Jeroen van de Pol

15 General introduction 1 A guiding coalition The second step in Kotters’ 8-step change model states that a guiding coalition is a coalition of effective people that can guide, coordinate and communicate [25]. This can be seen as the formation of a group with enough impact that can actually lead the change. Within the Netherlands, the Royal Dutch Pharmacists Association is the most likely party, supported by the larger community pharmacy chains. This coalition will need the support of other stakeholders as well such as GP professional bodies and governmental bodies. The current community pharmacy market is highly divided. With the majority of roughly the nationwide 2,000 community pharmacies being part of one of four community pharmacy chains that negotiate on their behalf with healthcare insurance companies [40]. These four companies also compete with each other and have diverging interests. So this creates a risk for the community pharmacy profession in which these diverging interests can lead to a reduction in cooperation and realizing necessary developments within the profession. However, the Royal Dutch Pharmacists Association in cooperation with these companies have organized a regular recurring meeting to discuss issues such as professional developments. This to create common grounds within the entire profession to facilitate developments based on the quality of care. Form a strategic vision and initiatives Within Kotters’ 8-step change model, a strategic vision and initiatives directly linked to the vision clarifies on how the future will be different from the past and present [25]. Already in the year 1993 the Royal Dutch Pharmacists Association (KNMP) in the Netherlands launched a campaign called “klaar om te wenden!” (translated to English: “ready about!”). The campaign was initiated to inspire community pharmacist to redefine their position within the healthcare setting by putting more emphasis on relationships with both patients and general practitioners [20]. However, the effect that the campaign eventually had was small. The KNMP also published a whitepaper in 2010 stating the role and position of the community pharmacist within healthcare [21]. Nowadays, the KNMP has stated a vision for the future ‘your pharmacist in 2020’ [39] and is also developing a renewed vision for 2025. However, some topics that were relevant regarding the transition of community pharmacy practice in 1993 and 2010 are still current topics today. This shows that shifting focus within a profession is a gradual process and suggests multiple barriers when implementing the strategic vision into daily community pharmacy practice.