Job responsibilities
Job responsibilities
The post holder will work within
their clinical competencies as part of a multi-disciplinary team to provide
expertise in clinical medicines management, provide face to face structured
medication reviews, manage long term conditions, management of medicines on
transfer of care and systems for safer prescribing, manage repeat prescription
authorisations and reauthorisation, acute prescription request, while
addressing both the public health and social care needs of patients in the GP
practice(s) that make up the PCN.
The post holder will perform face
to face medication review of patients with polypharmacy especially for older
people, people in residential care homes and those with multiple
co-morbidities. The post holder will provide leadership on quality improvement
and clinical audit and well as managing some aspects of the Quality and
Outcomes Framework.
This role is pivotal to improving
the quality of care and operational efficiencies so requires motivation and
passion to deliver an excellent service within general practice.
The post holder will be supported
to develop their role to become a non-medical prescriber if that qualification
is not already held.
Key duties and
responsibilities:
1. Patient facing Long-term
condition Clinics
See (where appropriate) patients
with single or multiple medical problems where medicine optimisation is
required (e.g. Respiratory, Cardiovascular and Diabetes). Review the on-going
need for each medicine, a review of monitoring needs and an opportunity to
support patients with their medicines taking ensuring they get the best use of
their medicines (i.e. medicines optimisation). Make appropriate recommendations
to Senior Clinicians and GPs for medicine improvement.
2. Patient facing Clinical Medication
Review
Undertake clinical medication
reviews with patients and produce recommendations for senior clinical
pharmacist, nurses and/or GP on prescribing and monitoring.
3. Patient facing Care Home
Medication Reviews
Undertake clinical medication
reviews with patients and produce recommendations for the senior clinical
pharmacist, nurses or GPs on prescribing and monitoring. Work with care home
staff to improve safety of medicines ordering and administration. Form part of
the Care Home MDT.
4. Patient facing Domiciliary
Clinical Medication Reviews
Undertake clinical medication
reviews with patients and produce recommendations for the senior clinical
pharmacists, nurses and GPs on prescribing and monitoring. Attend and refer
patients to multidisciplinary case conferences.
5. Risk stratification
Identification of cohorts of
patients at high risk of harm from medicines through pre-prepared practice
computer searches. This might include risks that are patient related, medicine
related, or both.
6.Unplanned hospital
admissions
Review the use of medicines most
commonly associated with unplanned hospital admissions and readmissions through
audit and individual patient reviews. Put in place changes to reduce the
prescribing of these medicines to high-risk patient groups.
7. Management of
common/minor/self-limiting ailments
Managing caseload of patients
with common/minor/self-limiting ailments while working within a scope of
practice and limits of competence. Signposting to community pharmacy and referring
to GPs or other healthcare professionals where appropriate.
8. Patient facing medicines
support
Provide patient facing clinics
for those with questions, queries and concerns about their medicines in the
practice.
9. Management of medicines at
discharge from hospital
To reconcile medicines following
discharge from hospitals, intermediate care and into 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. Set up and manage systems to ensure continuity of medicines supply
to high-risk groups of patients (e.g. those with medicine compliance aids or
those in Care Homes).
11. Medicine information to
practice staff and patients
Answers relevant medicine-related
enquiries from GPs, other network staff, other healthcare teams (e.g. community
pharmacy) and patients with queries about medicines.
Suggesting and recommending
solutions. Providing follow up for patients to monitor the effect of any
changes.
12. Signposting
Ensure that patients are referred
to the appropriate healthcare professional for the appropriate level of care
within an appropriate period of time e.g. pathology results, common/minor
ailments, acute conditions, long term condition reviews etc.
13. Repeat prescribing
Produce and implement a repeat
prescribing policy within each PCN practice. Manage the repeat prescribing
reauthorisation process by reviewing patient requests for repeat
prescriptions and reviewing medicines
reaching review dates and flagging up those needing a review.
Ensure patients have appropriate
monitoring tests in place when required.
14. Service development
Contribute pharmaceutical advice
for the development and implementation of new services that have medicinal
components (e.g. advice on treatment pathways and patient information
leaflets).
15. Information management
Analyse, interpret and present
medicines data to highlight issues and risks to support decision making.
16. Medicines quality improvement
Undertake clinical audits of
prescribing in areas directed by the GPs, feedback the results and implement
changes in conjunction with the relevant practice team.
17. Medicines safety
Implement changes to medicines
that result from MHRA alerts, product withdrawal and other local and national
guidance.
18. Implementation of local
and national guidelines and formulary recommendations
Monitor practice prescribing
against the local health economies RAG list and make recommendations to GPs for
medicines that should be prescribed by hospital doctors (red drugs) or subject
to shared care (amber drugs). Assist practices in seeing and maintaining a
practice formulary that is hosted on each practices computer system.
Auditing practices compliance
against NICE technology assessment guidance.
Provide updates at meetings and
via GP Teamnet on important prescribing messages.
19. Education and Training
Provide education and training to
primary healthcare team on therapeutics and medicines optimisation.
20. Care Quality Commission
Work with the general practice
teams to ensure the practices are compliant with CQC standards where medicines
are involved.
21. Public health
To support public health
campaigns. To provide specialist knowledge on all public health programmes
available to the general public.
22. Collaborative working
arrangements - PCN MDT.
Liaises with CCG colleagues
including CCG pharmacists on prescribing related matters to ensure consistency
of patient care and benefit.
Liaises with colleagues including
CCG,STP/ICS Pharmacists and Pharmacy Technicians on prescribing related matters
to ensure consistency of patient care and benefit
Liaises with colleagues including
CCG,STP/ICS Pharmacists and Pharmacy Technicians Heads of Medicines
Management/Optimisation to benefit from peer support.
Foster and maintain strong links
with all services across the PCN and neighbouring networks. Explores the
potential for collaborative working and takes opportunities to initiate and
sustain such relationships.
