Clinical Pharmacist

To provide a comprehensive pharmacy service to patients of the CLICK Primary Care Network.

The post holder will work within their competencies as part of a multi-disciplinary team to provide expertise in clinical medicines management, provide face to face structured medication reviews, manage long term conditions, management of medicines on transfer of care and systems for safer prescribing, manage repeat prescription authorisations and reauthorisation, acute prescription requests, while addressing both the public health and social care needs of patients in the GP practices that make up the Primary Care Network.

The post holder will undertake medication reviews of patients with polypharmacy especially for older people, people in residential care homes and those with multiple co-morbidities. The post holder will provide leadership on quality improvement and clinical audit as well as managing some aspects of the Quality and Outcomes Framework and the Primary Care Network Direct Enhanced Service Specifications.

Main duties of the job

1. Patient Facing Clinical Medication Reviews
2. Patient Facing Care Home Medication Reviews
3. Patient Facing Domiciliary Clinical Medication Reviews
4. Risk Stratification
5. Unplanned Hospital Admissions
6. Management of Common, Minor and Self-limiting Ailments
7. Patient Facing Medicines Support
8. Management of Medicines at Discharge from Hospital
9. Medicine Information to Practice Staff and Patients
10. Signposting
11. Repeat Prescribing
12. Service Development
13. Information Management
14. Medicines Quality Improvement
15. Implementation of Local and National Guidelines and Formulary Recommendations
16. Provide Education and Training to Primary Healthcare Team on Therapeutics and Medicines Optimisation
17. Ensure Practices are Compliant with CQC Standards Where Medicines are Involved
18. Support Public Health Campaigns
19. Collaborative Working Arrangements

About us

CLICK (Chard, Ilminster and Langport) Primary Care Network (PCN) is located in South Somerset with 5 GP practices and a diverse population spread across town and rural locations. CLICK has a population size of around 50,000 patients.

Currently led under the Clinical Director leadership of Dr Christoph Kollmeier.

The PCN is made up of:

• Langport Surgery
• The Meadows (Ilminster)
• Churchview (Ilminster)

As a PCN we are forward thinking, innovate and driven to deliver the best patient care for our population. This includes health population management, and this role ties in with supporting that and tracking the improvements we can make to patients' lives.

Job Responsibilities

Key Relationships:

• The patients, doctors, prescribers and practice teams within the Primary Care Network
• Somerset ICB Practice Support Pharmacists and Medicines Management Team
• Local Community Pharmacists
• Other professionals, other NHS/private organisations e.g. ICB and the general public

Key Duties and Responsibilities:

1. See (where appropriate) patients with single or multiple medical problems where medicine optimisation is required (e.g. Respiratory, Cardiovascular and Diabetes). Review the ongoing 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 Senior Pharmacists or GPs for medicine improvement.
2. Undertake clinical medication reviews with patients and produce recommendations for senior clinical pharmacist, nurses and/or GPs on prescribing and monitoring.
3. Undertake clinical medication reviews with patients 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.
4. Undertake clinical medication reviews with patients and produce recommendations for senior clinical pharmacist, nurses and/or GPs on prescribing and monitoring. Attend and refer patients to multidisciplinary case conferences.
5. Identification of cohorts of patients at high risk of harm from medicines through pre-prepared practice computer searches. This might include risks that are patient related, medicine related, or both.
6. 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.
7. Manage a caseload of patients with common, minor or self-limiting ailments while working within a scope of practice and limits of competence. Signpost to community pharmacy and refer to GPs or other healthcare professional where appropriate.
8. Provide patient facing clinics for those with questions, queries and concerns about their medicines in the practice. Provide telephone support for patients with questions, queries and concerns about their medicines.
9. Reconcile medicines following discharge from hospital, 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).
10. Answer relevant medicine-related enquiries from GPs, other network staff, other healthcare teams (e.g. community pharmacy) and patients with queries about medicines, suggesting and recommending solutions. Provide follow up for patients to monitor the effect of any changes.
11. 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.
12. Produce and implement a repeat prescribing policy within each PCN practice. 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 rests in place when required.
13. Contribute pharmaceutical advice for the development and implementation of new services that have medicinal components (e.g. advice on treatment pathways and patient information leaflets).
14. Analyse, interpret and present medicines data to highlight issues and risks to support decision making.
15. Undertake clinical audits of prescribing in areas directed by the GPs, feedback the results and implement changes in conjunction with the relevant practice team. Implement changes to medicines that result from MHRA alerts, product withdrawal and other local and national guidance.
16. Monitor practice prescribing against the local health economy's RAG list and make recommendations for 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 each practices computer system. Provide newsletters or bulletins on important prescribing messages.
17. Provide education and training to primary healthcare team on therapeutics and medicines optimisation.
18. Work with general practice teams to ensure practices are compliant with CQC standards where medicines are involved. Support public health campaigns. Provide specialist knowledge on all public health programmes available to the general public.
19. Participate in the Primary Care Network multi-disciplinary team. Liaise with colleagues including ICB, STP/ICS Pharmacists and Pharmacy Technicians on prescribing related matters to ensure consistency of patient care and benefit. Liaise with colleagues including ICB, STP/ICS Pharmacists and Pharmacy Technicians, Heads of Medicines Management/Optimisation to benefit from peer support. Foster and maintain strong links with all services across the PCN and neighbouring networks. Explore the potential for collaborative working and takes opportunities to initiate and sustain such relationships. Liaise with other stakeholders as needed for the collective benefit of patients, including but not limited to: Patients and their representatives, GPs, nurses and other practice staff, Social prescribers, first contact physiotherapists, physicians associates and paramedics, Community pharmacists and support staff, Other members of the Medicines Management team including Pharmacists, Pharmacy Technicians and Dieticians, Community nurses and other allied health professionals, Hospital staff with responsibilities for prescribing and medicines optimisation.

