Introduction: The coronavirus (COVID-19) pandemic has impacted healthcare worldwide. It has altered service delivery and posed challenges to practitioners in relation to workload, well-being and support. Within primary care, changes in physicians’ activities have been identified and innovative work solutions implemented. However, evidence is lacking regarding the impact of the pandemic on pharmacy personnel who work in primary care. Aim: To explore the impact of the pandemic on the working practice (including the type of services provided) and job satisfaction of pharmacists and pharmacy technicians within Scottish general practice. Due to the stressful nature of the pandemic, we hypothesise that job satisfaction will have been negatively affected. Methods: An online questionnaire was distributed in May–July 2021, approximately 15 months since initial lockdown measures in the UK. The questionnaire was informed by previous literature and underwent expert review and piloting. Analysis involved descriptive statistics, non-parametric statistical tests and thematic analysis. Results: 180 participants responded (approximated 16.1% response rate): 134 pharmacists (74.4%) and 46 technicians (25.6%). Responses indicated greater involvement with administrative tasks and a reduction in the provision of clinical services, which was negatively perceived by pharmacists. There was an increase in remote working, although most participants continued to have a physical presence within general practices. Face-to-face interactions with patients reduced, which was negatively perceived by participants, and telephone consults were considered efficient yet less effective. Professional development activities were challenged by increased workloads and reduced support available. Although workplace stress was apparent, there was no indication of widespread job dissatisfaction. Conclusion: The pandemic has impacted pharmacists and technicians, but it is unknown if changes will be permanent, and there is a need to understand which changes should continue. Future research should explore the impact of altered service delivery, including remote working, on patient care.

Objective To identify what matters to clinicians and patients when discussing cancer medicines’ impact on health-related quality of life (HRQoL). Methods A framework of HRQoL domain/domain elements was developed, informed by analysis of published patient reported outcome measures (PROMs), applicable to prostate cancer. Using mixed methods (eDelphi, Nominal Group Technique and questionnaire), prostate cancer clinicians and patients attending prostate cancer clinics and support groups were asked which domains/domain elements would be important to them when discussing the impact prostate cancer medicines have on their HRQoL. Results Twenty-one clinicians and 71 patients participated from the West of Scotland. Clinicians and patients identified 53/62 domain elements across seven domains as important, of which 32 (60%) were common to both groups. Clinicians placed more importance than patients on Mood & Emotion; in contrast, patients placed importance on a broader range of Symptoms & Side Effects, being informed about their care, and having effective healthcare professional collaboration. Conclusion This study provides insight into the similarities and differences between what clinicians and patients think is important when discussing the impact of cancer medicines on HRQoL. Future research should involve exploring the potential for consistency of medicines PROMs across different cancer types to support patient-clinician communication and drive improvements in care.

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In recent years significant developments have been made in passively modelocked solid-state lasers by the application of semiconductor-based saturable absorbers1,2. Such saturable absorbers have been developed for use in broadly tunable lasers such as Ti:sapphire and Cr:LiSAF where attractive features such as improved reliability and self-starting are introduced, although at the expense of wavelength tunability compared to Kerr-Lens-Modelocked lasers.

This chapter discusses the importance of applying methods based on the systems thinking paradigm in analysing accidents that may occur in a complex healthcare system involving telemedicine/telehealth. Different accident analysis approaches (models and methods) have been utilised to analyse incidents/accidents in different safety-critical domains, including healthcare, to identify weaknesses and to be able to propose safety recommendations. With the advent of systemic accident analysis (SAA) approaches based on the systems thinking paradigm, can they be feasibly and practically applied to incidents resulting from unintended issues relating to telemedicine/telehealth? This chapter discusses three popular SAA approaches, benefits and limitations, including their necessity for improving safety and even security relating to telemedicine processes.