Clinical Pharmacy During the daily ward visit the Pharmacist will: - Review prescriptions to ensure they are legal, safe, cost-effective, clinically necessary, appropriate, accurate, and complete - Arrange for drugs to be supplied to patients, wards and departments - Provide information and advice to nursing staff and patients on a daily basis, about drugs, doses, administration and potential side-effects - Provide similar information and advice to junior medical staff on a daily basis, and to Consultants as and when needed in both verbal and written form (e.g. Make entries in patient records) - Access and interpret clinical information for patients, and use it to individualise and monitor treatment - Undertake risk management and ensure compliance with legislation and relevant national policies and guidelines, along with local policies and procedures including the Trust Formulary. - Work in an effective team with and clinically supervise, pharmacy technicians involved in Trust Medicines Management scheme on designated wards - Responsible for deciding stock holdings with the senior nurse for the ward Dispensary - For allocated sessions or agreed periods each week act as the supervising pharmacist or Responsible Pharmacist in the dispensary. - Clinically assess in-patients and Discharge prescriptions by reviewing current in-patient medication chart against Discharge prescription - Check the prescriptions charts for: legality, legibility and intention of prescriber, that the medication is suitable for the patient, any errors in dose, frequency, form and route, determine specific patient requirements, resolving any queries with the prescriber and determining specific patient requirements - Assess Out Patient prescriptions as above - Check the dispensing of the pharmacy technicians and pharmacy assistants/dispensers. - Issue dispensed items to outpatients with appropriate information and advice on their medicines and how to take them. - Ensure that out of stock items are assessed for urgency, notified to the patient/ward staff, obtained as soon as possible and dispensed promptly, to maintain treatment - Ensure that prescriptions are dispensed, checked and dispatched, according to priority and in a timely fashion - Check calculations for a range of prescription types including formulas for extemporaneously prepared medication, pediatric prescriptions and complex dosing regimes. - Dispense using the Pharmacy computer for issuing medication. Input patient specific information on the system which will be held as part of the patient record - Respond to queries from medical staff and all other hospital staff. - Supervise the clinical standards within the dispensary. - Help to supervise and train new Pharmacy staff working in the dispensary. Medicines Information - Participate in the provision of the Medicines Information service in order to provide up-to-date, evaluated information on medicines, and give pharmaceutical advice to patients and healthcare professionals. - In response to enquiries, advise health care professionals regarding the treatment of individual patients to optimise their drug therapy. Enquiries are of a diverse nature and examples include: - choice and effects of drugs in pregnancy or breastfeeding, identification and management of drug interactions and adverse drug reactions, drug choice and dosage in renal impairment and how to administer medicines. - Answer enquiries from health care professionals on specific patient groups or disease states and make recommendations to help inform their practice. - Answer enquiries from patients, empowering them with knowledge about their medications these will primarily originate from the Patients Medicines Helpline located in the Medicines Information department at GRH. - Take in enquiries by telephone, use a variety of information sources and clinical knowledge to answer the enquiry and respond by agreed deadline by means of verbal or written communication. Pharmacy Manufacturing Unit - Work within the manufacturing unit and follow the Standard Operating Procedures and worksheets within the area. - Develop knowledge of aseptic preparation of pharmaceuticals to enable broader understanding for the checking and releasing of products. - Perform an initial and final check and release on a range of aseptically prepared products prepared under section 10 e.g. Cytotoxics, adult parenteral nutrition(PN), and neonatal parenteral nutrition - Perform an initial and a final check on MHRA licensed aseptic batches, pre-packed and over-labelled medicines. - Perform a clinical check on adult cytotoxic prescriptions received in the department and intervene as necessary with prescribers (seeking advice from senior members of staff as necessary). - Answer queries from patients and hospital staff on chemotherapy, parenteral nutrition and other operational manufacturing issues (referring to senior members of staff when appropriate). - Participate in a daily ward round for parenteral nutrition (alongside the dietician) and together with the dieticians, and examination of blood results, formulate an appropriate nutrition bag for the patient. Working in Mental Health - Support the mental health dispensary and the clinical mental health pharmacy service to provide care to patients in mental health/learning disabilities inpatient units, and under mental health community services in Gloucestershire - Support clinical pharmacy services to inpatient wards and community mental health team bases - Clinical validation by reviewing all prescriptions regularly, ensuring optimum dose, administration and compliance with legislation. - Reporting of medication errors. - Improving patients adherence with medication - Attending weekly multidisciplinary team meetings: - Advising on individual drug treatments, including possible side effects and interactions after appropriate mentoring. - Reviewing and rationalising patients medication. - Encouraging compliance with national protocols, and local guidelines and formularies. - Educating patients and carers, including individual counselling on newly prescribed medicines and discharge counselling for patients giving both written and verbal information as appropriate - Undertaking medicines reconciliation assurance in conjunction with the Medicines - Accessing and interpreting patients test results, including the use of clozapine patient monitoring systems. - Compiling electronic discharge medication summaries & uploading them onto the electronic clinical notes Working in Clinical Oncology - Provide a daily ward visit to an oncology ward providing the same service as described in section above -clinical pharmacy - Clinically screen prescriptions for systemic anti-cancer therapy (SACT) in the chemotherapy outpatient department at CGH - Gain some accompanied experience at Sue Ryder hospice - Gain experience in haematology - Attend the ward MDT weekly as the rota allows Participation in the Emergency Duty Service and 7 day working Additional contact details: David Richards 0300 422 6109 Senior pharmacist Lead for Medicine Paul Adams 0300 422 6108 Senior pharmacist Medicines Information