Job responsibilities The post holder will work within their clinical competencies as part of a multi-disciplinary team to provide expertise in clinical medicines management, provide face to face structured medication reviews, manage long term conditions, management of medicines on transfer of care and systems for safer prescribing, manage repeat prescription authorisations and reauthorisation, acute prescription request, while addressing both the public health and social care needs of patients in the GP practice(s) that make up the PCN. The post holder will perform face to face medication review of patients with polypharmacy especially for older people, people in residential care homes and those with multiple co-morbidities. The post holder will provide leadership on quality improvement and clinical audit and well as managing some aspects of the Quality and Outcomes Framework. This role is pivotal to improving the quality of care and operational efficiencies so requires motivation and passion to deliver an excellent service within general practice. The post holder will be supported to develop their role to become a non-medical prescriber if that qualification is not already held. Key duties and responsibilities: 1. Patient facing Long-term condition Clinics See (where appropriate) patients with single or multiple medical problems where medicine optimisation is required (e.g. Respiratory, Cardiovascular and Diabetes). Review the on-going need for each medicine, a review of monitoring needs and an opportunity to support patients with their medicines taking ensuring they get the best use of their medicines (i.e. medicines optimisation). Make appropriate recommendations to Senior Clinicians and GPs for medicine improvement. 2. Patient facing Clinical Medication Review Undertake clinical medication reviews with patients and produce recommendations for senior clinical pharmacist, nurses and/or GP on prescribing and monitoring. 3. Patient facing Care Home Medication Reviews Undertake clinical medication reviews with patients and produce recommendations for the senior clinical pharmacist, nurses or GPs on prescribing and monitoring. Work with care home staff to improve safety of medicines ordering and administration. Form part of the Care Home MDT. 4. Patient facing Domiciliary Clinical Medication Reviews Undertake clinical medication reviews with patients and produce recommendations for the senior clinical pharmacists, nurses and GPs on prescribing and monitoring. Attend and refer patients to multidisciplinary case conferences. 5. Risk stratification Identification of cohorts of patients at high risk of harm from medicines through pre-prepared practice computer searches. This might include risks that are patient related, medicine related, or both. 6.Unplanned hospital admissions Review the use of medicines most commonly associated with unplanned hospital admissions and readmissions through audit and individual patient reviews. Put in place changes to reduce the prescribing of these medicines to high-risk patient groups. 7. 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. 8. Patient facing medicines support Provide patient facing clinics for those with questions, queries and concerns about their medicines in the practice. 9. Management of medicines at discharge from hospital 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 high-risk groups of patients (e.g. those with medicine compliance aids or those in Care Homes). 11. Medicine information to practice staff and patients Answers relevant medicine-related enquiries from GPs, other network 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. 12. Signposting 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. 13. Repeat prescribing Produce and implement a repeat prescribing policy within each PCN practice. Manage the repeat prescribing reauthorisation process by reviewing patient requests for repeat prescriptions and reviewing medicines reaching review dates and flagging up those needing a review. Ensure patients have appropriate monitoring tests in place when required. 14. 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). 15. Information management Analyse, interpret and present medicines data to highlight issues and risks to support decision making. 16. Medicines quality improvement Undertake clinical audits of prescribing in areas directed by the GPs, feedback the results and implement changes in conjunction with the relevant practice team. 17. Medicines safety Implement changes to medicines that result from MHRA alerts, product withdrawal and other local and national guidance. 18. Implementation of local and national guidelines and formulary recommendations Monitor practice prescribing against the local health economies 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). Assist practices in seeing and maintaining a practice formulary that is hosted on each practices computer system. Auditing practices compliance against NICE technology assessment guidance. Provide updates at meetings and via GP Teamnet on important prescribing messages. 19. Education and Training Provide education and training to primary healthcare team on therapeutics and medicines optimisation. 20. Care Quality Commission Work with the general practice teams to ensure the practices are compliant with CQC standards where medicines are involved. 21. Public health To support public health campaigns. To provide specialist knowledge on all public health programmes available to the general public. 22. Collaborative working arrangements - PCN MDT. Liaises with CCG colleagues including CCG pharmacists on prescribing related matters to ensure consistency of patient care and benefit. Liaises with colleagues including CCG,STP/ICS Pharmacists and Pharmacy Technicians on prescribing related matters to ensure consistency of patient care and benefit Liaises with colleagues including CCG,STP/ICS Pharmacists and Pharmacy Technicians Heads of Medicines Management/Optimisation to benefit from peer support. Foster and maintain strong links with all services across the PCN and neighbouring networks. Explores the potential for collaborative working and takes opportunities to initiate and sustain such relationships.