Job responsibilities
The clinical pharmacist in a general practice organisation has the following key responsibilities in relation to delivering health services.
These key responsibilities are based on those outlined in Annex B1 of the Network Contract Directed Enhanced Service 2023-24 specification
There may be, on occasion, a requirement to carry out other tasks; this will be dependent upon factors such as workload and staffing levels.
a. Work as part of a multi-disciplinary team in a patient-facing role to clinically assess and treat patients using their expert knowledge of medicines for specific disease areas
b. Be a prescriber, or completing training to become a prescriber, and work with and alongside the general practice team
c. Be responsible for the care management of patients with chronic diseases and undertake clinical medication reviews to proactively manage people with complex polypharmacy, especially the elderly, people in care homes, those with multiple co-morbidities (in particular frailty, COPD and asthma) and people with learning disabilities or autism (through STOMP Stop Over Medication Programme)
d. Provide specialist expertise in the use of medicines whilst helping to address both the public health and social care needs of patients at the organisation and to help in tackling inequalities
e. 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
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services
f. Through structured medication reviews, support patients to take their medications to get the best from them, reduce waste and promote self-care
g. 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
h. Develop relationships and work closely with other pharmacy professionals across the wider health and social care system
i. 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 difficulties), liaison with community pharmacists, and anticoagulation
j. Be part of a professional clinical network and have access to appropriate clinical supervision. Appropriate clinical supervision means:
i. Each clinical pharmacist must receive a minimum of one supervision session per month by a senior clinical pharmacist
ii. The senior clinical pharmacist must receive a minimum of one supervision session every three months by a GP clinical supervisor
iii. Each clinical pharmacist will have access to an assigned GP clinical supervisor for support and development
iv. A ratio of one senior clinical pharmacist to no more than five junior clinical pharmacists, with appropriate peer support and supervision in place
k. To act as the point of contact for all medicine related matters, establishing positive working relationships
l. To consult patients within defined levels of competence and independently prescribe acute and repeat medication
m. To receive referrals and directed patients from triage services and other clinicians
n. To receive and resolve medicines queries from patients and other staff
o. To provide medication review services for patients in the practice and during domiciliary visits to the local nursing home
p. To manage a caseload of complex patients
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q. To manage a therapeutic drug monitoring system and the recall of patients taking high risk drugs, i.e., anticoagulants, anticonvulsants and DMARDs, etc.
r. To deliver long term condition clinics and home visits, particularly for patients with complicated medication regimes, and prescribe accordingly
s. To provide pharmaceutical consultations to patients with long term conditions as an integral part of the multidisciplinary team
t. To review medications for newly registered patients
u. To improve patient and carer understanding of confidence in and compliance with their medication
v. To maintain accurate clinical records in conjunction with extant legislation
w. To encourage cost-effective prescribing throughout the organisation
x. To implement and embed a robust repeat prescribing system
y. To provide advice and answer medication related queries from patients and staff
z. To organise and oversee the organisations medicines optimisation systems, including the repeat prescribing and medication review systems
aa. To improve the quality and effectiveness of prescribing through clinical audit and education, to improve performance against NICE standards and clinical and prescribing guidance.
bb. To develop yourself and the role through participation in clinical supervision, training and service redesign activities
cc. To ensure appropriate supervision of safe storage, rotation and disposal of vaccines and drugs. To apply infection-control measures within the practice according to local and national guidelines
dd. To provide subject matter expertise on medication monitoring, implementing and embedding a system
ee. To support clinicians with the management of patients suffering from drug and alcohol dependencies
ff. To actively signpost patients to the correct healthcare professional
gg. To manage a caseload of complex patients and potential care institutions and to provide advice for the GP management of more complex patients or areas such as addictive behaviours, severe mental illness or end of life care
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hh. To review the latest guidance, ensuring the organisation conforms to NICE, CQC etc.
ii. To provide targeted support and proactive reviews for vulnerable, complex patients and those at risk of admission and re-admission to secondary care
jj. To handle prescription queries and requests directly
kk. To provide proactive leadership on medicines and prescribing systems to the organisation, patients and their carers
ll. To support in the delivery of enhanced services and other service requirements on behalf of the organisation
mm. To participate in the management of patient complaints when requested to do so, and participate in the identification of any necessary learning brought about through clinical incidents and near-miss events
nn. To undertake all mandatory training and induction programmes
oo. To contribute to and embrace the spectrum of clinical governance
pp. To attend a formal appraisal with your manager at least every 12 months. Once a performance/training objective has been set, progress will be reviewed on a regular basis so that new objectives can be agreed
qq. To contribute to public health campaigns (e.g., COVID-19 or flu clinics) through advice or direct care
rr. To maintain a clean, tidy, effective working area at all times.
Secondary responsibilities
In addition to the primary responsibilities, the clinical pharmacist may be requested to:
a. Support delivery of QOF, incentive schemes, QIPP and other quality or cost effectiveness initiatives
b. Agree and review prescribing formularies and protocols, and monitor compliance levels
c. Improve the data quality of medicines records and linking to conditions
d. Deliver training, mentoring and guidance to other clinicians and staff on medicine issues
e. Working in partnership with pharmacists and clinicians in the local ICB & PCN, improve the safety and quality of prescribing after discharge from hospital admissions and attendance