The published evidence supports a multidisciplinary approach to drug therapy management. Pharmacist prescribing has already been introduced successfully in the United States, with good clinical outcome measures and high levels of doctor and patient satisfaction. In our study, questionnaires were sent to 195 doctors, 200 nurses and all 87 pharmacists working at five hospitals in Birmingham, to identify attitudes towards pharmacist‐written prescriptions and pharmacist prescribing. The combined response rate was 57.5 per cent. Few doctors (4.3 per cent) and nurses (5.2 per cent) responding had any experience of prescriptions written by a pharmacist, but all of those with such experience agreed that they had found it helpful. Support for pharmacist‐written prescriptions and pharmacist prescribing ranged from 43.6 per cent to 94 per cent, depending on the scenario described and the profession of the responder. Overall, a high proportion (78.7 per cent to 86.1 per cent) of doctors and nurses responding agreed that it would be useful if pharmacists were permitted to write prescriptions and prescribe drug treatment, though a majority believed that this should only include pharmacists with postgraduate education/training and routinely attached to the clinical area in question. Important issues identified as possible barriers to pharmacist prescribing in the UK include pharmacist willingness to accept this new role, education/training, familiarity with the patient, communication between health care professionals, professional and legal accountability and resource implications. If further training/education was made available for those who felt a need for it, 98.5 per cent of pharmacists stated that they would be happy to write prescriptions for existing therapy, and 95.5 per cent would also be happy to initiate/prescribe drug treatment. The future role of the hospital pharmacist in drug therapy management is explored. The perceived barriers to the introduction of pharmacist prescribing are not insurmountable. If tackled appropriately, the introduction of pharmacist‐written prescriptions and pharmacist prescribing is likely to prove a valuable contribution to patient care.

Objective — To examine the reasons behind hospital doctors' perceived barriers to pharmacist prescribing in the United Kingdom. Method — Postal questionnaires using a combination of open and closed questions were sent to hospital doctors seeking responses to scenarios describing pharmacists writing prescriptions for drug treatment. Content analysis of the qualitative responses was undertaken to identify the major themes which represented potential barriers. Setting — Five National Health Service teaching hospitals in Birmingham, UK. Key findings — Completed questionnaires were received from 94/193 doctors (49 per cent). Fifty‐two respondents (55 per cent) expanded on their opinions in responding to the scenarios presented. Thirty‐eight respondents described potential problems or gave reasons why they believed pharmacists should not be permitted to transcribe or prescribe drug treatment. Eleven respondents spontaneously added supportive comments and the remainder were neutral. Five major themes clearly emerged: pharmacists' awareness of clinical and patient details, potential communication problems, belief that a doctor should write the initial inpatient prescription, the division of overall clinical responsibility and loss of the opportunity to review the drug treatment. Conclusion — Potential barriers to pharmacist prescribing were identified both by doctors who agreed and by doctors who disagreed with the general concept. Some doctors had misconceptions about the division of responsibility relating to drug treatment. This study has identified important issues that the pharmacy profession will need to address if we are to be accepted as prescribers and provides a valuable starting point for further work.

This paper describes a strategy to identify a comprehensive collection of citations supporting the evidence for the effectiveness of hospital pharmaceutical services in the UK. The large number of references identified demonstrate that hospital pharmacists in the UK make significant contributions to both the research literature and to patient care. However, database searches alone highlighted just 34% of the total references finally included in this study, demonstrating that pharmacy practice research work may be difficult to access by conducting database searches alone. The results from this project provide a resource for the profession and can be utilised as a foundation for future developments in both the delivery and research of hospital pharmacy practice.