PCN Clinical Pharmacist

Job responsibilities

Job Summary

The post holder is an experienced pharmacist, who acts within their professional boundaries, to develop, manage and mentor a team of pharmacists.

The post holder will work as part of a multi-disciplinary team in a patient-facing role. The post holder will take responsibility for areas of chronic disease management within the practice and undertake clinical medication reviews to proactively manage patients with complex polypharmacy, especially for older people, people in residential care homes and those with multiple co-morbidities.

The post holder will provide primary support to general practice staff with regards to prescription and medication queries. They will help support the repeat prescriptions system, deal with acute prescription requests, 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 patient in the GP practice (s).

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.

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. 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.

Primary Responsibilities

Patient facing long term conditions clinics

-See patients in multimorbidity clinics and in partnership with primary healthcare colleagues and implement improvements to patients medicines, including deprescribing.

-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

Patient facing domicillary/home visits

-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.

Differential/Undifferential diagnosis

-Manage own caseload for patients and diagnosis people with long term and/or acute/common conditions/ailments while remaining within scope of practice and limits of competence

- Referring to GP and/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

Telehphone medicines support

- Provide a telephone help line for patients with questions, queries and concerns about their medicines.

Extended Hours/Out of Hours/On call service

- Provide out of hours/on call/extended services for the practice and the patients. These can include patient facing and telephone consultations

- Signposts to other services and/or healthcare professionals where appropriate, while working within a scope of practice and limits of competency.

Medicine Information to practice staff and patients

-Answers all medicinerelated enquiries from GPs, other practice 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.

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 readmission 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

-To reconcile medicines following discharge from hospitals, intermediate care and into care homes, including identifying and rectifying unexplained changes manage these changes without referral to a GP.

-Perform a clinical medication review, produce a post discharge medicines care plan including dose titration and booking of follow up tests and working with patients and community pharmacists to ensure patients receive the medicines they need post discharge 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).

-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.

Telephone triage

-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.

Repeat prescribing

-Produce and implement a practice repeat prescribing policy. Manage the repeat prescribing reauthorisation 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, development and implementation of computer searches to identify cohorts of patients at high risk of harm from medicines.

-Responsibility 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 a new medicine/recommendations allow the development of a new care pathway (e.g. new oral anticoagulants for stroke prevention in atrial fibrillation).

Information management

-Analyse, interpret and present medicines data to highlight issues and risks to support decision-making.

Medicines Quality Improvement programmes

-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 through the use of medicines, including MHRA alerts, product withdrawals and emerging evidence form 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 recommedations

-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. Assist practices in setting and maintaining a practice formulary that is hosted on the practices computer system.

-Suggest and develop computer decision support tools to help remind prescribers about the agreed formulary choice and local recommendations.

-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.

Education and Training

-Provide education and training to primary healthcare team on therapeutics and medicines optimisation.

-Provide training to visiting medical, nursing, pharmacy and other healthcare students where appropriate.

Education, Training and Development

Essential

• Understands and demonstrates the characteristics of a role model to members in the team and/or service
• Demonstrates understanding of the mentorship process
• Demonstrates ability to conduct teaching and assessment effectively according to a learning plan with supervision from more experience colleague
• Demonstrates self-development through continuous professional development activity
• Participates in the delivery of formal education programmes; inspiring others to be positive in their support of continuous improvement
• Demonstrates an understanding of current educational policies relevant to working areas of practice and keeps up to date with relevant clinical practice.
• Ensure there is appropriate clinical supervision in place all pharmacists
• Ensures all pharmacists are engaged with the review and appraisal systems within the practice

Research and Evaluation

Essential

• Demonstrates ability to critically evaluate and review literature
• Demonstrates ability to identify where there is a gap in the evidence base to support practice
• Demonstrates ability to generate evidence suitable for presentations at practice and local level
• Demonstrates ability to apply research evidence base into working place
• Demonstrates understanding of principles of research governance.

