Job responsibilities
Patient facing long-term condition clinics
See patients in multimorbidity clinics and in partnership with primary healthcare colleagues and implement improvements to patients medicines, including de-prescribing.
Manage own case load and run long-term condition clinics where responsible for prescribing as an independent prescriber for conditions where medicines have a large component (e.g., medicine optimisation for stable angina symptom control, warfarin monitoring and dose adjustment for patients requiring longterm anticoagulants).
- 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).
Patient facing clinical medication review
Undertake clinical medication reviews with patients with multimorbidity and polypharmacy and implement own prescribing changes (as an independent prescriber) and order relevant monitoring tests.
Patient facing care home/residential clinical medication reviews
Manage own caseload of care home residents. Undertake clinical medication reviews with patients with multimorbidity and polypharmacy and implement own prescribing changes (as an independent prescriber) and order relevant monitoring tests.
Work with care home staff to improve safety of medicines ordering and administration.
Management of common/minor/self-limiting ailments
Managing caseload for 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.
Patient facing medicines support
Provide patient facing clinics for those with questions, queries, and concerns about their medicines in the practice.
Telephone medicines support
Provide a telephone help line for patients with questions, queries, and concerns about their medicines.
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 test results, common/minor ailments, acute conditions, long term condition reviews etc.
Medicine information to practice staff and patients
Answer all medicinerelated enquiries from GPs, other practice staff, other Healthcare teams (e.g. community pharmacy) and patients.
Suggest and recommend solutions.
Provide follow up for patients to monitor the effect of any changes.
Unplanned hospital admissions
Devise and implement practice searches to identify cohorts of patients most likely to be at risk of an unplanned admission and readmissions from medicines.
Work with case managers, multidisciplinary (health and social care) review teams, hospital colleagues and virtual ward teams to manage medicines-related risk for re-admission and patient harm.
Put in place changes to reduce the prescribing of these medicines to high-risk patient groups.
Management of medicines at discharge from hospital
Reconcile medicines following discharge from hospitals, intermediate care and into care homes, including identifying and rectifying unexplained changes, and manage these changes without referral to a GP
Perform clinical medication reviews, produce post discharge medicines care plans including dose titration and booking of follow up tests, and work 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).
Work in partnership with hospital colleagues (e.g. care of the elderly doctors and clinical pharmacists) to proactively manage patients at high risk of medicine related problems before they are discharged to ensure continuity of care.
Repeat prescribing
Produce and implement a practice repeat prescribing policy. Manage the repeat prescribing re-authorisation process by reviewing patient requests for repeat prescriptions and reviewing medicines reaching review dates; make necessary changes as an independent prescriber, and ensure patients are booked in for necessary monitoring tests where required.
Risk stratification
Design, develop and implement computer searches to identify cohorts of patients at high risk of harm from medicines.
Responsible for management of risk stratification tools on behalf of the practice.
Working with patients and the primary care team to minimise risks through medicines optimisation.
Service development
Develop and manage new services that are built around new medicines or NICE guidance, where new medicine/recommendations allow the development of a new care pathway (e.g. new oral anticoagulants for stroke prevention in atrial fibrillation).
Medicines Quality Improvement Initiatives
Identify and provide leadership on areas of prescribing and medicines optimisation.
Conduct clinical audits and improve projects or work with colleagues such as GP registrars, practice managers etc.
Present results and provide leadership on suggested changes. Contribute to national and local research initiatives.
Medicines safety
Identify national and local policy and guidance that affects patient safety using medicines, including MHRA alerts, product withdrawals and emerging evidence from clinical trials.
Manage the process of implementing changes to medicines and guidance for practitioners.
Care Quality Commission
- Provide leadership to the general practice team to ensure the practice is compliant with CQC standards where medicines are involved.
- Undertake risk assessment and management and ensure compliance with medicines legislation.
Implementation of local and national guidelines and formulary recommendations
- Monitor practice prescribing against the local health economys RAG list for medicines that should be prescribed by hospital doctors (red drugs) or subject to shared care (amber drugs).
- Liaise directly with hospital colleagues where prescribing needs to be returned to specialists.
- Auditing practices compliance against NICE technology assessment guidance. Provide newsletters on important prescribing messages to improve prescribers knowledge and work with the team to develop and implement other techniques known to influence implementation of evidence such as audit and feedback.
Public health
- To support public health campaigns. To provide specialist knowledge on all public health programmes available.
Education and Training
- Provide education and training to the primary healthcare team on therapeutics and medicines optimisation.
- Provide training to visiting medical, nursing, pharmacy, and other healthcare students where appropriate.
- The post holder will be required to undertake the national CPPE modular training programme of 26 days in the first 18 months.
- Support Pharmacist and Pharmacy Technician placements in conjunction with the RUH, Community Pharmacies and other educational facilities.
Supervision and Line Management of Pharmacy Technicians
Ensure there is appropriate clinical supervision in place for Pharmacy Technicians which directly report to the postholder.
Ensure all Pharmacy Technicians are engaged with the Probation and Appraisal Process.
Support Pharmacy Technicians through their training and education.
Follow professional and organisational policies/procedures relating to performance management.
Manage and coordinate Annual Leave requests with the rest of the Pharmacy team.