Swydd-ddisgrifiad a phrif gyfrifoldebau manwl

Provision of Clinical Pharmacy Service to the ED

To lead the clinical pharmacy service for patients admitted to the ED to ensure safe, clinically effective and cost-efficient use of medicines in these patients

To be responsible for implementing changes to clinical pharmacy practice and reducing variation in prescribing practice in the ED

To reduce the time taken for medicines reconciliation to take place for patients admitted to in-patient wards within the hospital from the ED by using independent prescribing qualification to document, review and prescribe patients’ regular medication on Sunrise EPR whilst in the ED

To utilise independent prescribing qualification to facilitate discharge of patients directly from the ED who require prescribed medication

To develop the role of pharmacist non-medical prescriber within the ED

Obtain key pharmaceutical information on newly admitted patients.

Information collected on a daily basis including:

- Collecting, interpreting and documenting details of medication taken at home (the medication history)

- Confirming details of the medication history with the patient, carer(s), GP Surgery, the GP (occasionally), SCR, and by reviewing the patient’s own drugs from home if available, working alongside the Medicines Optimisation Pharmacy Technicians

- Confirming and documenting important factors affecting the patient’s ability to manage their medicines at home (e.g., sight, hearing, manual dexterity, and use of a compliance aid)

- Resolving any discrepancies and problems identified with patients’ medication independently as an independent prescriber to complete medicines reconciliation

Provide clinical pharmacy service through daily ED visit

During the visit the pharmacist will:

- Responsible for appropriate management of patients referred for medicine optimisation or medicine reconciliation, prescribing patient’s regular medication whilst they are in the ED before admission to in-patient wards

- Review prescriptions to ensure they are legal, safe, cost-effective, clinically necessary and appropriate, accurate, and complete

- Undertake Medicines Optimisation

- Arrange for drugs to be supplied to patients, ward(s) or department(s)

- Provide information and advice to ward and nursing staff on a daily basis, about drugs, doses, administration and potential side-effects

- Provide information and advice to junior medical staff on a daily basis, and to Consultants as and when needed, including suggestions for initiating and modifying treatment

- Educate patients as appropriate about changes to their medication, and how to take specific medicines (e.g. warfarin, inhaler devices)

- Access and interpret clinical information for specific patients (e.g. from the ePMA system (Sunrise Clinical Manager), the Patient administration system (TrakCare), Pharmacy computer system (EMIS) as well as case notes and Summary Care Record (SCR)), and use it to individualise and monitor treatment

- Document relevant clinical and pharmaceutical information during in-patient stay which may be used to prepare discharge prescription and/or communicated to patient, carer(s) or GP

- Review discharge prescriptions written by medical staff, using professional judgement to make a final decision about content and appropriateness of discharge prescriptions when a suitable prescriber cannot be contacted

- Participate in Consultant ward rounds as appropriate, providing pharmaceutical advice and information to medical staff, nursing staff, and patients as part of a multi- professional team

- Undertake risk management and ensure compliance with legislation and relevant national policies and guidelines, along with local policies and procedures including the Gloucestershire Joint Formulary

- Undertake regular controlled drug checks within the ED, monitor the use of controlled drugs within the ED and report any concerns relating to controlled drugs to the controlled drugs accountable officer

- Work in an effective team with technicians involved in Trust Medicines Management scheme in the ED and on designated wards

- Usually work unsupervised, although the post-holder can seek advice from a range of colleagues as and when required

- Complete all of the above using the Trust ePMA system (Sunrise Clinical Manager)

Prepare patients for discharge from the ED

Facilitate efficient prescribing and dispensing of medication for patients discharged directly from the ED to help improve patient flow within the ED

Daily tasks include:

- Communicate with junior medical staff (and Consultants) to clarify aspects of the prescription including drug, dosage, frequency, duration of treatment, and length of supply when necessary.

- Use professional judgement to make a final decision about content and appropriateness of discharge prescriptions when a suitable prescriber cannot be contacted.

