Rheumatology Specialist Pharmacist

Job description

Job responsibilities

To further examine the opportunities for biologics. 

This may include:

Introducing new biosimilars when available and monitoring their outcomes

Reviewing stopping criteria

Monitor homecare deliveries to reduce waste, including patients in a partnership

Help in moving appropriate patients to subcutaneous formulations as they become available

To advise and develop biologic pathways in collaboration with the ICB when/ if new developments are made and/ or new biologics are introduced

Conduct audit on patients due to start on biologics are instead started on MTX S/C (if appropriate) and the financial savings this could make vs starting patients on biologics

Start biologic weaning clinic for stable patients with regular monitoring to wean patients off biologic safely resulting in reduced medication burden to patient and financial saving for trust

Start moderate pathway initiating clinic as per NICE - starting patients early on biologics will reduce the health-economic impact.

Counselling patients starting biologics and DMARD's thoroughly will help reduce calls to helpline and improve patient safety and compliance

Safety checks for patients initiated on biologic can be done by nurse/ pharmacist as a telephone clinic - increasing clinic capacity in doctors clinic for new patients

Combined counselling sessions for patients being started on DMARD's/  Biologics - having presentations to run through the information

Leads the highly specialised clinical pharmacy service to patients within rheumatology. Cross covers the pharmaceutical service to other clinical specialities to maintain a safe patient service. Ensures medicines are used appropriately, safely, and cost-effectively in accordance with NICE guidelines, national guidelines, Trust policy, standard operating procedures and medicine legislation. The post holder is expected to determine how the outcomes are best achieved in specific circumstances.

KEY RESULT AREAS:

To provide a comprehensive clinical pharmacy service to rheumatology patients as appropriate (predominantly out-patient based) including better monitoring and shared care management of patients on DMARDS, improved adherence to formulary medicines and prescribing guidelines, consistent patient treatment, improved patient counselling and decreased likelihood of missed doses

To work with the specialist nurses & consultants in rheumatology to implement biosimilar switching, to the benefit of the health economy and to maximise the income to the Trust from switches

To lead on setting up biologics review clinics for rheumatology patients & evaluate savings.

Duties and responsibilities

1. Service Provision

1.1 To lead on the implementation of the biosimilar switching as appropriate to ensure patients are switched as smoothly as possible & within the Trust timeframe of the biosimilar implementation

1.2 To work with the specialist nurses to keep a database of all switches & ensure patients are followed up

1.3 To keep a record of failures to switch & the reasons why

1.4 To produce financial reports for the Family, Diagnostic and Community and Planned Pathways Divisions where appropriate

1.5 To improve mechanisms within Rheumatology to minimise ‘waste’ with Homecare biologics. Examples of mechanisms include: monitoring dose changes; monitoring prescription requests and monitoring drug supplies.

1.6 To ensure the smooth running, day to day management of the Homecare pharmacy service to the rheumatology patients, as well as ensuring the switch happens with no disruption to patients.

1.7 To optimise funding applications for biological therapies that are used outside of national guidelines

1.8 To assist the existing CNS Rheumatology team in setting up a Biologics Review Service to optimise the use of biological therapy within the Rheumatology Service

1.9 To ensure that service provision is flexible and responsive to patient and service needs

1.10 To ensure the safe, clinically effective and cost-efficient use of drugs within rheumatology

1.11 To attend MDTs as part of the multi-disciplinary team

1.12 To meet any medication-related needs of rheumatology patients

1.13 To ensure that all healthcare professionals working in rheumatology are trained appropriately and are aware of all medicine related policies and procedures relating to the service

1.14 To provide drug expenditure reports and identify potential cost savings within the service as requested

1.15 To design and carry out audits as required

1.16 To attend outpatient clinics as deemed appropriate

1.17 Undertake risk management, including investigating clinical incidents in rheumatology and ensuring compliance with medicine legislation.

1.18 The post holder will be expected to identify, where necessary, areas that require service changes and develop a strategy to carry out the change through consultation with senior colleagues within and outside the pharmacy including commissioners.

1.19 Communication with ICB and NHS England about medicines policies or guidelines specific for their area of practice and for funding requests

1.20 Review and deal with high cost drug challenges from ICB and NHS England

1.21 Undertakes research into homecare medicines management services, which may include the trial of novel methods of providing homecare medicines management, or services for medicines previously not managed through homecare.

