Clinical Pharmacist

Job descriptionJob responsibilities Medicine reviews: Conduct telephone, face-to-face, virtual and domiciliary (where appropriate) clinical medication reviews to proactively manage patients including those with complex polypharmacy Review the on-going need for each medication, ensuring monitoring needs are performed and an opportunity to support patients achieve better health outcomes Reduce inappropriate poly-pharmacy and wasteful prescribing. Make appropriate recommendations Repeat prescribing: Advise and implement a practice repeat prescribing policy. Manage the repeat prescribing reauthorisation process by reviewing patient requests for repeat prescriptions and reviewing medicines reaching review dates and flagging up those needing a review. Ensure patients have appropriate monitoring tests in place when required.

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 the effect of any changes Medicine Management including Risk stratification: Ensure Drug monitoring robust systems are in place for drug monitoring at each practice , streamlining these where possible.

Develop and implement ways to improve monitoring of high-risk medication such as anticoagulants, anticonvulsants, and DMARDs, etc Monitor practice prescribing against local guidelines and formulary recommendations Identification of cohorts of patients at high risk of harm from medicines through pre-prepared practice computer searches Develop prescribing guidelines for use within the Primary Care Network Help increase uptake of Electronic Repeat Dispensing where required Telephone medicines support: Provide telephone support for patients with questions, queries and concerns about their medicines. Patient facing medicines support: Provide patient facing and/or virtual appointments or clinics for those with questions, queries and concerns about their medicines in the practice Management of common/minor/self-limiting ailments: Managing 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, 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 on 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). 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. Medicines safety & quality improvement: Implement changes to medicines that result from MHRA alerts, product withdrawal and other local and national guidance. Undertake clinical audits of prescribing in areas directed by the GPs, feedback the results and implement changes in conjunction with the practice team. Implementation of local and national guidelines and formulary recommendations: Monitor practice prescribing against the local health economy's RAG list and make recommendations to GPs for medicines that should be prescribed by hospital doctors (red drugs) or subject to shared care (amber drugs).

Assist practices in seeing and maintaining a practice formulary that is hosted on the practices computer system. Auditing practices compliance against NICE technology assessment guidance. Patient facing clinical medication review: Undertake clinical medication reviews with patients and produce recommendations for senior clinical pharmacist, nurses and/or GP on prescribing and monitoring. For patients with long-term condition 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. See (where appropriate either face to face or using video consultation) patients with single or multiple medical problems where medicine optimisation is required (e.g. COPD, asthma).

In conjunction with the CCG Medicines Optimisation Pharmacy team undertake clinical medication reviews with patients in Care Homes and produce recommendations for the senior clinical pharmacist, nurses or GPs on prescribing and monitoring. Work with care home staff to improve safety of medicines ordering and administration. Undertake clinical medication reviews with housebound patients and those requiring domiciliary visits. Produce recommendations for nurses and GPs on prescribing and monitoring.

Attend and refer patients to multidisciplinary case conferences. Education and Training: Provide education and training to primary healthcare team on therapeutics and medicines optimisation. Care Quality Commission: Work with the general practice team to ensure the practice is compliant with CQC standards where medicines are involved. Public health: To support public health campaigns.

To provide specialist knowledge on all public health programmes available to the general public