’ (pharmacist 12). ‘It depends on who gets paid.’ (pharmacist 18). GPs and pharmacists were asked about perceived barriers to collaboration.

Some GPs didn’t identify any barriers, others listed the expected issues; that is, time and poor communication. Several GPs and pharmacists mentioned payment as a potential issue. Pharmacists identified many more barriers which included time and poor communication but also lack of communication, GP attitudes, inaccessibility, lack of familiarity and motivation to interact. For example ‘doctors are a bit insular, they tend to socialise Cabozantinib molecular weight with each other and that actually carries over to the workplace, that kind of barrier, an invisible barrier . . .’ (pharmacist 1). ‘You can’t tell a doctor anything, he can’t learn from anybody he’s supposed to know it all . . .’ (pharmacist 7). ‘For some doctors, they look down on the pharmacist, they tell you what to do . . . they don’t treat you equally. . . .’ (pharmacist 13). Pharmacists also identified that GPs might feel threatened by pharmacist involvement or that there might be an element of territorialism involved. For example ‘I went on a conference. . . . It

got GPs and pharmacists together, you can see they are not very comfortable being together and in terms of providing health care for the patients, they think we are actually stealing their customers.’ (pharmacist 5). For example ‘. . . the GPs might feel that they’re Celecoxib a little bit under attack because they haven’t put their patients on asthma plans, stuff like that.’ (pharmacist 18). GPs

negated this, describing it as their role or responsibility PF-02341066 purchase in patient care. Pharmacists recognised this as well. For example ‘. . . the doctor should lead the team, that’s got nothing to do with territorialism, it’s . . .  accept[ing] responsibility . . .’ (GP 2). ‘. . . doctors still see themselves as the number one provider.’ (pharmacist 10). ‘For some doctors, they look down on the pharmacist, they tell you what to do . . . they don’t treat you equally.’ (pharmacist 13). Low morale of the GP was reported by some GPs and pharmacists and was clearly identified as a potential barrier to teamwork/improved relationships. Universally, the patient was also perceived to be a barrier to a team approach. For example ‘. . . some customers (patients), when you advise them something they never return to the GP or they go to the GP and they might have a different opinion . . . and that’s the problem. . . .’ (pharmacist 5), ‘The patient, if they think its too much trouble [to follow your advice] . . . if you talk to the patient they’ll say “I don’t have time to go see the doctor” that’s probably the main problem because they don’t see asthma as one of the biggest health problems, even though they’re using their puffer four or five times a day . . .’ (pharmacist 12).