Address A professional and experienced Clinical Pharmacist will undertake/demonstrate: Medication Review and Optimisation Respond to medication queries to include clarifying doses and/or products and give appropriate alternatives when availability issues occur. Discuss specific patient and prescribing issues (e.g. complicated regimes/polypharmacy, compliance difficulties, multiple adverse effects, medication reduction regimes) with other clinicians as necessary. Telephone clinics: o To discuss medication issues with patients as needed and appropriate, e.g.
adverse effects/interactions, overdose/inadvertent ingestion. OTC remedies, queries from care homes o To carry out medication reviews as agreed with Prescribing Lead GP. o To review and continue repeat medications for new patients who have just registered with the Practice, and suggest GP medication review where appropriate. Face to face clinics: o To discuss medication issues with patients as needed and appropriate.
o To carry out medication reviews as agreed with Prescribing Lead GP. Undertake clinical medication reviews with patients and produce recommendations for nurses and/or GP on prescribing and monitoring. o To review and continue repeat medications for new patients who have just registered with the Practice, and suggest GP medication review where appropriate. o Patient facing Care Home Medication Review Support GPs with management of care home residents Undertake clinical medication reviews with patients with multi-morbidity and poly-pharmacy and implement own prescribing changes (if an independent prescriber) and order relevant monitoring tests Work with care home staff to improve safety of medicines ordering and administration.
o Patient facing domiciliary clinical medication review Undertake clinical medication reviews with patients and produce recommendations for nurses and GPs on prescribing and monitoring. Attend and refer patients to multidisciplinary case conferences. o Patient Facing Long-Term Conditions Clinics According to experience and training undertake chronic disease reviews and medicine optimisation according to Practice guidelines: Hypertension (lifestyle advice and medication optimisation). Diabetes (medicines optimisation, reduction of polypharmacy, with referral to GP where necessary).
CHD (medicines optimisation, with referral to GP where necessary). Respiratory (medicines optimisation, with referral to GP where necessary). Chronic pain management (responding to patient or GP requests for review). Signposting o 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 results, common/minor ailments, acute conditions, long term condition reviews etc. Medicines Reconciliation To reconcile medicines following discharge from hospitals, intermediate care and into care homes, including identifying and rectifying unexplained changes 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 (e.g. those with medicine compliance aids or those in care homes).
Review secondary care requests for new medication (as communicated by discharge summaries, outpatient letters, etc.), raise any queries with relevant GP and discuss how to respond when inappropriate prescribing requests arise. Deal with anticoagulant start/stop requests from secondary care and contact patients who have defaulted on INRs or routine monitoring for DOACs. Deal with high risk disease modifying drugs and contact patients who have defaulted routine blood monitoring. Management of common/minor/self-limiting ailments Managing caseload of 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 Unplanned Admission Prevention Devise and implement Practice searches to identify cohorts of patients most likely to be at risk of an unplanned admission and readmissions from polypharmacy. Work with case managers, multidisciplinary (health and social care) review teams, hospital colleagues and virtual ward teams to manage medicines. Work with Practice team to put in place changes to reduce the prescribing of these medicines to high-risk patient groups. Prescribing Systems, Policies and Safety Work with the GPs to develop and implement safe and efficient prescribing policies and strategies for the whole Practice to maximise efficiency and reduce wastage.
Support and assist in audits in relation to prescribing targets, implementation of locality policies and the Quality Outcomes Framework (QOF). Work with the Lead Prescribing GPs on delivering targets for the local Prescribing Quality Schemes. Monitor practice prescribing against the local health economys RAG list and make recommendations to GPs for medicines that should be prescribed by hospital doctors (red drugs) or subject to shared care (amber drugs). Implement changes to medicines that result from MHRA alerts, product withdrawal and other local and national guidance.
Assist practices in seeing and maintaining a practice formulary that is hosted on the practices computer system. Provide newsletters or bulletins Medicine Information to Practice Staff and Patients Monitor and inform colleagues as relevant about ongoing prescribing issues, e.g. new guidelines (national and local), new products being asked for by secondary care, manufacturing and supply problems, new prescribing restrictions or contraindications, and individual and systematic errors made by colleagues. Advise on cost effective prescribing and prescribing budget issues in collaboration with the Senior Clinical Pharmacist.
Support innovation for patient education. Answers relevant medicine-related 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 Public Health To support public health campaigns - provide specialist knowledge on all public health programmes available to the general public. Service Development Contribute pharmaceutical advice for the development and implementation of new services that have medicinal components (e.g. advice on treatment pathways and patient information leaflets). Care Quality Commission Work with the General Practice team to ensure the practice is compliant with CQC standards where medicines are involved.
Other Tasks Duties may be varied from time to time under the direction of the line manager dependent on current and evolving practice workload and staffing levels. Other administration and professional responsibilities: Participate in the administrative and professional responsibilities of the practice team Ensure appropriate items of service claims are made accurately, reporting any problems to the practice administrator Ensure collection and maintenance of any required statistical information Attend and participate in practice meetings as required
