Job description

Job responsibilities

Management of medicines at discharge from hospital

To reconcile medicines following discharge from hospitals, intermediate care and into care homes; identify and rectify unexplained changes; manage these changes without referral to the GP; perform a clinical medication review; 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 discharged 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 and readmissions from medicines. Work with case managers, multidisciplinary (health and social care) review teams, hospital colleagues and virtual ward teams to manage medicines-related risk for readmission and patient harm. Put in place changes to reduce the prescribing of these medicines to highrisk patient groups.

Repeat prescribing

Review, update 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; 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

Provide a telephone help line for patients with questions, queries and concerns about their medicines. Hold clinics for patients requiring face to face clinical medication reviews (CMRs) 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 medication reviews with patients with multi-morbidity and polypharmacy and implement own prescribing changes (within competencies as an independent prescriber) and order relevant monitoring tests.

Care home medication reviews

Manage own caseload of care home residents or as part of multidisciplinary team. Undertake clinical medication reviews with patients with multimorbidity and polypharmacy and implement own prescribing changes (within competencies as an independent prescriber) and order relevant monitoring tests. Work with care home staff to improve safety of medicines ordering and administration.

Domiciliary clinical medication review

Manage own caseload or as part of multidisciplinary team, of vulnerable housebound patients at risk of hospital admission and harm from poor use of medicines. Implement own prescribing changes (within competencies 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 diagnosis and prescribing within competencies as an independent prescriber and make dose adjustments to repeat prescriptions when required.

Service development

Develop and manage new services that are built around new medicines or NICE guidance, where 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 manage public health campaigns to run at the practice. To provide specialist knowledge on immunisation.

Cost saving programmes

Support and implement cost saving changes to medicines and appliances identified by CCG practice support teams designed to save on medicine costs where a medicine or product with lower acquisition cost is now available. These may be identified within the annual Prescribing Improvement Plan.

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 where indicated.

Training & Shared Learning

Provide education and training to primary healthcare team on therapeutics and medicines optimisation. Provide training to visiting medical students.

Facilitate shared learning across clinicians within the practice on medication related issues.

Offer professional support, leadership and share learning with other clinical pharmacists and those working in associated local practices, especially with those developing this role within a practice.

Implementation of local and national guidelines and formulary recommendations

To provide input into the development of a Primary Care Network Medicines Optimisation Plan (MOP).

Monitor practice prescribing against the local health economys Red/Amber/Green and Do Not Prescribe lists for medicines that either should not be prescribed in primary care or should be prescribed by hospital doctors only or subject to shared care. Liaise directly with hospital colleagues where prescribing needs to be returned to specialists.

Based on consideration of the content of the Gloucestershire Joint Formulary, assist practices in setting up and maintaining a practice formulary that is hosted on the practices computer system. Suggest and develop computer decision support tools to help remind prescribers about the agreed formulary choice and local recommendations.

Auditing practices compliance against NICE technology assessment guidance.

Proactively provide internal practice communications on 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.

Medicines safety

Horizon scan to identify national and local policy and guidance that affects patient safety through the use of medicines, including MHRA alerts, product withdrawals and emerging evidence form clinical trials. Manage the process of implementing changes to medicines and guidance for practitioners.

Job responsibilities

Management of medicines at discharge from hospital

To reconcile medicines following discharge from hospitals, intermediate care and into care homes; identify and rectify unexplained changes; manage these changes without referral to the GP; perform a clinical medication review; 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 discharged 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 and readmissions from medicines. Work with case managers, multidisciplinary (health and social care) review teams, hospital colleagues and virtual ward teams to manage medicines-related risk for readmission and patient harm. Put in place changes to reduce the prescribing of these medicines to highrisk patient groups.

Repeat prescribing

Review, update 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; 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

Provide a telephone help line for patients with questions, queries and concerns about their medicines. Hold clinics for patients requiring face to face clinical medication reviews (CMRs) 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 medication reviews with patients with multi-morbidity and polypharmacy and implement own prescribing changes (within competencies as an independent prescriber) and order relevant monitoring tests.

Care home medication reviews

Manage own caseload of care home residents or as part of multidisciplinary team. Undertake clinical medication reviews with patients with multimorbidity and polypharmacy and implement own prescribing changes (within competencies as an independent prescriber) and order relevant monitoring tests. Work with care home staff to improve safety of medicines ordering and administration.

Domiciliary clinical medication review

Manage own caseload or as part of multidisciplinary team, of vulnerable housebound patients at risk of hospital admission and harm from poor use of medicines. Implement own prescribing changes (within competencies 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 diagnosis and prescribing within competencies as an independent prescriber and make dose adjustments to repeat prescriptions when required.

