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Users of pharmacy services mentioned ‘fast’ or ‘efficient’ dispensing when responding to questions about what made a good pharmacist. Explicitly negative views about pharmacists were rare amongst lay pharmacy users participating in this study, but one area where they did criticise pharmacists was not supplying their medicines as quickly as they would like them to: This out-patient user of the hospital pharmacy described his wish to have his prescription filled and be able to leave the hospital as soon as possible.

Respondent: ... well a few times I’ve spoken to the pharmacist, but you’d just rather get your pills and get out of here (laugh)

Interviewer: Are there any other ways they can help you?

Respondent: Not really no, I just think, less chat and just get on with it...to get to this stage, you’ve sat in a consultant’s room for 45 minutes...and then you’ve gone and got the bloods done, so that’s another wait, so by the time you get to here to get drugs, to get whatever you were gonna get, you’ve had enough (laugh) and you wanna get out. (Hospital pharmacy user C)

This pharmacist expressed the same point:

A lot of [patients] are looking to have their prescription dispensed quickly, in all honesty, erm, they want their prescription quickly and efficiently. (Primary care pharmacist C)

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Waiting for pharmacists to supply medicines when they are using the pharmacy as lay users was also mentioned by a GP and a practice nurse.

...I just recently have been to a pharmacist or two for various reasons for the first [for personal use] for a while and it is interesting because you get a very different view from that perspective...there was a wait, I mean I was a bit surprised at how long the wait was I must say...I was waiting 20 minutes...(GP A)

I’ve experienced being in a pharmacy...I went for a prescription for a neighbour, and I ended up waiting half an hour, because they couldn’t issue it without the pharmacist, because he was in with this other person, doing a consultation...you’re thinking, ‘oh, no...this is not fair, I’m having to wait forever for this!’ (Community nurse A)

The prompt supply of medicines was an important issue in hospital pharmacy too, and ‘out of hours’ (evenings and weekends) periods were mentioned in particular as times when waiting to obtain medicines was a source of some frustration, as described in the following quotes from a doctor and a nurse (from different hospitals):

…this may be the way that the hospital works itself, but often, particularly with drugs that are occasionally used [not ‘regularly’ used]...out of hours...getting access to pharmacy to get hold of replacements can sometimes be a little difficult, a little

fraught...we don’t always get as rapid a response from on call pharmacists as we would like. (Hospital doctor A)

... from our point of view, it’s timing which is the problem for us...a hospital works 24 hours a day, pharmacy doesn’t, and I think certainly here is very backward, they open at nine, they close at six thirty, you have an on call pharmacist but they’re not on site and...at half twelve on a Saturday...if we want to send anyone home, we can waste hours trying to get everything sorted out for them...if we could have anything from pharmacy, it would be more flexibility in the way that they operate... it’s more of an organisational, attitude, working thing that needs to change which would make the hospital run a lot more smoothly. (Hospital Nurse D)

Both interviewees above reflected that the issue may not be particularly that pharmacists themselves are ‘slow’ or ‘unresponsive’ as individuals, but suggested a number of possible reasons, including organisational factors that could prolong the medicines supply process. Nonetheless, their quotes do still portray pharmacy as ‘less responsive’ than other areas of the hospital.

The pharmacist as a timely supplier of medicines was a desirable quality from the point of view of those waiting to receive medicines, but can be a source of stress for pharmacists. For hospital pharmacists, working in the dispensary was pressurised:

... dispensary, it can be stressful at times, erm it’s ok for short periods of time, I wouldn’t like to be there all day...there’s no kind of a respite...(Hospital pharmacist S)

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Respondent: generally the hospital locums work in the dispensary doing all the dispensing...generally they’re used in the engine room...doing all the dirty work really Interviewer: How do feel about that, do you enjoy working there?

Respondent: No... it’s extremely busy, erm it’s disorganised (pause) it’s hard work actually...(Hospital pharmacist T)

This pressure on pharmacists to provide medicines quickly also extended out of the dispensary, to the hospital wards:

...I’ve been in situations in the past where patients have been very aggressive and verbally...not very nice and they think it’s your fault that their prescription isn’t on the ward...(Hospital pharmacist R)

This issue was also recognised by a nurse:

...filling take-home prescriptions and get the patient out as quickly as possible....the pressure feeds down from above, you know, to get the patient home. (Community nurse B – previously spent years working in hospital.)

The ability to cope with the pressure of a demanding dispensing workload, calmly, was raised as important for pharmacists in both sectors of practice.

...a good pharmacist is one that stays calm under pressure...even though we’re busy and the work begins to pile up, can get through it in a nice steady manner…some of them do get a bit giddy...you see the pressure getting to them...I can see the difference…someone comes in and I think ‘that person’s going to be fine’ and then another one comes in and I think ‘It’s not going to be fine’... you have to be a certain character anyway to survive in pharmacy and I think it’s quite high pressured, hard work...(Hospital support A)

...a good pharmacist is you need to be able to work under pressure, for example when there are 10 people waiting for prescriptions, or there are many things to do.

(Community pharmacist P)