The post holder as an employee of Rochdale Health Alliance will work within the Primary Care Network Clinical Pharmacist service for GP Practices members, as part of a multidisciplinary team. Providing expertise in clinical medicines management, through face-to-face structured medication reviews, management of long-term conditions, transfer of care and systems for safer prescribing, manage repeat prescription authorisations and reauthorisation. The post holder will provide leadership on quality improvement and clinical audit around medications, contributing to the Quality and Outcomes Framework and local contract performance indicators.
Main duties of the job
See (where appropriate) patients with single or multiple medical problems where medicine optimisation is required (e.g. Respiratory, Cardiovascular and Diabetes). Review the ongoing need for each medicine, a review of monitoring needs and an opportunity to support job purpose core duties and responsibilities to patients with their medicines taking ensuring they get the best use of their medicines (i.e. medicines optimisation). Make appropriate recommendations to Senior Pharmacists or GPs for medicine improvement.
Job responsibilities
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.
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.
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.
- 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.
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.
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.
Patient facing medicines support:
- Provide patient facing clinics for those with questions, queries and concerns about their medicines in the practice.
Telephone medicines support:
- Provide a telephone help line for patients with questions, queries and concerns about their medicines.
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).
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.
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.
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.
- 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).
Information management:
- Analyse, interpret and present medicines data to highlight issues and risks to support decision making.
- Undertake clinical audits of prescribing in areas directed by the GPs, feedback the results and implement changes in conjunction with the relevant practice team.
- Implement changes to medicines that result from MHRA alerts, product withdrawal and other local and national guidance.
Implementation of local and national guidelines and formulary recommendations:
- Monitor practice prescribing against the local health economy's 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 practice's computer system. Auditing practices compliance against NICE technology assessment guidance. Provide newsletters or bulletins on important prescribing messages.
Education and Training:
- Provide education and training to primary healthcare team on therapeutics and medicines optimisation.
Care Quality Commission:
- Work with the general practice teams to ensure the practices are compliant with CQC standards where medicines are involved.
Public health:
- To support public health campaigns. To provide specialist knowledge on all public health programmes available to the general public.
Collaborative working arrangements:
- Participate in the PCN MDT. Liaise with CCG colleagues including CCG pharmacists on prescribing related matters to ensure consistency of patient care and benefit.
Work as part of the RHA team and attend meetings/forums and supervision.
Foster and maintain strong links with all services across the PCN and neighbouring networks.
Explore the potential for collaborative working and take opportunities to initiate and sustain such relationships. Liaise with other stakeholders as needed for the collective benefit of patients including but not limited to:
1. Patients and their representatives
2. GP, nurses and other practice staff
3. Social prescribers, first contact physiotherapists, physicians associates and paramedics.
4. Community pharmacists and support staff
5. Other members of the medicines management (MM) team including pharmacists, Pharmacy Technicians and Dieticians
6. Locality / GP prescribing lead
7. Locality managers
8. Community nurses and other allied health professionals
9. Hospital staff with responsibilities for prescribing and medicines optimisation
Person Specification
Personal Qualities & Attributes
* Commitment to reducing health inequalities and proactively working to reach people from all communities.
* Demonstrates use of appropriate communication to gain the cooperation of relevant stakeholders (including patients, senior and peer colleagues, and other professionals, other NHS/private organisations, e.g. CCGs).
* Is able to recognise personal limitations and refer to more appropriate colleague(s) when necessary.
* Ability to identify risk and assess/manage risk when working with individuals.
* Ability to maintain effective working relationships and to promote collaborative practice with all colleagues.
* Ability to organise, plan and prioritise on own initiative, including when under pressure and meeting deadlines.
* High level of written and oral communication skills.
* Ability to work flexibly and enthusiastically within a team or on own initiative.
Qualifications
* Mandatory registration with the General Pharmaceutical Council
* Completion of an undergraduate degree in pharmacy and registration with the General Pharmaceutical Council.
* Membership Primary Care Pharmacy Association (PCPA)
* Membership of the Royal Pharmaceutical Society
* Clinical Diploma
Other
* Meets DBS reference standards and has a clear criminal record, in line with the law on spent convictions
* Self-motivation
* Immunisation status
* Access to own transport and ability to travel across the locality on a regular basis, including to visit people in their own homes
Experience
* Minimum of two years' experience as a pharmacist, demonstrated within a practice portfolio.
* Experience and an awareness of the breadth of common acute and long-term conditions that are likely to be seen in general practice.
* Experience of partnership/collaborative working and of building relationships across a variety of organisations.
Skills and Knowledge
* Understanding of the wider determinants of health, including social, economic and environmental factors and their impact on communities
* An appreciation of the nature of primary care prescribing, concepts of rational prescribing and strategies for improving prescribing
* Knowledge of IT systems, including ability to use word processing skills, emails and the internet to create simple plans and reports
* Able to identify and resolve risk management issues according to policy/protocol.
* Understand the principles of research governance
* In depth therapeutic and clinical knowledge and understanding of the principles of evidence-based healthcare
* Able to plan, manage, monitor and review general medicine optimisation issues in core areas for long term conditions
Disclosure and Barring Service Check
This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.
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