Table 1 Using normalisation process theory to assess individually tailored prescribing

Normalisation Process Theory predicts that for a new intervention to become integrated into usual practice, there needs to be continuous investment by all parties in four areas of work. These include

• Making Sense of the intervention: everyone must understand how the intervention is distinct from other ways of working and why it matters

• Engagement: individuals and collectively people must commit to do the work of the new practice

• Action: people must have the skills and resources to deliver the new way of working

• Monitoring: people must get feedback which reinforces and encourages this way of working

May and colleagues designed a 16 item questionnaire to support the critical examination of these areas of work in assessing implementation and integration of ways of working [17]. The tool has been updated into a more user friendly format in the NOMAD tool [18].

We have previously used the toolkit to examine the enablers and barriers to delivery of expert generalist practice (EGP) in the primary care setting [15]. In this study, we will use the same approach to examine individually tailored prescribing.