Main Duties & Responsibilities The post holder will ensure that the practice integrates with community and hospital pharmacy to help utilise skill mix, improve patient outcomes, ensure better access to healthcare and help manage workload. Primary Duties and Areas of Responsibility The following describes the primary areas of responsibility for this role. The clinical areas for delivery will be agreed after discussion with Primary Care Network (PCN) leads and in line with the individuals own scope of practice and experience. Patient Facing structured Clinical Medication Review Undertake clinical medication reviews with patients with multi morbidity and polypharmacy and order relevant monitoring tests according to protocols and policies. Focus will be on patient groups with a high risk of adverse medicines outcomes. Review the on-going need for each medicine, review monitoring needs and support patients with their medicines taking ensuring they get the best use of their medicines. Make appropriate recommendations to the lead clinical pharmacist or lead GP. Patient facing long term condition clinics Differentiated and undifferentiated diagnosis Review patients with single or multiple medical problems where medicines optimisation is required and people with learning difficulties or autism. Review the medicines management of those conditions and make recommendations and forward plans. Manage a case load of patients and diagnosis of patients with long term conditions whilst working within scope of practice and competence. Patient Facing care home medication review Undertake clinical medication reviews in patients with frailty and multiple morbidities and produce recommendations. Work with care home staff to raise awareness of medicines governance, safety and efficacy. Unplanned hospital admissions Review the use of medicines most associated with unplanned hospital admissions and readmissions. Suggest and recommend medicines management solutions to reduce the risk to identified patients and follow outcomes. Leadership on person centred medicines optimisation This will include ensuring prescribers in the practice conserve antibiotics in line with local antimicrobial stewardship guidance and quality improvement while contributing to quality and outcomes framework and enhanced services. Prescribe appropriately Prescribe safely, appropriately and within limits of competence and independent prescribing qualification. Clinical examination skills Work within your scope of practice to undertake clinical examinations and reach a differential diagnosis under appropriate clinical supervision. Develop effective working relationships Develop and establish clinical support with the well-established medicines optimisation team. Support for Self-Care Support the NHS self-care agenda by referring appropriately to GPs, signposting to community pharmacy consultation service and other healthcare professionals/organisations. Telephone Medicines Support Provide a telephone help line for patients with questions, queries and concerns about their medicines with some bookable appointments Medicine Information to Practice Staff and Patients Answer relevant medicine-related enquiries from GPs, other practice staff, other healthcare teams e.g. community pharmacy and patients with queries about medicines. Suggest and recommend solutions. Provide follow up for patients to monitor the effect of any changes Care co-ordination for frail patients Work with case managers, multidisciplinary health and social care review teams and hospital colleagues to manage medicines related risk for readmission and patient harm. Put in place changes to reduce the prescribing of these medicines to high-risk patient groups Management of Medicines at Admission and Discharge from Hospital To reconcile medicines following discharge from hospitals, including identifying and rectifying unexplained changes. Perform a clinical medication review, produce a post-discharge medicines care plan including dose titration and booking of follow up tests, and working with patients and community pharmacists to ensure patients receive the medicines they need post-discharge. Liaise with community pharmacy. Support systems to ensure continuity of medicines supply for high risk patient groups To assist with medicines reconciliation following a patient admission in response to enquiries from secondary care 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 and medicines re-authorisation. Adhere to the repeat prescribing protocols, liaise with Prescription Ordering Direct POD as required, and support medicines re-authorisation process. Risk Stratification Working with identified groups of high-risk patients, as per CCG medicines optimisation team to minimise risks through medicines optimisation. Medicines Quality Improvement Programme Identify and provide leadership on areas of prescribing and medicines optimisation. Conduct or work with other stakeholders on clinical audits and improve projects. Present results and provide leadership on suggested changes. Information Management Undertake clinical audits of prescribing in areas directed by the PCN, feedback the results and implement changes in conjunction with the practice team. Lead on evidence-based medicine and support CCG medicines strategies. Medicines Safety Adhere to national and local policy and guidance that affects patient safety through the use of medicines, including MHRA alerts, product withdrawals and emerging evidence form clinical trials. Manage the process of implementing changes to medicines and guidance for practitioners and ensure compliance with medicines legislation. Implementation of Local and National Guidelines and Formulary Recommendations Ensure prescribing is in accordance with Area Prescribing Committee guidelines and monitor prescribing of shared care, Specialist only / initiated medicines. Support prescribers in the use of the formulary tools and local recommendations. Education and Training Provide education and training to primary healthcare team on therapeutics and medicines optimisation. Provide training to visiting medical, nursing, pharmacy, and other healthcare students where appropriate. Care Quality Commission Provide support to the general practice team to ensure the practice is compliant with CQC standards where medicines are involved. Undertake risk assessment and management and ensure compliance with medicines legislation. Public Health To support public health campaigns. To provide specialist knowledge on public health programmes available to the general public. Collaborative Working Relationships The post-holder will be required to work with a wide range of stakeholders. It is important that the post-holder Demonstrates the ability to work well as part of a team and lead if requested to by the GP leads or pharmacy lead. Recognises the roles of other colleagues to patient care and liaises with other stakeholders as needed for the collective benefit of patients including but not limited to o Patients o GP, nurses and other practice staff o Other healthcare professionals including CCG pharmacists, pharmacy technicians, optometrists, dentists, health and social care teams, SALT and dieticians etc. o Locality / GP prescribing lead Locality managers o Community nurses and other allied health professionals o Community and hospital pharmacy teams o Hospital staff with responsibilities for prescribing and medicines optimisation Demonstrates use of appropriate communication to gain the co-operation of relevant stakeholders within the local care network to build sustainable relationships that: o Develop and maintain strong links with all services o Explore potential for collaborative working o Integrate general practice with community and hospital pharmacy teams o ensure consistency of patient care and benefit Is able to recognise personal limitations and refer to more appropriate colleagues when necessary. Liaises with CCG colleagues including CCG pharmacists and technicians on prescribing related matters to ensure consistency in Medicines Optimisation approach Liaises with CCG colleagues, the Head of Medicines Optimisation and the MO team to benefit from peer support and governance. Professionalism Demonstrate understanding of the pharmacy role in governance and is able to implement this appropriately within the workplace. Demonstrate understanding of, and contributes to, the workplace vision Engages with Patient Participation Groups and involves PPGs in development of the role and practices. Demonstrates ability to improve quality within limitations of service Reviews yearly progress and develops clear plans to achieve results within priorities set by others. Demonstrate ability to motivate self to achieve goals Provides a leadership style which is underpinned by strongly held values of the organisation and around equality, diversity and openness; effectively builds and maintains relationships with direct reports and other key individuals across the organisation Promotes diversity and equality in people management techniques and leads by example. Health and Safety/Risk Management The post-holder must comply at all times with the Practices Health and Safety policies, in particular by following agreed safe working procedures and reporting incidents using the organisations Incident Reporting System. The post-holder will comply with the Data Protection Act 1984 and the Access to Health Records Act 1990. Equality and Diversity The post-holder must co-operate with all policies and procedures designed to ensure equality of employment. Co-workers, patients and visitors must be treated equally irrespective of gender, ethnic origin, age, disability, etc.