Box 2. Perceived impact of GP–CP joint-working on the delivery of care.

GP work delegated to CPs 'The hospital has added something or they’ve taken something off … and the receptionists were getting spooked by it […] So when I came along, this is somebody who knows about the medicines and what looks like likely and unlikely combinations […] So there was … just this gap, this vacuum waiting to be filled.' (CP2, interview) Delivery of enhanced care 'It’s reduced their sort of paperwork time significantly […] potentially you could say that that does mean that they could maybe have more appointments and so on.' (SC1, interview) 'I think it's a good idea [to be seen by a CP] as normally I would have to wait 6 weeks to see a doctor. Also I felt he had more time to discuss things about my meds.' (Patient feedback form, comment 4) Patient outcomes and patient safety '[The practice] hadn’t got recalls on people taking methotrexate, [patients] weren’t having their blood tests. People on [new oral anticoagulants] weren’t having their blood test [to check] kidney function [...] We picked up a few old ladies who’d got really low kidney function.' (CP1, interview) 'Three patients were identified that were taking regular OTC meds — 2 NSAIDs, 1 aspirin 25 mg — which were either contraindicated, inappropriate, interacted with, or in combination with current meds were contributing to/exacerbating conditions the patient had previously reported.' (CP16, survey) 'The pharmacist service has benefited me by taking less tablets per day. I know it takes time to get it correct but the service has been first class. Also the [reduction in] swelling in my ankles has been a big plus. Thank you once again.' (Patient feedback form, comment 2)