Working within your clinical and professional boundaries in a patient facing role as part of a multidisciplinary team to manage medicines on transfer of care and systems for safer prescribing. Perform face-to-face structured medication reviews of patients with polypharmacy; especially for those with frailty and/or with multiple co-morbidities as well as undertaking reviews of patients with specific long-term conditions that fall within your competency. Work in partnership with stake holder organisations to improve the safety and quality of care for patients and manage medicines on transfer of care. Deliver medicines optimisation initiatives within GP practices including the provision of specialist professional pharmaceutical advice and services to ensure the safe and cost-effective use of medicines. This will involve work to deliver key medicines optimisation outcomes against a set work plan. Contribute to quality improvement and clinical audit, as well as supporting aspects of the Quality and Outcomes Framework, medicines safety and antibiotic stewardship. You will also be required to contribute towards practice financial stability through medicines optimisation and related targets in QOF. Patient facing - long-term condition clinics Working within the practice-based team to undertake medication reviews particularly in high-risk groups such as: - Frail elderly - Polypharmacy - Renal impairment - Hepatic impairment - Substance misuse - Patients on high-risk medicines - STOPP/START identified patients - Revolving door Hospital admissions 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 GPs for medicine improvement. Patient facing Structured Medication Review Undertake structured medication reviews with patients and produce recommendations for nurses and/or GPs on prescribing and monitoring. This would be a level 3 clinical medication review looking at the patients full clinical condition, blood monitoring, interface care arrangements, social isolation etc. including reducing inappropriate polypharmacy and wasteful prescribing. Care Home Medication Reviews Undertake structured medication reviews and produce recommendations for nurses or GPs on prescribing and monitoring. Work with care home staff to improve safety of medicines ordering and administration. 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. Medicine information to practice staff and patients Answers relevant medicine-related enquiries from GPs, other practice 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 and effect of any changes. 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 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).