Lead Clinical Pharmacist

Line Manager: Practice Manager / Prescribing Lead GP

Location: All sites

Job Purpose

 

  • To work across Larwood and Bawtry Primary Care Network ensuring that medicines management processes within the practice are optimised to achieve highly effective, safe and patient centred prescribing.

  • Manage and support a small team of pharmacists and pharmacy technicians

  • To work as part of a multi-disciplinary team in a patient facing role taking responsibility for areas of chronic disease management within the practice and undertaking 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.

  • As an experienced pharmacist and holding an independent prescribing qualification, undertake patient consultations as appropriate including a focus on groups of patients who would benefit from targeted prescribing support and intervention (e.g. patients with multiple long term conditions).

  • To work closely with other practice staff within the Larwood and Bawtry Primary Care Network as well as across the wider Bassetlaw footprint, including GPs and pharmacists, to tailor the design and delivery of pharmacy interventions, policies and guidelines that address practice and Bassetlaw wide health and care priorities.

  • To offer professional clinical leadership and mentorship and facilitate shared learning with other less experienced clinical practice pharmacists working in associated local practices to support the development of their role and enhance their impact on patient care.

Key working relationships

  • Patients

  • GP, nurses and other practice staff

  • Other local practices clinical pharmacists

  • Community nurses, dieticians and other allied health professionals

  • Community pharmacists and support staff

  • Hospital staff with responsibilities for prescribing and medicines optimisation

  • Liaise closely with members of the CCGs medicines management team

Responsibilities underpinning the role

  • To develop and facilitate a good working relationship with community pharmacists and other local providers of healthcare

  • To establish and maintain strong and effective mechanisms for providing pharmacy advice and guidance to GPs and other clinical staff in their management of patients and promotion of medicines optimisation

  • To identify national and local policy and guidance that affects patient safety through the use of medicines, including MHRA alerts, product withdrawals and emerging evidence from clinical trials

To manage the process of implementing changes to medicines and guidance for practitioners

  • To plan and organise own workload, including audit and project work, and training sessions for practice team when necessary

  • Provide support and training to other practice pharmacists in the locality as necessary including formal supervision on a monthly basis

  • To record personally generated information and maintain a database of information relating to the work done in the practice.  Personally generated information includes information and records relating to audit and clinical work undertaken by the post holder, reference notes relating to clinical/technical information, etc. The database includes maintaining up-to-date, detailed records of all work done in the practice for which the post holder is accountable (done by the post holder or others)

  • Provide advice regarding off licence products including liquid medications for patients with swallowing difficulties

  • Engage with community and hospital pharmacy colleagues and develop referral processes between primary care professionals including the promotion of the repeat dispensing service

  • Manage practice formularies to improve the quality, safety and cost effectiveness of prescribing

  • To maintain registration as a pharmacist and comply with appropriate professional codes

  • Maintain effective mentorship support from the lead practice GP in order to ensure ongoing clinical and personal development

  • As appropriate to the post, to maintain and develop professional competence and expertise, keep up to date with medical/therapeutic evidence and opinion, and local and national service, legislation and policy developments, agree objectives and a personal development plan and participate in the appraisal process

  • Attend practice meetings, BEST (CCG training events) and Patient Participation Group meetings as appropriate

  • Attend meetings with other practice based pharmacists / CCG pharmacists to share best practice

  • Promote the role of the practice pharmacist

  • To undertake any other duties commensurate with the post holder’s grade as agreed with the practice lead GPs

 

All employees should understand that it is their personal responsibility to comply with all organisational and statutory requirements (e.g. health and safety, equal treatment and diversity, confidentiality and clinical governance).

Key duties and responsibilities

Management of medicines at discharge from hospital

To reconcile medicines following discharge from hospitals, intermediate care and into care homes; identify and rectify unexplained changes; manage these changes with minimal referral to the GP; perform clinical medication reviews as appropriate; produce post-discharge medicines care plans including dose titration and refer to recall team of follow-up tests; 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.

 

Risk stratification

Design, development and implementation of computer searches to identify cohorts of patients at high risk of harm from medicines using standardised approaches. Work with patients and the primary care team to minimise risks of unplanned admissions through medicines optimisation.

 

Repeat prescribing

Review, update 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.

