Key Duties: Provision of Clinical Pharmacy Services: The post holder will: Provide clinical pharmacy services on rotation to the acute medical, surgical, emergency, and critical care units WRH, under the clinical supervision of Lead Specialist Pharmacists. Provide specialised pharmaceutical advice concerning the care of patients and undertake pharmaceutical risk management for the Units where duties are being carried out. Ensure compliance with medicines legislation, the Trust Medicines Policy, and medicines related national and local guidelines within the Units where duties are being carried out. Be accountable for his or her own professional actions guided by appropriate technical and professional SOPs and associated policies, national directives, standards, guidelines, senior pharmacist colleagues, and the post-holders own specialised knowledge. Plan his or her duties and prioritise workload where duties are being carried out according to the needs of patients, medical and nursing staff in order to complete the following within the time available: Analysing patients individual pharmaceutical care needs Identifying and correcting prescribing errors/unclear prescriptions with medical staff. Advising prescribers on doses, side effects, alternative treatments Communicate complex pharmaceutical recommendations and advice concerning patients treatment effectively to medical and nursing staff and other health care professionals. Interview newly admitted patients to construct an accurate medication history, assess compliance/concordance issues, and: Review information against the admission details and prescription chart. Identify to medical staff any potential or actual medicines-related hospital admissions or associated issues and outline any required action to resolve identified discrepancies. Construct pharmaceutical care plans for patients, assess and monitor clinical progress and outcome with regard to their medication and actively intervene to ensure that patients receive optimal care with minimal side effects. Monitor TPN on a daily basis against individual patients need and clinical condition. Assess patients discharge information requirements as early as possible in the admission stay to be able to prepare information on medicines for them based on individual need. Assist with the therapeutic blood monitoring of identified drugs within the post-holders clinical area including: Initial patient assessment and initiation of appropriate loading or starting doses Completion of request cards for level assaying Interpretation of blood level results and subsequent adjustment of the patients dose of medicine and amendment of the patients prescription in order to optimise the beneficial results of therapy whilst minimising any potential toxicity. Use MS Word, Excel and Powerpoint to produce patient information, information for medical and nursing staff, audits and project reports. Provision of Information and Counselling: The post holder will: Advise medical, nursing and technical pharmacy staff on the safe and appropriate management of medicines together with the safe handling and disposal of medicines including those which are noxious or harmful. Advise all health care professionals on storage, stability, compatibility and expiry issues regarding medicines. On rotation, assist the Specialist Pharmacist for Medicines Information by providing information to consultants, General Practitioners, medical, nursing and pharmacy staff on all aspects of medicines and therapy with medicines for individual patients and patient groups. Counsel and provide information about their medicines to patients with complex needs such as a physical disability which may affect information requirements (sight or hearing) or language difficulties. Provision of Professional Dispensary Services: The post holder will be responsible for: Providing on a rotational basis the clinical pharmacist check on all prescriptions dispensed by the Worcester Dispensary. This will require the scrutiny of prescriptions from medical and other practitioners to ensure they are accurate, appropriate for the patients needs, legal and cost-effective with respect to: Appropriate therapeutic selection of medicines Appropriate dose, frequency and quantity Avoidance of potentially harmful drug-drug interactions or side effects Adherence to the Trust Formulary, unlicensed medicines policy and high cost drug procedures. Questioning and challenging the prescriptions of prescribers whenever the post holder perceives it to be professionally appropriate and in the best interests of the patient. Ensuring the accurate dispensing and documentation of clinical trial material as requested. Use the Pharmacy Computer System to query the availability, location and cost of medicines, and to dispense and supply medicines. Use the Electronic Discharge System for processing discharge prescriptions Provision of cancer services: Provide on a rotational basis the professional checking of chemotherapy prescriptions for patients. This will require the scrutiny of prescriptions from oncologists and haematologists to ensure they are accurate, appropriate for the patients needs and supplied within appropriate commissioning frameworks with respect to: Appropriate therapeutic selection of medicines Appropriate dose, frequency and quantity Avoidance of potentially harmful drug-drug interactions or side effects Adherence to the Trust Formulary, unlicensed medicines policy and high cost drug procedures. Questioning and challenging the prescriptions of prescribers whenever the post holder perceives it to be professionally appropriate and in the best interests of the patient. Pre-check and release chemotherapy in the aseptic units of the trust ensuring compliance with GMP. Use the Electronic prescribing system as required to facilitate management of chemotherapy patients. Managerial responsibilities: The post holder will: Provide day to day clinical supervision for pre-registration pharmacy graduates, pharmacy technicians, assistant pharmacy technicians, and students within the WRH dispensary and other pharmacy services. Financial Responsibilities: The post-holder will: Help to maintain the security of medicines and supplies within the WRH Pharmacy Department. Undertake regular statutory checks of Controlled Drugs on hospital wards. Provide advice and support to their allocated wards in relation to the Safe and Secure Handling of medicines Provision of Education, Training and CPD: The post holder will be responsible for: Participating in the Trust personal development review (PDR), agreeing service and personal objectives with the Clinical Pharmacy Team Leader and being responsible for self audit to demonstrate both achievement of objectives and evidence of value to the Directorate/Trust. Identify personal training and development required to ensure the quality of the service. Agreeing and completing a yearly training plan (PDP) with the Clinical Pharmacy Team Leader (WRH) in line with PDR objectives Other Operational Responsibilities: The post holder will: Assist in the delivery of the WRH pharmacy departments dispensing and other operational, and clinical, services as required to meet the needs of the service: Accurately, with no margin for error, dispense/prepare medicines ensuring doses are correct and accurately weighed, measured and or counted. Enter patient details on the Pharmacy Computer System from prescriptions of doctors and other practitioners and produce medicine labels. Check medicines that other pharmacy staff have dispensed/prepared to ensure they have been dispensed correctly. Participate in the Weekend service and additionally in the Bank Holiday rota. Undertake emergency duties of a pharmaceutical nature integral to fulfilling an Emergency Duty Commitment, on a rota with other pharmacists at WRH/AH.