respondents and of importance for clinical autonomy. Community pharmacists' perceptions of their autonomy were mainly affected by occupational status and work pattern. Contractor pharmacists were much more likely to opt for high autonomy responses than employees and locums. Similarly pharmacists who worked full-time were more likely to opt for these responses than those working part-time. Little association was found between high autonomy and gender, size of employing organisation and length of time qualified. Conclusions: Differences in perceived autonomy may be due, in part, to the extent to which organisational and managerial constraints operate. With the moves towards an enhanced role for community pharmacists in a primary care-led NHS, these differences should be taken into account in safeguarding pharmacists' professional standing, policy making and managing service delivery.