Pharmacy practice in hyperdiverse, urban communities: perspectives of independent community pharmacists in East and South-East London

Duckett, Kathryn; (2011) Pharmacy practice in hyperdiverse, urban communities: perspectives of independent community pharmacists in East and South-East London. PhD thesis, London School of Hygiene & Tropical Medicine. DOI:

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This study considers pharmacy practice in hyperdiverse, urban communities through the eyes of independent community pharmacists, who are underrepresented figures in anthropological research. Taking the role of the pharmacist as being dynamic and negotiable, this is an investigation into how pharmacists find ways to be relevant in the light of, or even in spite of, a shifting professional remit and the changing landscape of community pharmacy in Great Britain, (where almost 50% of pharmacy contracts are held by just 9 national chains). The study explores 'independence' as it is positioned by the pharmacists; expressed through a rhetorical framework of autonomy, engagement and the bespoke nature of practice, narratively embedded in accounts of urban situations. The research takes an ethnographic approach and was conducted in East and South-East London boroughs combining participant observation and active interviews with pharmacists. All but one of the pharmacists represented in the study were from ethnic minority backgrounds; this reflects a bias typical of urban independent pharmacy. The urban setting presents particular challenges but also particular opportunities and this study demonstrates how pharmacists cope with the constraints and possibilities afforded by their situation. In exploring concepts of professional personhood the study highlights the pharmacists' focus on the importance of autonomy and the creation of distinct professional personas. The significance of engagemen wtith customers is examined through stories of 'acceptance' and developing pharmacy 'communities' alongside the practice of maintaining personal relationships. This reveals the use of cultural capital by the pharmacists, taking advantage of shared cultural heritage and language skills to provide a distinct service offer. The value of providing a 'bespoke' service is investigated through areas of particular significance in differentiating independent pharmacy; 'time' and 'specialism'. The discussion concludes by raising questions about the place of independent pharmacy within the profession and emphasising the contribution independent pharmacists can make to the delivery of care in this setting.

Item Type: Thesis
Thesis Type: Doctoral
Thesis Name: PhD
Additional Information:
Faculty and Department: Faculty of Public Health and Policy > Dept of Health Services Research and Policy


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