Specialty Registrar in Public Health, Screening and Immunisation Team, NHS England (West Midlands), St Chads Court, Hagley Road, Birmingham, UK.
Consultant in Public Health, Specialised Commissioning Team (West Midlands), St Chads Court, Hagley Road, Birmingham, UK.
J Public Health (Oxf). 2018 Jun 1;40(2):359-365. doi: 10.1093/pubmed/fdx078.
Community pharmacies are now commissioned nationally in England to provide a seasonal influenza vaccination service. However, there is little evidence about the effectiveness of a pharmacy-based immunization service in improving uptake.
The Donabedian framework was used to evaluate a community pharmacy service in the West Midlands from a commissioning perspective. A mixed methods approach was adopted, including provider and patient surveys, data from the national influenza vaccination returns and an electronic pharmacy data recording system.
Patient satisfaction with the service was high. There was no increase in uptake rates. Impact on reaching new patients was limited. The service had an appropriate information system to record activity. Promotion and signposting for the service was weak. Poor engagement with stakeholders led to dissatisfaction and General Practitioner complaints. Commissioners responded to emerging issues to ensure the pharmacies' set up was compliant with the Service Level Agreement.
Improvements in convenience and choice for patients did not result in an increase in uptake rates. With a national pharmacy influenza programme, local arrangements to optimize the service may be limited. Clear arrangements for activity transfer and recording, partnership working and a good communications strategy are crucial in achieving a positive outcome.
目前，英国全国委托社区药房提供季节性流感疫苗接种服务。然而，关于基于药房的免疫接种服务在提高接种率方面的有效性的证据很少。
从委托的角度出发，使用 Donabedian 框架评估西米德兰兹地区的社区药房服务。采用了混合方法，包括对提供者和患者进行调查、利用国家流感疫苗接种报告的数据以及电子药房数据记录系统。
患者对服务的满意度很高。接种率没有提高。对接触新患者的影响有限。该服务有一个适当的信息系统来记录活动。服务的推广和引导很薄弱。与利益相关者的不良合作导致不满和全科医生的投诉。委托人为解决新出现的问题做出了回应，以确保药房的设置符合服务级别协议。
为患者提供的便利和选择的改善并未导致接种率的提高。在全国性的药房流感计划下，优化服务的地方安排可能受到限制。明确活动转移和记录、合作关系和良好的沟通策略的安排对于取得积极成果至关重要。