 

Telephone and patient facing medicines support

Provide telephone help line support for patients with questions, queries and concerns about their medicines. Hold clinics for patients requiring face-to‐face clinical medication reviews (CMRs) i.e. a review of the ongoing need for each medicine, a review of monitoring needs and an opportunity to support patients with their medicine taking.  As part of the Primary Care Navigation team the post-holder will be available to advise patients with common minor or self-limiting ailments whilst working with the scope of practice and limits of competence; signposting to community pharmacists and referring to GPs or other healthcare professionals where appropriate.

 

Medication review

Undertake clinical medication reviews with patients with multi‐morbidity and polypharmacy and implement own prescribing changes within areas of competence (as an independent prescriber) and order relevant monitoring tests.

 

Care home medication reviews

Manage own caseload of care home residents. Undertake clinical medication reviews with patients with multi‐morbidity 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 and promotion of waste reduction.

 

Domiciliary clinical medication review

Manage own caseload of vulnerable housebound patients at risk of hospital admission and harm from poor use of medicines. Implement own prescribing changes (as an independent prescriber) and ordering of monitoring tests. Attend and refer patients to multidisciplinary case conferences as appropriate.

 

Long term condition clinics

See patients in multi-morbidity clinics and in partnership with primary healthcare colleagues and implement improvements to patient’s medicines, including de-prescribing. Run own 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 long‐term anticoagulants).

 

Service development

Develop and manage new services that are built around new medicines or NICE guidance, where new medicine/recommendations support the development of a new care pathway (e.g. new oral anticoagulants for stroke prevention in atrial fibrillation).

 

Cost saving programmes

Make recommendations for, implement and, if relevant, manage practice pharmacy technicians, to make changes to medicines designed to save on medicine costs where a medicine or product with lower acquisition cost is now available and clinically indicated.

 

Medicine information to practice staff and patients

Answer medicine‐related enquiries from GPs, other practice staff and patients with queries about medicines. Suggesting and recommending solutions as appropriate. Providing follow up for patients to monitor the effect of any changes as indicated.

 

Information management

Analyse, interpret and present medicines data to highlight issues and risks to support decision making across the wider primary care team.

 

Medicines quality improvement

Identify and provide leadership on areas of prescribing requiring improvement for example in the conduct of own audits and improvement projects or work with colleagues such as GP registrars. Present results and provide leadership on suggested change. Contribute to national and local research initiatives as agreed with the practice.

 

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 assessments and management and ensure compliance with medicines legislation.

 

Training & Shared Learning

Provide education and training to primary healthcare team on therapeutics and medicines optimisation. Provide training to visiting medical students. Facilitate shared learning across clinicians within the practice on medication related issues.

 

Offer professional support, leadership and formal mentorship with other clinical pharmacists working in associated local practices, especially with those developing this role within a practice.

 

Public Health

To support Public Health campaigns, proving specialist knowledge on all Public Health programmes available to the general public, including greener prescribing, eg reducing CFC’s

 

Implementation of local and national guidelines and formulary recommendations

Monitor practice prescribing against the local health economy’s Red/Amber/Green/Grey lists for medicines that should be prescribed by hospital doctors or subject to shared care. Liaise directly with hospital colleagues where prescribing needs to be returned to specialists. Based on consideration of the content of the Joint Formulary, assist practices in setting and maintaining a practice formulary that is hosted on the practice’s computer system. Suggest and develop computer decision support tools to help remind prescribers about the agreed formulary choice and local recommendations. Audit the practice’s compliance against NICE technology assessment guidance. Proactively provide internal practice communications 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.

Qualifications, Skills and Experience:

  • Has an experience / awareness of a range of common acute and long-term conditions that are likely to be seen in General Practice

  • Completion of an undergraduate degree in Pharmacy, and registration with the General Pharmaceutical Council

  • Minimum of 5 years post graduate experience in pharmacy, and 2 years in a GP Practice, as demonstrated within a practice portfolio

  • Member of the Royal Pharmaceutical Society (RPS)

  • Must hold a prescribing qualification

  • Experience of leading a team to provide high standard of patient care

 

Other Duties and Responsibilities:

  • Uphold confidentiality at all times

  • Follow security procedures

  • Follow all professional and organisational policies and procedures

  • To be a positive role model to others and promote the Practice in a positive light

  • To carry out any other duties relevant to the role

 

Special Working Conditions

  • The post-holder is required to travel independently between sites and to attend meetings both internally and hosted by other agencies.

  • The post-holder will have contact with bodily fluids whilst in clinical practice (eg wound exudates, urine).

Apply

To apply, please download and complete our application form below. Once complete, please send to sharronwood@nhs.net.