Clinical Pharmacist

Job description

Job responsibilities

Job Purpose

1. To improve patients health outcomes and the efficiency of the practice team by providing direct, accessible and timely medicines expertise, including identifying areas for improvement and initiating change.
2. To be the primary contact within the practices for queries relating to medicines management, in particular around individual patient care.
3. To focus on individual patient care by addressing immediate and future needs through personalised care planning
4. Proactively to transfer, from other clinical staff, workload relating to medicines optimisation to improve patient care and safety.
5. To demonstrate the effectiveness of the practices and PCN, and the CP role through audit and data analysis
6. To take on general practice workload including initial assessment of common presentations, recognise signs of serious illness, differential diagnosis and independent management minor ailments.
7. To follow up patients and investigations, particularly blood tests.

Job Summary:

1. The post holder is a pharmacist, who acts within their professional boundaries, supporting and working in the GP practices within the PCN. In this role they will be supported by a senior clinical pharmacist and GP leads who will discuss the development of the role and offer mentorship. Their line manager will be the PCN Manager. They will work autonomously and travel between surgeries to ensure that the population of the PCN has equitable access to their service.
2. The post holder will work as part of a multidisciplinary team. Within each practice this will be the GPs, nurses, HCAs and administrative staff. As the PCNs develop this will include social prescribing link workers, physiotherapists, paramedics and other additional roles as proscribed nationally. The Clinical Pharmacist will bring their expertise around medicines and prescribing to assist the team in providing holistic care.
3. The post holder will take responsibility for areas of chronic disease management within the practice and undertake clinical medication reviews to manage proactively patients with complex polypharmacy. Areas of focus might include CVD, COPD, Asthma, Diabetes, Frailty, etc.
4. The post holder will provide primary support to general practice staff with regards to prescription and medication queries. This may be face to face in surgery, patients homes, care homes, via telephone consultation or via online working. They will help support the repeat prescription system, deal with acute prescription requests, and medicines reconciliation on transfer of care and systems for safer prescribing, providing expertise in clinical medicines advice while addressing both public and social care needs of patients in the GP practice(s). They may run minor ailment clinics in surgery as appropriate for a pharmacy led clinic.
5. The post holder will provide clinical leadership on medicines optimisation and quality improvement and manage some aspects of the quality and outcomes framework and enhanced services.
6. The post holder will ensure that the practice integrates with community and hospital pharmacy to help utilise skill mix, improve patient outcomes, ensure better access to healthcare and help manage workload.
7. The role is pivotal to improving the quality of care and operational efficiencies so requires motivation and passion to deliver excellent service within general practice. The post holder will be supported to develop their role, if not already, to become a non-medical prescriber.

1. Clinical - Long Term Conditions / Chronic Disease Management - via pharmacist led clinics, telephone and office based notes reviews

a) Undertake disease focused medication reviews, particularly of high risk groups (elderly, renal/hepatic impairment, patients on high-risk medicines, etc.) to improve effectiveness and safety, and to ensure appropriate compliance with national and local guidelines.

b) These may be patients with single or multiple medical problems where medicine optimisation is required (e.g. respiratory, hypertension).

c) Ensure the care for patients taking high risk drugs e.g. DMARDs, anticoagulation, are safe and appropriate.

d) Review the on-going need for each medicine.

e) Titrate medication according to need and guidance.

f) Review monitoring requirements and arrange appropriately, ensuring recalls are placed on the IT system.

g) Use the opportunity to support patients with administration of their medicines.

h) Telephone advice to patients with LTCs on specific medicines management issues.

i) Provide health promotion where appropriate, including flu vaccinations.

j) Discuss where necessary any recommendations or concerns with Senior Pharmacists or GPs.

k) Undertake audits and reviews of LTC groups where bulk changes are required.

