Navigating the challenge of practice change: lived experience of community pharmacists in England

In England, the community pharmacy profession is changing. With mounting pressures on the NHS to meet the needs of 21st century healthcare, community pharmacists are perceived as an untapped resource to relieve these stressors. Despite these calls to action, evidence suggests that change within the community pharmacy profession has been enacted slowly and inconsistently. Whilst existing research into practice change exists, a critical voice, the voice of community pharmacists themselves is seldom centred. Exploring their experiences is critical to fully understand the challenges of change in the context of practice. This study utilised a phenomenological methodology to explore the lived experiences of practice change for community pharmacists in England. In-depth, semi-structured interviews with ten community pharmacists at two time points was intended to centralise and give voice to the lived experience of the participants. Reflecting the complex contexts in which community pharmacists work, Rogoff’s Planes of Analysis framework was adapted and used to underpin the data analysis and view change through three separate, but interlinked ‘planes’: Micro level: the personal experience, Meso level: the socio-cultural context of practice, Macro level: the wider profession and policy. The experience of the individual was foregrounded, and situated within the context of the organisation and the wider profession. The findings of this study illustrate the challenge of practice change for community pharmacists, whose role as change ‘translators’ takes place in complex systems driven by external policy, organisational demands, and personal agendas, which are frequently at odds. Findings were presented under four themes that illustrated key experiences of change: agency in the change process, role tensions, networks of support, and psychological safety. This study proposes that aligning community pharmacists’ psychological and socio-cultural needs with external drivers of change is critical to meet the external demands for practice change, whilst nurturing a professionally fulfilled workforce.