Qualifications

Essential

• Mandatory registration with General Pharmaceutical Council (GPhC)
• Independent prescriber or working towards/intent of gaining an independent prescribing qualification
• Masters degree in pharmacy (MPharm) (or equivalent)

Desirable

• Membership of the Royal Pharmaceutical Society
• A member of or working towards Faculty membership of the Royal Pharmaceutical Society
• Specialist knowledge acquired through postgraduate diploma level or equivalent training/experience

Experience

Essential

• Minimum of 5 years post - qualification experience.
• In depth therapeutic and clinical knowledge and understanding of the principles
• An appreciation of the nature of GPs and general practices
• An appreciation of the nature of primary care prescribing, concepts of rational prescribing and strategies for improving prescribing
• Excellent interpersonal, influencing and negotiating skills
• Excellent written and verbal communication skills
• Demonstrate the ability to communicate complex and sensitive
• information in an understandable form to a variety of audiences (e.g. patients)
• Is able to plan, manage, monitor, advise and review general medicine optimisation issues in core areas for long term conditions.
• Good IT skills
• Able to obtain and analyse complex technical information
• Recognises priorities when problem solving and identifies deviations from the normal pattern and is able to refer to seniors or GPs when appropriate
• Able to work under pressure and to meet deadlines
• Produce timely and inform ative reports
• Gain acceptance for Recommendations and influence/motivate/ persuade the audience to comply with the recommendations/ agreed course of action whe re there may be significant barrier
• Work effectively independently and as a team member
• Demonstrates accountability for delivering professional expertise and direct service provision
• Able to plan, manage, monitor, advise and review general pharmaceutical care programmes for patients across core areas, including disease states/long term conditions
• Uses skills in a range of routine situations requiring analysis or comparison of a range of options
• Recognises priorities when problem-solving and identifies deviations from normal pattern and is able to refer to seniors or GPs when appropriate.
• Able to follow legal, ethical, professional and organisational policies/procedures and codes of conduct

Leadership

Essential

• Demonstrate understanding of the pharmacy role in governance and is able to implement this appropriately within the workplace.
• Demonstrate understanding of, and contributes to, the workplace vision
• Engages with Patient Participation Groups (PPGs) and involves PPGs in development of the role and practices
• Demonstrates ability to improve quality within limitations of service
• Reviews yearly progress and develops clear plans to achieve results within priorities set by others.
• Demonstrate ability to motivate self to achieve goals
• Demonstrates ability to lead a team and provide support to other clinical pharmacists
• Provides a leadership style which is underpinned by strongly held values of the organisation and around equality, diversity and openness; effectively builds and maintains relationships with direct reportee(s) and other key individuals across the organisation
• Promotes diversity and equality in people management techniques and leads by example.

Management

Essential

• Demonstrate understanding of the implications of national priorities for the team and/or service and manage the team through these changes
• Demonstrate understanding of the process for effective resource utilisation
• Demonstrate understanding of, and conforms to, relevant standards of practice
• Demonstrates ability to identify and resolve risk management issues according to policy/protocol
• Follows professional and organisational policies/procedures relating to performance management
• Demonstrate ability to extend boundaries of service delivery within the team
• Lead and mentor a team of differing abilities

Other Requirements

Essential

• Excellent communication skills (written and oral)
• Competent in the use of Office and Outlook
• Effective time management (planning and organising)
• Good interpersonal skills
• Problem solving and analytical skills
• Ability to follow clinical policy and procedure
• Understanding of the audit process
• Understanding of clinical risk management
• Self Motivation
• In date CRB
• Polite and confident
• Flexible and cooperative
• Motivated, forward thinker
• Problem solver with the ability to process information accurately and effectively, interpreting data as required
• High levels of integrity and loyalty
• Sensitive and empathetic in distressing situations
• Ability to work under pressure/in stressful situations
• Effectively able to communicate and understand the needs of the patient
• Commitment to ongoing professional development
• Effectively utilise resources
• Punctual and committed to supporting the team effort
• Safeguarding adult and children level three
• Flexibility to work outside of core office hours
• Disclosure Barring Service (DBS) check
• Occupational Health Clearance

Desirable

• Full Driving License
• EMIS/SystmOne/Vision user skills

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).