1. Clinical - Repeat Prescribing and Medication Reviews

a) Develop and quality-assure improved, safe and efficient repeat prescribing and medication review processes within the practices/PCN, and implement changes as required.

b) Undertake focused and structured clinical medication reviews with individual patients and produce a management plan on future prescribing and monitoring, with a focus on maximising effectiveness and reducing harm.

c) Review processes will update repeat prescribing in line with local and national policies to align to best practice and reduce wastage.

d) Medication reviews will be undertaken via clinics in the practice, domiciliary visits and in residential and nursing homes. These may be face to face or records based reviews.

e) Ensure computer records are updated and accurate, and recall / review dates are entered appropriately.

1. Clinical - Acute Illness Pharmacist led clinics

a) Pharmacists may be involved in clinics assessing patients who present with undifferentiated minor illness, working within their scope of practice and limits of competence.

b) Undertake initial assessment of common general practice presentations, working through differential diagnosis, identifying potential serious disease and referring to GPs and other healthcare professionals where appropriate.

c) Triaging and managing minor illness, with particular focus on educating patients on self-care, and signposting to minor ailment schemes, minor eye complaints service, dental services, etc.

d) Telephone advice to patients with acute illness queries.

1. Risk Stratification around medication harm and avoidable hospital admissions

a) Review the use of medicines most commonly associated with unplanned hospital admissions through audit and individual patient reviews with the intent of reducing avoidable admissions.

b) Put in place changes to reduce the prescribing of these medicines to highrisk patient groups

c) Identification of cohorts of patients at high risk of harm from medicines through practice computer searches. This might include risks that are patient related, medicine related, or both.

1. Management of medicines at discharge from hospital

a) To reconcile medicines following discharge from hospitals, intermediate care and into/from care homes, including identifying and rectifying unexplained changes and working with patients and community pharmacists to ensure patients receive the medicines they need post-discharge.

b) Set up and manage systems to ensure continuity of medicines supply to highrisk groups of patients (e.g. those with medicine compliance aids or those in care homes).

c) Reconcile patients computer records with discharge medication and discuss discrepancies or concerns with hospital doctors/pharmacists

d) Ensure changes to discharge medication are in concordance with national and local policies, and to ensure optimisation of treatment and reduce inappropriate or wasteful prescribing.

e) Ensure instructions and recommendations are enacted within the practice, including organising reviews, blood test monitoring and appropriate up/down titration.

f) Ensure patients are informed and aware of any changes to their medication.

Team Information, Education and Training

a) Answers relevant medicines and prescribing related enquiries from GPs, other practice staff, other healthcare teams (e.g. community pharmacy) with queries about medicines.

b) To consider the skills of the reception team and develop plans for training as necessary to ensure safe and efficient prescribing processes.

1. Implementation of local and national guidelines, safety alerts and formulary recommendations

a) Implement changes to medicines and prescribing that result from MHRA alerts, product withdrawal and other local and national guidance.

b)Assessing the practices compliance with NICE guidance and advise on the implementation of new guidance

c) Assist practices in maintaining and complying with a practice/PCN/Locality formulary.

d) Monitor practice prescribing against the local health economys RAG list / formulary and make recommendations to GPs for medicines that should be prescribed by hospital doctors (red drugs) or subject to shared care agreements (ESCAs) for amber drugs.

1. Audit and Monitoring

a) To plan and undertake prescribing audits to identify areas where improvement is needed, develop action plans and implement appropriate changes.

c) Analyse practice complex prescribing data to inform GPs and non-medical prescribers on their collective and individual performance.

d) Analyse, interpret and present medicines management / prescribing data to highlight issues and risks.

f) Undertake specific audits on the effectiveness of the role, and where improvements or review of service/role are needed

g) Assist with the implementation and monitoring of CCG medicines management targets and initiatives, including the medicines management QIPP plan and national prescribing targets.

h) Support the implementation of actions resulting from audit findings when necessary.

i) To agree all auditing and monitoring priorities in discussion with the practice.

Person Specification

Qualifications

Essential

• see attached

Desirable

• see attached

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).

Employer details

Employer name

Richmond Medical Centre

Address

179 Richmond Road

Solihull

West Midlands

B92 7SA

Employer's website

https://www.richmondmc.co.uk/ (Opens in a new tab)