Table 1.

Representative Quotes From The Main Themes And Subthemes Emerging From Inductive Thematic Analysis Of Interviews With 7 Pharmacists, In Relation To Providing The Pilot Sore Throat Test And Treat (STTT) Service In Wales

Theme 1: Impact on Patient Care
Service set-up as a tool for patient education	PA3: “ … so I think actually having that physical evidence in front of you, not only does it make you feel more confident in your diagnosis and your decision, but also you’ve got it there to fall back” PA6: “It [Choose Pharmacy] does [act like a guide], certainly with the sore throat test and treat, it pretty much will lead you through the order you need to go in on the consultation, so it’s really innovative it that way.” PA4: “It [Choose Pharmacy] gives us access to patient information, eventually access to some of the care records of the patient for more effective and safer treatment.” PA4: “It’s [Choose Pharmacy] in its infancy, it’s developing as time goes on, but it has to be the way forward hasn’t it.”
Role of service in antimicrobial stewardship	PA3: “ … I mean antibiotic stewardship with this service I think is fab, especially because sore throat is such a common reason why people go to their GP.” PA1: “I think it’s such a valued one [STTT], and we talk about antibiotic resistance and things like that, which is huge all right. You know, the facts that we were shown on the day of the training you know, and how certain countries have got it so missed managed, it’s got to be done.”
Appropriate use of primary care resources	PA6: “I think it [STTT] would be really positive for pharmacy. For us to show that we can actually make an impact on patient care and for GPs, it [STTT] should reduce their workload a lot, because I’m sure they see an awful lot of people with sore throats that could be dealt with by this service.” PA4: “Yes, we can reduce the workload of the GP, but it’s also about educating our patients and reassuring our patients they don’t need to see a GP.”
Improved access to services	PA5: “ … it’s really good that we can like offer extra services to the customers who come to us for advice anyway about over the counter stuff like sore throat, so it’s really good to have an add on and just provide them with a bit more of a better service … ” PA6: “Um ye they seemed to be um they find it easier than, a lot of the time with the surgery next door particularly they’ll have to wait a number of days, sometimes weeks for an appointment anyway so they’re quite happy that they can just come in and be seen”
Theme 2: Empowering Pharmacists to Deliver the Service
Role of training in developing confidence with delivery and differential diagnosis	PA2: “I was also concerned about differential diagnosis, so lots of other conditions it could be and trying to figure out if it could be something else as well.” PA5: “I think you’re always worried about that [differential diagnosis] anyway, because obviously you’ve got to make a decision whether to refer a patient or not.” PA6: “I think it was good [training] and it was well structured as well, um no I think it gave us everything we needed.” PA4: “ … 100%, it [training] reaffirmed all the bits that I already knew, um taught me a few things that I didn’t know with the swabbing … ” PA3: “ … it [training] gave the opportunity to ask questions and for things to be explained properly, you weren’t rushing through anything.” PA6: “ … once you have done a few [consultations] you’re a lot more confident with it [POCT] so the first time I did it [throat swabbing] I was bit panic stations … ” PA6: “The actual point of care test? Probably just because generally we are not very hands on anyway, that’s just a different skill set you know so.” PA5: “I think I was more nervous about the operational side of it, as to kind of how you swab and doing the test correctly and things like that … ” PA2: “We’re really really happy with the point of care test, I think it’s simple to use and it gives you the result quite quickly.” PA2: “Yes, I think the difficulty we’d have is making sure that the training was as good as the training that we had … ” PA3: “I would worry that if they [NHS] needed to train everybody, like every pharmacist to do the service, I would worry that the training standard would suffer as a result … ”
Appropriate staffing resource	PA2: “I had concerns about how long it was going to take, to run the actual test. We were told, a bit vague about 5 to 10 mins” PA3: “I think because we’re two pharmacists no [New service effect workflow]. But I think if you were a pharmacist on your own then I think it could, quite badly really [New service effect workflow].” PA6: “It does um, but it’s the same as any service really in community pharmacy, if you’re doing a service with a patient, unless youhave got a second pharmacist, you’re not going to be there for the walkJins and things. So, you might come out of a consultation and find you’ve got a load of people waiting in the shop.”
Willingness to engage	PA4: “Because you have to understand that not all pharmacists are at the stage of their career where they want to be developing new skills. Lots might be at the stage of their career where the think you know, sort of like rolling it down a bit now and just taking a bit of a back step.” PA6: “Um because I know of, I know there are plenty of pharmacists around who still don’t do MURs or don’t engage in DMRs and things, so those sorts of pharmacists are unlikely then to engage with this sort of service you know.” PA6: “Yep, I think so. But maybe what you’d have to do is look at the people who are already engaged with other areas of choose pharmacy first and prioritise them and then you work on engagement with the people who aren’t currently providing other choose pharmacy services.”
Theme 3: Interface with GP surgeries
Pre-implementation and nature of existing relationships	PA4: “ … I get to talk to most of the GPs on a weekly basis, not every day but the relationship is good … ” PA2: “No, we’ve got good relationships with the GPs here, so we see them every day … ” PA5: “It is always difficult to get in contact with the GPs because they are so busy, um so the way we actually did was I just kind of went over there, kind of dropped in on them, didn’t actually get to speak to the GPs because it’s quite hard to get to speak to them so I just spoke to the receptionist staff about it … ”
Perceived value of service	PA7: “ … but it wasn’t so much that but yes they [GPs] were really really receptive of it [STTT] as well, and they [GPs] seem quite excited about it.” PA3: “ … and in that cluster we [Pharmacist and GPs] discussed a few different things, one of which was sore throat test and treat and all the GP’s were really really keen for the service … ” PA6: “So that was fairly easy [contacting GPs]. There’s been a bit of feedback from the surgeries that, they’ve sort of said well why can’t we have the same equipment to do the same tests.”
Role of GP staff	PA4: “ … so as well as having to speak to the GPs, it’s not as much the GPs, it’s the receptionist and the practice manager, because they are the people who are answering the phone to that initial request for the service.” PA7: “They [receptionists] seem to really like it [STTT] actually because I think it takes a lot of pressure of them to send anyone with a sore throat up here, rather than to find a space for an appointment for them.” PA2: “ … so they’re [GPs] really chuffed with this and the staff on the counter are really chuffed as well because there is less pressure to fill GP appointments and they’re already struggling with them to be honest.”