Professional Development

1. Work with your line manager to undertake continual personal and professional development, taking an active part in reviewing and developing the role and responsibilities.
2. Adhere to organisational policies and procedures, including confidentiality, safeguarding, lone working, information governance and health and safety.
3. Work with your line manager to access regular clinical supervision, to enable you to deal effectively with the difficult issues that people present.
4. Review yearly progress and develop clear plans to achieve results within priorities set by others.
5. Participate in the delivery of formal education programmes.
6. Demonstrate an understanding of current educational policies relevant to working areas of practice and keep up to date with relevant clinical practice.

Research and Evaluation

1. Critically evaluate and review literature.
2. Identify where there is a gap in the evidence base to support practice.
3. Generate evidence suitable for presentations at practice and local level.
4. Apply research evidence base into the workplace.

Health and Safety / Risk Management

Must comply at all times with the Health and Safety policies, in particular following safe working procedures and reporting incidents using the organisations Incident Reporting Systems. Comply with the Data Protection Act 2018 and the Access to Health Records Act 1990.

Special Working Conditions

The post holder is required to travel independently between work sites and to attend meetings etc., hosted by other agencies. The post holder may have contact with body fluids, i.e. wound exudates, urine, etc., while in clinical practice. Work as part of the team to seek feedback, continually improve the service and contribute to business planning. Undertake any tasks consistent with the level of the post and the scope of the role, ensuring that work is delivered in a timely and effective manner. Duties may vary from time to time, without changing the general character of the post or the level of responsibility.

Person SpecificationOther

• Meet DBS reference standards and has a clear criminal record, in line with law on spent convictions.
• Adaptable and self-motivated.
• Safeguarding Level 3 and other mandatory training.
• Immunisation status.
• Access to own transport and ability to travel across the locality on a regular basis, including to visit people in their own homes.
• Participate in the provision of Extended Hours outside of core practice hours.

Qualifications

• Mandatory registration with the General Pharmaceutical Council.
• Completion of an Undergraduate degree in pharmacy, MPharm or equivalent.
• Demonstrates an understanding of, and conforms to, relevant standards of practice.
• Follows professional and organisational policies and procedures relating to performance management.
• Completed or prepared to undertake Primary Care Pharmacy Education Pathway, PCPEP.
• Independent prescriber or working towards it.
• Intent of gaining independent prescribing qualification.
• Clinical Diploma.
• Membership of the Royal Pharmaceutical Society.
• Membership of the Primary Care Pharmacy Association (PCPA).

Experience

• Experience and an awareness of the breadth of common acute and long-term conditions that are likely to be seen in general practice.
• Demonstrates ability to integrate general practice within community and hospital pharmacy teams community groups.
• Experience of partnership and collaborative working and of building relationships across a variety of organisations.
• An appreciation of the nature of GPs and general practices.
• An appreciation of the nature of primary care prescribing, concepts of rational prescribing and strategies for improving prescribing.
• Understanding of the wider determinants of health, including social, economic and environmental factors and their impact on communities.
• Knowledge of IT systems, including the ability to use word processing skills, emails and the internet to create simple plans and reports.
• Able to obtain and analyse complex technical information.
• Able to gain acceptance for recommendations and influence, motivate and persuade the audience to comply with the recommendations or agreed course of action where there may be significant barriers.
• Able to identify and resolve risk management issues according to policy or protocol.
• Minimum of 2 years experience as a pharmacist, demonstrated within a practice portfolio.
• In depth therapeutic and clinical knowledge and understanding of the principles of evidence-based healthcare.
• Able to plan, manage, monitor and review general medicine optimisation issues in core areas for long term conditions.
• Familiarity with EMIS Clinical System.
• Familiarity with Somerset ICB prescribing formularies.

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

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