Advanced Clinical Pharmacist Primary Care

Job description

Job responsibilities

Key Responsibilities:

*manage a clinical caseload and prescribe as an independent prescriber

*provide comprehensive clinical pharmacy support to the PCN, its staff, and its patients

*provide clinical leadership on medicines optimisation and quality improvement

*work as part of a multi-disciplinary team in a patient facing role to clinically assess and treat patients

*be a prescriber, or completing training to become prescribers, and work with and alongside the general practice team;

*be responsible for the care management of patients with chronic diseases and undertake clinical medication reviews to proactively manage people with complex polypharmacy

*provide specialist expertise in the use of medicines whilst helping to address both the public health and social care needs of patients at the PCN's practice(s) and to help in tackling inequalities;

*provide leadership on person-centred medicines optimisation (including ensuring prescribers in the practice conserve antibiotics in line with local antimicrobial stewardship guidance) and quality improvement, whilst contributing to the quality and outcomes framework and enhanced services;

*through structured medication reviews, support patients to take their medications to get the best from them, reduce waste and promote selfcare;

*have a leadership role in supporting further integration of general practice with the wider healthcare teams (including community and hospital pharmacy) to help improve patient outcomes, ensure better access to healthcare and help manage general practice workload;

*develop relationships and work closely with other pharmacy professionals across PCNs and the wider health and social care system;

*take a central role in the clinical aspects of shared care protocols, clinical research with medicines, liaison with specialist pharmacists (including mental health and reduction of inappropriate antipsychotic use in people with learning disabilities), liaison with community pharmacists and anticoagulation;

*be part of a professional clinical network and have access to appropriate clinical supervision. Appropriate clinical supervision means:

oi. each clinical pharmacist must receive a minimum of one supervision session per month by a senior clinical / advanced practice pharmacist

oThis does not need to be a senior clinical / advanced practice pharmacist within the PCN but could be part of a wider local network, including from secondary care or another PCN.

oii. the senior clinical / advanced practice pharmacist must receive a minimum of one supervision session every three months by a GP clinical supervisor;

oeach clinical pharmacist/senior clinical pharmacist/advanced practice pharmacist will have access to an assigned GP clinical supervisor for support and development;

oiv. a ratio of one senior clinical / advanced practice pharmacist to no more than five junior clinical pharmacists, with appropriate peer support and supervision in place.

Additional Duties:

*assess and triage patients, including same day triage, and as appropriate provide definitive treatment (including prescribing medications following policy, patient group directives, NICE (national) and local clinical guidelines and local care pathways) or make necessary referrals to other members of the primary care team;

*manage undifferentiated undiagnosed condition and identify red flags and underlying serious pathology and take appropriate action; use complex decision making to inform the diagnosis, investigation, complete management of episodes of care within a broad scope of practice;

*actively take a personalised care approach and population-centred care approach to enable shared decision making with the presenting person;

*and complete the relevant training in order to provide multi-professional clinical practice and CPD supervision to other roles within primary care, for example, first contact practitioners and the personalised care roles.

Responsibility for Patient/Client Care

*This is a patient-facing role focused on delivering medicines optimisation for all patients. The position requires a flexible and adaptable approach and includes a range of responsibilities, with particular emphasis on certain activities during different phases of the clinical pharmacy team's operations.

*The post holder must possess the skills to consult with patients who have single or multiple medical conditions requiring medicines optimisation. They will manage their own caseload of vulnerable patients at risk of hospital admission and harm due to poor medication management, as well as oversee the work of the network clinical pharmacist.

*The role involves running long-term condition clinics, where the post holder will be responsible for prescribing as an independent prescriber, particularly for conditions heavily reliant on medication, such as the optimisation of new antihypertensives or management of stable angina patients.

*The post holder will regularly review the ongoing necessity of each medication, assess monitoring requirements, and support patients in their medication adherence to ensure they derive optimal benefit from their prescriptions.

*Patients will be actively involved in decisions regarding their prescribed medications, with support offered to enhance adherence.

*The post holder will conduct structured clinical medication reviews for patients with multiple health issues and polypharmacy, implementing prescribing changes as an independent prescriber or facilitating necessary alterations, including ordering relevant tests.

*The postholder will focus on frail patients taking 10 or more medications, as this can lead to side effects and harm within proactive care.

*Recommendations will be provided to clinical pharmacists, nurses, or GPs regarding prescribing and monitoring practices.

*The role involves attending and referring patients to multidisciplinary case conferences, identifying key needs for vulnerable patients, and formulating comprehensive care plans.

