Background
Integrated working between community pharmacists and general practitioners (GPs) has previously been hindered by a number of interprofessional barriers.¹ One aspiration of the Local Pharmaceutical Services (LPS) contract introduced in 2002, is that it will enable community pharmacists to work more closely with other health professionals, as part of an integrated primary health care team (PHCT).² 

Methods 
A longitudinal study was conducted as part of the national evaluation of LPS pilots. Two postal questionnaire surveys were sent to all first wave LPS providers: the first questionnaire captured pharmacy details prior to involvement in LPS and the second questionnaire captured the same information, plus additional details, once the pilots had been operational for at least nine months. Data from both questionnaires were analysed and compared using SPSS. 90% of providers responded to the first questionnaire (28/31) and 89% to the second (24/27). Twenty pharmacies responded to both surveys, although, due to personnel changes, only 13 of these questionnaires had been completed by the same individual. Differences in responses from the two questionnaires were examined to identify changes resulting from the implementation of the LPS pilot. 

Results
Fifty eight percent (14/24) of respondents to the second questionnaire stated that it was an aim of their LPS pilot to improve integration into the PHCT. Of these, 71% (10/14) said that this aim had been met to some extent. However, data from a separate question showed that the majority of respondents (9/13, 69%) felt neither more nor less integrated into the PHCT than before the start of their LPS pilot.

Respondents to the second questionnaire provided details of 55 GP practices with which they had the closest links. Relationships with 47% of these practices (26/55) were said to have improved over the last year, 51% (28/55) had remained the same, with only 2% (1/55) deteriorating. Analysis of both questionnaires revealed a small improvement in access to GP patient records. Six providers (6/20 (30%)) had seen an increase in the number of practices at which they had access to GP records; half of these had not had access to records prior to LPS. Results from the second questionnaire show that over half the providers did not have access to records at any practices (13/21), yet 62% (8/13) thought that having access would enhance their service provision. The majority of those without access to records were multiple community pharmacies (8/13, 62%).

Discussion
These results suggest that LPS may have contributed to strengthening relationships between providers and GP practices, with varying impact depending on the size of the community pharmacy business. However, relationships take time to develop and to date the improved relationships have not yet been manifested by any substantial increase in access to GP records. Additional data is required to examine the true extent to which LPS has contributed to providers feeling more integrated into the wider PHCT.