A survey of the provision of clinical pharmacy services in relation to existing published standards.

OBJECTIVE: To investigate the provision of clinical pharmacy services in hospitals in one NHS region in UK, and to measure the delivery of these services against published standards.
METHOD: The study comprised two phases. Phase 1 was a postal questionnaire to hospital chief pharmacists seeking information on the provision of clinical pharmacy in their hospital. Phase 2 involved a semi-structured interview with hospital chief pharmacists to obtain a detailed understanding of clinical pharmacy services in their hospital and factors influencing the provision of these services.
RESULTS: Ninety-four percent of all hospitals surveyed were providing a clinical pharmacy service. However, only two thirds provided a service to all wards, and the main reason given for not doing so, was lack of resources. There was a divergence of opinion amongst chief pharmacists whether it was better to provide a limited service to all wards or a good service to some wards. Thirty-seven percent of hospitals did not meet the minimum standard of frequency for visiting acute wards, whereas, 58 were meeting the optimal standard of frequency of visits for non-acute short stay wards and 67 for long stay wards, primarily because the latter required less frequent visiting. The study showed that hospital pharmacies were influencing prescribing decisions in a variety of ways other than ward visiting.
CONCLUSION: Although hospital chief pharmacists see clinical pharmacy as a core service, published standards for these services are not being met. As a result of staff shortages, managers are using a variety of approaches to maintain clinical pharmacy services. There is scope for further devolvement of duties to pharmacy technicians in order to release valuable pharmacist time.