*Patient-facing clinics will be provided for individuals with questions or concerns about their medications.

*Telephone consultations will be offered to address patients' inquiries related to their medications.

*The post holder will respond to medication-related questions from GPs, other network staff, healthcare teams (including community pharmacists), and patients, suggesting solutions and following up to monitor the impact of any changes.

*The role includes initiating practice searches to identify cohorts of at-risk patients, such as those with unplanned admissions or readmissions due to medication issues. Collaboration will occur with case managers, multidisciplinary review teams, hospital colleagues, and virtual ward teams to manage medication-related risks effectively.

*A robust system for reconciling medicines at the point of care transition will be developed, which includes identifying and addressing changes without requiring GP referral. This will involve conducting a clinical medication review and producing a post-discharge medicines care plan, complete with dose titration and follow-up test arrangements, while ensuring collaboration with patients and community pharmacists.

*The post holder will ensure the establishment and management of systems that maintain continuity of medicine supply for high-risk patient groups, such as those using compliance aids or residing in care homes.

*Strong partnerships with hospital colleagues will be cultivated to ensure proactive management of patients at high risk of medication-related problems, thereby improving their care.

*Collaboration with community pharmacy colleagues will also be prioritised to enhance medicines optimisation and patient safety.

*A mechanism will be developed for referring patients to appropriate healthcare professionals for pathology test results or for addressing common, minor, or low-acuity conditions, as well as long-term condition reviews.

*The post holder will recognise priorities and refer cases to senior colleagues or GPs when necessary.

*Clinical pharmacist services will be provided across primary care and hospital sectors as required.

The application of additional clinical duties may include:

*Provide pharmacist support and clinical decision-making during consultant-led ward rounds and multidisciplinary team (MDT) meetings as appropriate.

*Offer highly specialised and complex Medicines Information (both legal and clinical) to healthcare staff, including Integrated Care Boards (ICBs), Community Trusts, PCNs, and any other personnel involved in patient care.

*Ensure accurate and timely transfer of care upon patient discharge, identifying and following up with complex and at-risk patients in the community. Provide clinical support and professional supervision to the pharmacy technician workforce.

*Collaborate with the ICBs Medicines Management Team to create effective and seamless community and domiciliary patient care, ensuring that the proactive and reactive needs of patients and the healthcare system are met.

Further information about the Trust and this role can be found on the Job Description and Person Specification document attached. It is important to us that we ensure our recruitment processes are accessible and inclusive to everyone - if as a potential candidate you are concerned a person specification may prevent or restrict your application for employment as a result of unintentional barriers on the grounds of your sex, race, age, sexual orientation, religion/belief or disability please initially contact the Trust's Recruitment team - detailed in the advert. The Trust will seek to resolve this issue wherever possible.

We are happy to talk Flexible Working - all requests for flexible working options can be discussed as part of the interview process.

Person Specification

Qualifications

Essential

• Master's degree in pharmacy (MPharm) or equivalent.
• Registered as a Pharmacist with the General Pharmaceutical Council
• Independent prescriber qualification held
• PCPEP SOAP held

Desirable

• Postgraduate clinical pharmacy diploma or equivalent.

Experience

Essential

• Significant experience working in general practice, hospital or community setting
• * Experience working in a multidisciplinary team, co-ordinating complex activities/programmes of care with other professionals and agencies
• * Track record of problem solving
• * Experience in managing own priorities whilst working under pressure
• * Confident in the use of computer systems, spreadsheets, databases, data collection and coordination and word processing.
• * Effective communicator able to communicate highly complex and sensitive information where there may be barriers to understanding
• * Inquisitive and eager to learn, asks questions and responds positively to change in practice/procedure. Seeks ways to improve self and others
• * Methodical/systematic worker able to work on own initiative
• * Accurate, good attention to detail
• * Can plan, manage, monitor, advise and review general medicine optimisation issues in core areas for long-term conditions
• * Produce timely and informative reports
• * An appreciation of the nature of primary care prescribing, concepts of rational prescribing and strategies for improving prescribing
• * An understanding of the principles of equal opportunities as it relates to staff and patients and able to demonstrate personal commitment to challenging discrimination and promoting equalities.
• * An understanding of equality within the workforce and how it can impact on this post.

Desirable

• Knowledge of NHS primary and secondary care working including managing prescribing across the interface

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

Hampshire and Isle of Wight Healthcare NHS Foundation Trust

Address

Western Community Hospital

Walnut Grove

Southampton

Hampshire

SO16 4XE

Employer's website

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