Article Green Open Access 2023

The Collaborative Care Model: Realizing healthcare values and increasing responsiveness in the pharmacy workforce

Research in Social and Administrative Pharmacy
Journal · Vol. 19 · Issue 1 · pp. 110-122
Abstract

Healthcare values are fairly ubiquitous across the globe, focusing on caring and respect, patient health, excellence in care delivery, and multi-stakeholder collaboration. Many individual pharmacists embrace these core values. However, their ability to honor these values is significantly determined by the nature of the system in which they work. The paper starts by presenting the prevailing pharmacist workforce model, the ‘Atomistic’ Model, in Scotland, in which core roles are typically separated into hierarchically disaggregated jobs focused on one professional ‘pillar’: Clinician/Practice Provider; Educator; Leader/Manager; and Researcher. This skills-segregation yields a workforce of individuals working in isolation rather than collaborating, lacking a shared purpose. Key strategic flaws include suboptimal responsiveness to population needs, inconsistency/inequity of care, erosion of professional agency, and lower job satisfaction. It is conjectured that this results from a lack of congruence between values, professional ethos, and organizational structure. ‘Atomism’ culminates in a syndrome of widespread professional-level cognitive dissonance. The paper contrasts this with an emerging workforce vision, the Collaborative Care Model. This new model defines a systems-first-approach, built on the principle that all jobs must include all four professional ‘pillars’. Vertical skills integration, involving education and task sharing, supports sustainability and succession planning. Horizontal skills integration (across practice, leadership/management, education, and research) is included to improve responsiveness to population need and individual professional agency. The working conditions, supportive ethos, and career structure needed to make the model work are described. Moral and workforce theory are used to justify why the model may be more effective for population health, delivering greater job satisfaction for individuals and ultimately helping systematically realize healthcare values. Finally, the paper sketches the first steps needed to implement the model at the national level, starting with the operationalization of new multi-‘pillar’ professional curricula across the career spectrum. Potential challenges also are discussed. © 2022 Elsevier Inc.

Keywords

Author Keywords

skills development values Workforce Professionalism Pharmacists

Index Keywords

human Humans leadership pharmacist pharmacy (shop) workforce health care delivery Delivery of Health Care Pharmacists Pharmaceutical Services Pharmacy
Author Affiliations
NHS Greater Glasgow and Clyde, Glasgow, Scotland, United Kingdom
Public Health Pharmacy, NHS Tayside, Dundee, United Kingdom
NHS Highland, Inverness, Highland, Scotland, United Kingdom
NHS Education for Scotland, Edinburgh, Scotland, United Kingdom
Craigavon Area Hospital, Portadown, Armagh, Northern Ireland, United Kingdom, School of Pharmacy, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom
International Pharmaceutical Federation (FIP), The Hague, Netherlands
College of Arts, Humanities and Social Sciences, Edinburgh, Scotland, United Kingdom
Funding & Acknowledgements
University of Edinburgh, ED
We would like to thank the beautiful countryside of Driesh and Mayar (Glen Clova, Scotland) for allowing the tranquility necessary to conceptualize this work. We would also like to thank the 4th Year Philosophy students from Edinburgh University for debating an early version of this model during their seminar on community wealth building.
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