1.22 Pharmacy lead in the achievement of short, and long term, objectives within rheumatology in relation to medicine optimisation, especially regarding DMARDS

1.23 Develop and manage biologic review meetings to discuss all biologic initiations and yearly reviews

1.24 Counselling patients and answering concerns on their medication including telephone support clinics

1.25 To manage non biologic patients through drug switching DMARD management

1.26 To implement NICE guidance

1.28 Write or respond to business cases for service development to secure additional funding.

1.29 Attend departmental meetings to advise on medicine use and financial implications

1.30 Horizon scan for new drugs and advise the rheumatology meetings on the financial implications

1.31 Co-ordinate Medicines Use Savings Projects

1.32 Review prescribing data from out-patient clinics

1.33 To develop shared care guidelines for rheumatology

1.34 Responsible for self-audit and data collection to evaluate the on-going effectiveness of the role of Advanced Clinical Pharmacist for rheumatology

2. Clinical Practice

2.1 To act as a clinical role model to all pharmacists and ensure the safe clinically effective/evidence based and cost efficient use of drugs

2.2 If the service needs require it to train and work as an Independent Prescriber according to Trust Policies and within your identified scope of practice, as appropriate to the role

2.3 To professionally screen/check prescriptions, thus taking professional responsibility, as required by legislation

2.4 To integrate research evidence into practice

2.5 To plan, monitor and review drug treatment protocols dosing including implementation of new drugs and treatment strategies

2.6 To optimise patient knowledge of their drugs including counselling patients and relatives on the use of their drugs.

2.7 To enhance the quality of patient care

2.8 To ensure that in-patients reviewed have accurate drug histories documented, any supplies of their own medication checked, and any medication required supplied as soon as possible. To ensure that all changes to medication are communicated to the GP.

2.9 To demonstrate expert clinical knowledge

2.10 To influence prescribers and recommend changes to patient’s treatment where appropriate

2.11 To make decisions with limited information

2.12 To work with a whole-system patient focused approach

2.13 To communicate with patients and health care professionals

2.14 To prioritise clinical interventions according to individual patient needs

2.15 To help with the monitoring and implementation of Clinical Management Guidelines and Formulary adherence

2.16 To contribute to the implementation of national guidance as needed

3. General Service Provision

3.1 To provide a high quality, patient focused pharmaceutical service to in-patients, outpatients, discharge patients and other patients as required by the rheumatology

3.2 To input prescription information using the Pharmacy Computer system

3.3 To be able to use the computerised e-prescribing & medical notes system used in the Trust

3.4 To dispense and supply drugs to patients (including using the automated dispensing system (‘Robot’))

3.5 To provide evaluated pharmaceutical advice and information, to all health care professionals and patients of the Trust using on-line data bases and primary sources

3.6 To have a working knowledge of pharmacy stock control and ordering systems

3.7 To collect and handle prescription monies according to Government and Trust policy

Full details on attached JD. This job description may be subject to change according to the varying needs of the service. Such changes will be made after discussion between the post holder and the manager. All duties must be carried out under supervision or within Trust policy and procedure.

Person Specification

Qualifications

Essential

• Masters qualification in pharmacy or equivalent qualification plus one- year pre-registration experience
• Registrant of the General Pharmaceutical Council (GPhC)
• Postgraduate diploma in clinical pharmacy or equivalent experience or qualification
• Independent prescriber status or ability to complete course leading to independent prescriber qualification

Experience

Essential

• Substantial post-registration experience as a practising clinical pharmacist.
• Experience of dealing with highly complex clinical issues which require the pharmacist to analyse information from a range of sources, which may not be in agreement, to formulate a response. In such situations, it may be necessary to find a novel solution to an unusual clinical situation. The pharmacist will have developed negotiating and persuasive skills with other clinical team members, patients and relatives.
• Experience of dealing with a wide variety and grade of hospital staff (including senior medical and managerial staff) on a regular and ongoing basis.
• Experience of hospital clinical pharmacy services, including high cost and homecare services.

Desirable

• Experience in consultant rounds
• Experience of managing funding applications for PbR excluded drugs
• Experience of undertaking specific project-based work
• Wide experience in the use of computers and data analysis and reporting
• Experience of risk management
• Experience in training and supervision of staff
• Experience of undertaking drug use review, audit, drug expenditure reporting, therapeutic drug monitoring, writing prescribing guidelines

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.

Employer details

Employer name

The Princess Alexandra Hospital NHS Trust

Address

The Princess Alexandra Hospital

Harlow

Essex

CM20 1QX

Employer's website

https://www.pah.nhs.uk (Opens in a new tab)