Job Purpose: The post holder will provide primary support to general practice staff with regard to prescription and medicines management at different sites. They will help support the repeat prescription system, deal with acute prescription requests, and medicines reconciliation on the transfer of care and systems for safer prescribing, providing expertise in clinical medicines advice while addressing both public and social care needs of patients in the GP practice (s). They will deliver an efficient, cost-effective, and high-quality clinical service by providing clinical and professional development to the clinical workforce within K&W Healthcare & member practices.
Key Responsibilities:
Clinical reviews/input
Demonstrate a significant reduction in the amount of GP time spent (especially locum GP time) by seeing patients in appointment slots for clinical medication reviews, and responding to urgent medication requests and queries. Complex patients or those with additional needs may require longer appointment slots.
Review the ongoing need for each medicine, a review of monitoring needs, and an opportunity to support patients with their medicines. Ensuring they get the best use of their medicines
Minor ailments triage: Managing caseload of patients with common /minor/self-limiting ailments requesting GP appointments and triaging patients appropriately.
Provide patient-facing clinics for those patients with questions, queries, and concerns about their medication in order to improve medication adherence.
Minor ailments appointment slots – as appropriate
Contribute to multidisciplinary reviews about medication-related issues
Reconcile medicines following hospital discharge
Review daily pathology results for selected patients on known medicines
Targeted medication reviews particularly in high-risk patients (frail elderly, poly-pharmacy, renal and hepatic impairment, high-risk medicines, etc.)
Undertake clinical medication reviews with patients and produce recommendations for the nurses and GPs on prescribing.
Administer influenza and travel vaccines
Support practices with the management of patients with drug dependence and alcohol-related disorders.
Signpost patients to other services or sources of information in addition to medication information when necessary in order to improve the general health and well-being of patients.
Make appropriate recommendations to the senior clinical pharmacist or GPs for medical improvement.
Unplanned Admissions and Discharge
Review the use of medicines most commonly associated with unplanned hospital admissions and readmissions through audits and individual patient reviews.
Put in place changes to reduce the prescribing of these medicines to high-risk patient groups.
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 medicine supply to high-risk groups of patients (e.g. those with medicine compliance aids or those in care homes).
Medicines optimisation
Assist with QOF targets, especially with the management of long-term conditions: Asthma, COPD, diabetes, hypertension, and heart failure- seeing these patients where their long-term condition needs to be reviewed or where dose optimizations and monitoring are required as per guidelines.
Undertake training/certification in health assessments, history taking, and physical examination. Commit to starting an independent prescribing course within 6 months of the probationary period ending
Reduce inappropriate poly-pharmacy
Address medicines adherence with patients and provide follow-up phone calls to check progress.
Audits and Risk Stratification
Increase quality and safety of prescribing through regular K&W audits and practice-specific audits
Implement drug withdrawals and alerts e.g. MHRA aimed at improving medicines safety
Implementing medication-related NICE guidelines
Identification of cohorts of patients at high risk of harm from medicines through practice computer searches.
Repeat prescribing process
Link with the community and hospital pharmacies about discharges and repeat prescribing queries.
Improve the repeat prescribing process within K&W practices by working extensively with dispensing community pharmacies. Communicating with them more effectively about medication queries
Implement and manage the repeat dispensing process.
Manage the repeat prescribing reauthorization process by reviewing requests for repeat prescriptions and medicines reaching review dates
Syncing patient's medication to reduce wastage, DMD corrections to facilitate EPS
Help improve the processes for monitoring and prescribing high-risk drugs (especially warfarin and methotrexate)
Ensure all practices have a repeat prescribing policy and all staff are aware and are adhering to it.
Medicines Optimisation Systems
Improve the quality, safety, and cost-effectiveness of prescribing by liaising with GPs and/or other non-medical prescribers to action MM recommendation
Be a source of medicines information for all of the K&W practice teams and patients (e.g. around doses, side effects, adverse events, possible alternatives e.g. around stocks)
Working with GPs to ensure medicines management audits, prescribing recommendations and targets are up-to-date.
