Job responsibilities
Job Description: Clinical Pharmacist & Team
(The job description provided is wide ranging with some competencies involved will be subject to experience of the candidate. All the primary duties and areas of responsibility listed can only be achieved by a clinical pharmacist team.)
Job Summary (Clinical Pharmacist)
The post holder will work as part of a multi-disciplinary team in a patient -facing role in the practice.
The post holder will take responsibility for areas of chronic disease management and undertake clinical medication reviews to proactively manage patients with complex polypharmacy.
The post holder will provide primary support to general practice staff with regards to prescription and medication queries. They will deal with acute prescription requests and 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 the patient.
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.
The post holder 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.
Primary Duties and Areas of Responsibility
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 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 domiciliary/home
visits 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. Identifying key areas of need for vulnerable patients and formulating care plans.
Management of common/minor/self-limiting
ailments Manage caseload for patients with common/minor/self-limiting ailments while working within a scope of practice and limits of competence. Signpost to community pharmacy and refer to GPs or other healthcare professionals where appropriate
Differential/ Un-differential
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 medicines queries
Telephone medicines support Provide a telephone help line for patients with questions, queries and concerns about their medicines.
Extended Hours /Out of Hours/On
call services Provide out of hours/on call/extended services for the practice and patients (if appropriate). These can include patient facing and telephone consultations. Signpost to other services and/or healthcare professionals where appropriate.
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 with queries about medicines.
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 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 Reconcile medicines following discharge from hospitals, intermediate care and into care homes, including identifying and rectifying unexplained changes and managing these changes. Perform a clinical medication review, produce a post discharge medicines care plan including dose titration, booking follow up tests 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 highrisk groups of patients.
Telephone triage Ensure patients are referred to the appropriate healthcare professional for the appropriate level of care within an appropriate period of time.
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, develop and implement system 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. Work 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).
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 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. 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. Audit 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.
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.
Public health Support public health campaigns. Provide specialist knowledge on all public health programmes available where applicable.