Service development

Develop and manage new services that are built around new medicines or NICE guidance, where 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 manage public health campaigns to run at the practice. To provide specialist knowledge on immunisation.

Cost saving programmes

Support and implement cost saving changes to medicines and appliances identified by CCG practice support teams designed to save on medicine costs where a medicine or product with lower acquisition cost is now available. These may be identified within the annual Prescribing Improvement Plan.

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 where indicated.

Training & Shared Learning

Provide education and training to primary healthcare team on therapeutics and medicines optimisation. Provide training to visiting medical students.

Facilitate shared learning across clinicians within the practice on medication related issues.

Offer professional support, leadership and share learning with other clinical pharmacists and those working in associated local practices, especially with those developing this role within a practice.

Implementation of local and national guidelines and formulary recommendations

To provide input into the development of a Primary Care Network Medicines Optimisation Plan (MOP).

Monitor practice prescribing against the local health economys Red/Amber/Green and Do Not Prescribe lists for medicines that either should not be prescribed in primary care or should be prescribed by hospital doctors only or subject to shared care. Liaise directly with hospital colleagues where prescribing needs to be returned to specialists.

Based on consideration of the content of the Gloucestershire Joint Formulary, assist practices in setting up and maintaining a practice formulary that is hosted on the practices computer system. Suggest and develop computer decision support tools to help remind prescribers about the agreed formulary choice and local recommendations.

Auditing practices compliance against NICE technology assessment guidance.

Proactively provide internal practice communications on 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.

Medicines safety

Horizon scan to identify national and local policy and guidance that affects patient safety through the use of medicines, including MHRA alerts, product withdrawals and emerging evidence form clinical trials. Manage the process of implementing changes to medicines and guidance for practitioners.

Person Specification

Experience

Essential

• In depth therapeutic and clinical knowledge and understanding of the principles of evidencebased healthcare.
• 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.
• Excellent interpersonal, influencing and negotiating skills.
• Excellent written and verbal communication skills.
• Demonstrate the ability to communicate complex and sensitive information in an understandable form to a variety of patients
• Is able to plan, manage, monitor, advise and review general medicine optimisation issues in core areas for long term conditions.
• Good IT skills.
• Able to obtain and analyse complex technical information.
• Recognises priorities when problem solving and identifies deviations from the normal pattern.
• Able to work under pressure and to meet deadlines.
• Produce timely and informative reports.
• Gain acceptance for recommendations and influence/ motivate/ persuade the audience to comply with the recommendations/ agreed course of action where there may be significant barriers.
• Work effectively independently and as a team member. Demonstrates accountability for delivering professional expertise and direct service provision.
• Self-motivation & Initiative.
• Adaptable.
• Full driving licence.

Desirable

• Minimum of 5 years post qualification experience.
• Minimum of 1 years prescribing experience

Qualifications

Essential

• Mandatory Registration with General Pharmaceutical Council
• Masters Degree in Pharmacy (MPharm)

Desirable

• Membership of the Royal Pharmaceutical Society
• A member of or working towards Faculty Membership of the Royal Pharmaceutical Society
• Clinical Diploma
• Independent Prescriber

Experience

Essential

• In depth therapeutic and clinical knowledge and understanding of the principles of evidencebased healthcare.
• 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.
• Excellent interpersonal, influencing and negotiating skills.
• Excellent written and verbal communication skills.
• Demonstrate the ability to communicate complex and sensitive information in an understandable form to a variety of patients
• Is able to plan, manage, monitor, advise and review general medicine optimisation issues in core areas for long term conditions.
• Good IT skills.
• Able to obtain and analyse complex technical information.
• Recognises priorities when problem solving and identifies deviations from the normal pattern.
• Able to work under pressure and to meet deadlines.
• Produce timely and informative reports.
• Gain acceptance for recommendations and influence/ motivate/ persuade the audience to comply with the recommendations/ agreed course of action where there may be significant barriers.
• Work effectively independently and as a team member. Demonstrates accountability for delivering professional expertise and direct service provision.
• Self-motivation & Initiative.
• Adaptable.
• Full driving licence.

Desirable

• Minimum of 5 years post qualification experience.
• Minimum of 1 years prescribing experience

Qualifications

Essential

• Mandatory Registration with General Pharmaceutical Council
• Masters Degree in Pharmacy (MPharm)

Desirable

• Membership of the Royal Pharmaceutical Society
• A member of or working towards Faculty Membership of the Royal Pharmaceutical Society
• Clinical Diploma
• Independent Prescriber

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.

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).

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.

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).

Employer details

Employer name

Cheltenham Peripheral Network

Address

c/o Leckhampton Surgery

17 Mooreend Park Road

Cheltenham

Gloucestershire

GL53 0LA

Employer's website

https://www.leckhamptonsurgery.co.uk/ (Opens in a new tab)