Job Role Management of medicines at discharge from hospital To reconcile medicines following discharge from hospitals, intermediate care and into care homes; identify, manage and rectify changes; perform clinical medication reviews; 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. 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). Work in partnership with hospital colleagues (e.g. care of the elderly doctors and clinical pharmacists) to proactively manage patients at high risk of medicine-related problems before they are discharges to ensure continuity of care. Risk Stratification Design, development and implementation of computer searches to identify cohorts of patients at high risk of harm from medicines. Responsibility for management of risk stratification tools on behalf of the practice. Working with patients and the primary care team to minimise risks through medicines optimisation. Unplanned hospital admissions Devise and implement practice searches to identify cohorts of patients most likely to be at risk of an unplanned admission or readmissions from medicines. Work with case managers, multidisciplinary (health and social care) review teams, hospital colleagues and virtual ward teams to manager medicines-related risk for readmission and patient harm. Put in place changes to reduce the prescribing of these medicines to high-risk patient groups. Repeat prescribing Set up and manage electronic repeat dispensing where appropriate. Manage the repeat prescribing reauthorisation process by reviewing patient requests for repeat prescriptions and reviewing medicines reaching review dates; make necessary changes as an independent prescriber, and ensure patients are booked in for necessary monitoring tests where required. Telephone and patient facing medicines support Hold clinics for patients requiring face-to-face clinical medication reviews i.e. a review of the ongoing need for each medicine, a review of monitoring needs and an opportunity to support patients with their medicine taking. Medication review Undertake clinical reviews with patients with multi-morbidity and polypharmacy and implement own prescribing changes (including as a future independent prescriber) and order relevant monitoring tests. Domiciliary clinical medication review Manage own caseload of vulnerable housebound patients at risk of hospital admission and harm from poor use of medicines. Implement own prescribing changes (as an independent prescriber) and ordering of monitoring tests. Attend and refer patients to multidisciplinary case conferences. Long-term condition clinics See patients in multi-morbidity clinics and in partnership with primary healthcare colleagues and implement improvements to patients medicines, including de-prescribing. Run own long term condition clinics where responsible for prescribing as an independent prescriber for conditions where medicines have a large component (e.g. medicine optimisation for stable angina symptom control, warfarin monitoring and dose adjustment for patients requiring long term anticoagulants). Service development Develop and manage new services that are built around new medicines or NICE guidance where a new medicine/recommendations allow the development of a new care pathway (e.g. new oral anticoagulants for stroke prevention in atrial fibrillation). Care Quality Commission Provide leadership to the practice manager and GPs to ensure the practice is compliant with CQC standards where medicines are involved. Public Health To devise and support the management of public health campaigns to run at the practice alongside other practice colleagues. To provide specialist knowledge on immunisation. Medicine information to practice staff and patients Answers all medicine-related enquiries from GPs, other practice staff and patients with queries about medicines. Suggesting and recommending solutions. Providing follow up for patients to monitor the effect of any changes. Information management Analyse, interpret and present medicines data to highlight issues and risks to support decision making. Medicines quality improvement Identify and provide leadership on areas of prescribing requiring improvement. Either conduct own audits and improvement projects or work with colleagues. Present results and provide leadership on suggested change. Contribute to national and local research initiatives. Training Provide education and training to primary healthcare team on therapeutics and medicines optimisation. Implementation of local and national guidelines and formulary recommendations Monitor practice prescribing against the local GMMMG formularies e.g. RAG list for medicines that should be prescribed by secondary care (red drugs) or subject to shared care (amber). Liaise directly with hospital colleagues where prescribing needs to be returned to/reviewed by specialists. Support practice use of approved local and national formularies. Auditing practices compliance against NICE technology assessment guidance. Provide feedback and share appropriate information regarding important prescribing messages to improve prescribers knowledge and work with the team to develop and implement other techniques known to influence implementation of evidence such as audit and feedback, including contributing to PCN discussions, communications and introductions to other personnel. Medicines safety Keep informed about and identify national and local policy, safety alerts and guidance that affect patient safety through use of medicines including MHRA/CAS alerts, product withdrawals and emerging evidence from clinical trials. Manage the process of implementing changes to medicines and guidance for practitioners.