Provide newsletters or bulletins on important prescribing messages
Liaising with other pharmacy teams including the CCG medicines management team to obtain practice-specific prescribing data and information on other local prescribing initiatives guidance.
Encourage practices to work in line with the NWL integrated formulary.
Encourage regular locums to work in line with locally agreed guidance.
Empower other K & W Healthcare staff to contribute to good quality medicines management for member practices and care homes.
Work with the general practice team to ensure that the practice is compliant with CQC standards where medicines are involved.
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.
Public Health
To support public health campaigns
To provide specialist knowledge on all public health programs available to general practice
Maintaining an open door policy throughout the day unless consulting with a patient. K&W & practice personnel can contact the clinical pharmacist for any medication advice and urgent issues that they feel are appropriate.
Practice sessions will be set up on an agreed day(s) of the week. Admin and GPs can directly book in patients and telephone consults. GPs can also directly book patients requiring pharmacist interventions into sessions.
An overview (brief) will be developed about the clinical pharmacist role and the appropriate types of patients that can be booked into sessions.
Other duties
Assist with the implementation of the various local and national frameworks and strategies which aim to improve the quality and provision of care to patients
Work in conjunction with other professionals to ensure clinical, management, and administration teams are working in partnership to provide the provision of patient-centered care.
Participate in the development and implementation of systems for use by colleagues.
Contribute to the development and implementation of clinical pathways to ensure a streamlined service is delivered.
Contribute to new initiatives and ways of working to deliver the core services, maximizing the potential to effectively provide a high-quality service.
Be responsible for personal and professional practice and development, ensuring registration with the relevant regulatory bodies and compliance with the code of professional conduct at all times.
Regularly reflect on clinical practice to ensure a satisfactory training standard is maintained.
Advise patients within the limits of their competence, recognizing when to seek help. When they are not able to advise the patient in a safe and skilled manner, or when necessary, the post-holder will ask advice from a more experienced colleague or duty doctor, or clinical service lead.
Assist with the education of callers in the correct use of the service and other health-related organisations.
Training and education and information
Mentor, support and advise pharmacists trainees and other prescribing clinicians
Participate in MDT learning activities
Participate in and contribute to MDT clinical supervision sessions and case reviews
Develop and deliver education sessions and training to clinical and non-clinical staff on medicines issues
Deliver education and support to individual patients and patient support groups on medicines
Provide ad-hoc medicines advice to doctors and other clinicians
Assess emergent clinical evidence and develop strategies for implementation in practice
Provide advice on cost effective prescribing and supply issues
Essential Qualifications:
1st degree - Vocational master’s degree in pharmacy (4 years)
Registered with General Pharmaceutical Council (GPhC)
Previous pre-registration training
Completed or be working towards completing the CPPE pathway.
Evidence of continuing professional development to at least meet the mandatory requirements of the GPhC
IT skills to at least ECDL standard or equivalent experience
Desirable
Member of Royal Pharmaceutical Society and/or other professional groups to facilitate continuing professional development
Independent prescribing qualification or commitment to achieving this on appointment
Significant post registration experience
Experience of working in primary care and/or hospital and community pharmacy
Skills
Must be able to demonstrate the English language proficiency level required for this post
Excellent communication skills
both verbal and written
Self-motivating with a drive to develop medicines management and clinical services
Well-developed negotiating and influencing skills
Awareness of and commitment to the clinical governance agenda
Good analytical skills and the ability to translate broad national strategy into deliverable local plans
Ablity to consult on the telephone, via the internet, and face to face.
Ability to recognize own limitations and act upon them appropriately;
Willingness to learn new skills and to problem solve on a daily basis
Experience:
Significant relevant post-registration experience
Knowledge and experience of pharmacy within primary care and community settings.
Knowledge and experience of the operation of NHS Organisations
Knowledge of or experience in coaching and mentoring practices and tools techniques and methods
Ability to achieve demanding tasks and objectives against deadlines
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