England's Healthy Living Pharmacy (HLP) initiative: Facilitating the engagement of pharmacy support staff in public health

Background: The concept of the Healthy Living Pharmacy (HLP) in England was first piloted in Portsmouth in 2010. HLPs proactively promote health and wellbeing, offering brief advice, services or signposting on a range of health issues such as smoking, physical activity, sexual health, healthy eating and alcohol consumption.
Objectives: To explore the views and attitudes of pharmacy support staff on the Healthy Living Pharmacy (HLP) initiative. 
Methods: Qualitative semi-structured, face-to-face interviews were conducted with pharmacy support staff recruited from community pharmacies involved in the HLP initiative in the Northumberland region of England. A topic guide was developed which underwent face validity testing and piloting with one participant. Interviews were audio recorded, transcribed verbatim and analyzed using framework technique. 
Results: A total of 21 pharmacy support staff from 12 HLPs participated in the study. Results suggest that involving pharmacy support staff at very early stages of the HLP planning process drives their motivation for service delivery. Level of engagement with HLP services was often related to support staff roles within pharmacy. Integration of public health roles with routine pharmacy activities was perceived to be more suited to pharmacy counter based roles than dispensing roles. Further training needs were identified around how to proactively deliver public health advice, mainly in service areas perceived ‘difficult’ by the participants, such as weight management. A total of 19 facilitators/barriers were identified from the data including training, access to information, client feedback, availability of space and facilities within pharmacies, time and competing priorities. 
Conclusions: Pharmacy support staff engagement with the HLP initiative can be promoted by involving them from the outset of the service introduction process. Support staff might benefit from targeted training around certain public health areas within the HLP initiative. Facilitators/barriers identified in this study will inform development and further roll out of HLP initiative in wider areas.