503 Barriers and facilitators to the development of pharmacy workforce digital skills– a qualitative study
Authors: Burgin A M , Gardner P H , Easthall C , Randell R 
Published: April 2023

Abstract

Introduction
The NHS Long Term Plan envisions a health and social care system that is patient-centred, equitable and safe, with staff who feel supported and enabled to do their work. Digitalisation is seen as essential to successful delivery of this, and its use to support medicines related activity continues to grow. Pharmacy staff need the necessary knowledge and skills to feel confident, competent and capable to use digital systems for patient benefit (1). However, development of Pharmacy workforce digital skills, and innovation with technology, continues to be a challenge (2).

Aim
This project aimed to,
• define the barriers and facilitators faced by pharmacy staff, across an Integrated Care Provider, when developing digital skills.
• create recommendations to enable pharmacy staff to develop the digital skills required to work with, and fully realise the potential of, digital systems in healthcare.

Methods
Senior pharmacy leadership staff from primary care, community pharmacy, mental health and secondary care, and front-line pharmacy staff from mental health and secondary care, participated in online focus groups and semi-structured interviews. Front-line pharmacy staff from Community Pharmacy and Primary Care did not participate in the focus groups and interviews. Their input was gathered through completion of a questionnaire. Thematic analysis was used to analyse the data.

Results
Pharmacists, Pharmacy Technicians and Pharmacy Assistants/Support Workers were recruited to the study. Seven themes were identified from the combined data set. These were, 1) Digital Knowledge and Skill Development, 2) Supporting staff with change, 3) Enabling Innovation, 4) Risks of poor digital skill development, 5) Technology as a barrier, 6) Leadership, and 7) Across the health care system. The themes informed a set of recommendations.
One of the stronger themes identified by nearly all participants related to ‘supporting staff with change’. Participants described the scale and pace, resistance to and fear of change, and having to learn new skills and processes as a consequence of digital system implementation. Some participants observed variation in practice and changes in professional identity as they adapted and adopted digital systems. Some participants described themselves, and members of staff they managed, as having a fixed ‘can’t do’ mindset when faced with technology. Some participants recognised the potential with digital yet felt constrained by their roles and the restrictions set by digital system configuration.

Discussion/Conclusion
The changes that occur in response to digital systems affect staff in multiple ways. Some effort is made in response to this through creation of a standard process for system use in clinical practice, but this is often months after digital system implementation. It is suggested that implementation is no longer considered and managed as a single moment in time, but is an iterative change process that incorporates alternative change models and tools to those currently used. This may improve staff adaptability, system use, digital skill development, innovation and realisation of health technology benefits. A weakness of the study is limited participantion from front-line Community and Primary Care pharmacy staff.

References
1. The NHS Constitution. The Topol Review. Preparing the healthcare workforce to deliver the digital future. [Internet]. 2019 [cited 01/09/22]. Available from: The Topol Review — NHS Health Education England (hee.nhs.uk).
2. Hardie, T., Mahadeva, S., & Horton, T. (2021). Realising the benefits of technology in health care. London: The Health Foundation. [cited 20/10/22]. Available from: Realising-the-benefits-of-technology-in-healthcare.pdf (hdruk.ac.uk)