Table 6.

Themes, sub-themes, and codes describing pharmacists’ views of the determinants of the number of NHS influenza vaccinations provided at pharmacies

Main theme	Sub-themes	Codes
Pharmacy factors	Pharmacist numbers	Other pharmacist(s) available to maintain day-to-day functions of the pharmacy
		Maximising the number of pharmacists able to immunise
		Reliance on pharmacist to provide the (flu) service
	Extended trading	Evening opening hours
		Weekend opening hours
	Pharmacy location	Proximity/co-location with GP practice
		Footfall
		Pharmacy as part of defined community
		Rurality
		Town centre
		Population served by pharmacy
	Staff support	Delegation of roles to staff
		Training
		Recruiting patients
	Flexibility to offer vaccinations	Drop in/no appointments needed
	Identifying patients	Checking against prescriptions
		Promoting vaccination to people accessing other pharmacy services
		Targeting specific at-risk groups
	Planning approach	Business focus — profitability
		Providing a high-quality professional service (altruism)
		Capacity or absence of planning
		Planning to supplement (mop up) GPs
	Impact on other services	Reducing level of other services to accommodate vaccination
	Premises/facilities	Number of consultation rooms
Public awareness	Word of mouth	Snowballing
		Staff raising awareness
	Promotional material	Corporate display materials
		Insufficient/inadequate/delayed promotional materials
		Promotional displays
		Restrictions on advertising
		No awareness of NHS service
		Decision not to promote by pharmacy
		Importance of flu vaccination/eligibility
External factors	Finance	Profit motive
		Incentives
		Unimportance of profit
	GP relationships	Reciprocity
		Conflict avoidance
		Views of GPs and practice staff
	Vaccine availability	Supply chain shortages
		Purchasing restrictions
		Uncertain demand
	Administrative burden	Paperwork
	Commissioning processes	Accreditation processes
		Patient Group Direction
		Approval by health board