- Acting as an independent prescriber, prescribe discharge medication on Sunrise EPR or outpatient prescription form (FP10 or hospital outpatient prescription) for patients discharged directly from the ED

- Communicating with patients, carers, community pharmacists as necessary to establish what medication is available at home, and/or to explain changes made to their prescription during ED admission.

- Able to assess and respond appropriately to individual patient’s needs for help with managing their medicines at home.

- Assessing the suitability of patient’s own drugs for re-use/continued use at home, if necessary.

- Supply pharmaceutical and clinical information to the patient’s family doctor (GP) including details of and reasons for medication changes, advice given to the patient, or monitoring needed by the GP.

- Fulfil requirements of the Discharge Medicines Service (DMS)

- Complete all of the above using the Trust ePMA system (Sunrise Clinical Manager)

Provide expert pharmaceutical advice to the Emergency Department

Responsibilities include:

- Collect relevant data, prepare reports for the ED and discuss with the Clinical Director, General Manager, and Divisional Accountant on their drug usage and expenditure as required.

- Monitor prescribing in order to make suggestions to managers and clinicians for ensuring rational and cost-effective prescribing.

- Develop, implement, monitor and revise policies and procedures relating to drug use.

- Represent the service, and occasionally the department, as part of multi-professional teams, and at meetings.

- Provide clinical or financial information about drugs on request by Consultants, Divisional Clinical Director, General Manager, or Accountant.

Specialist Clinical Pharmacist for the Emergency Department

- Specialist Clinical Pharmacist for the ED providing clinical support and guidance for colleagues as needed.

- Responsible for planning, managing, implementing and developing the clinical pharmacy service within the ED in conjunction with the Associate Pharmacy Director(s) and lead clinical pharmacist for medicine

- Manage rotational Clinical Pharmacists assigned to the ED.

- Manage and/or supervise MOPTs and ED based ATOs when carrying out ED- based activities.

- Audit and monitor the current service and any developments, and respond to the needs to the directorate within the capacity of the pharmacy department.

- Maintain an up-to-date knowledge of the therapeutics within specialist clinical area.

- Attend Consultant ward rounds and other ward rounds as appropriate to provide advice, request review of medication and influence rational and cost-effective prescribing.

- Provide a Clinical Pharmacy Service to ED/wards in order to;

reduce risks associated with poor prescribing

ensure accurate assessment of drug histories

provide highly specialised advice on appropriate drug treatment in line with own professional judgement, experience, evidence-based medicines and treatment guidelines

 on occasion, give a specialist opinion in areas where information is lacking and/or medical opinion differs

educate junior doctors on good prescribing practice

persuade senior/junior medical staff to follow agreed prescribing policies

- Initiate, collaborate in, analyse and report on multi-disciplinary audits and research involving the pharmacy service and/or the ED as required.

Development of Clinical Pharmacy Service in the Emergency Department

- Contribute to the clinical pharmacy service strategy including participation in the clinical pharmacy meetings.

- Prepare business plans for proposed new service developments.

- Plan, undertake and participate in project work and clinical audit to monitor and develop the service.

- Work with departmental leads to enhance service where appropriate in order to increase efficiency and modernise the department. 

  Prescribing

If post holder holds a Postgraduate Certificate in Non-Medical Prescribing they must practise within the boundaries of local strategy, professional guidance and the law. 

- Prescribe medicines for agreed patients within their competency as a dependent (e.g. supplementary) prescriber in line with current legislation, local policies and within their own level of experience and competence

- Prescribe medicines in their competency as an independent prescriber in line with current legislation, local policies and within their own level of experience and competence

General Duties

Participation in Weekend/Bank Holiday Working/late night duty

- The post holder will be part of the weekend and bank holiday working rota at Gloucestershire Royal as per departmental arrangements.

- Participate in the dispensary late night rota and lock up the department at the end of the working day

Additional working pattern details: To compliment the current pattern of Emergency Department Pharmacist cover, a minimum of 5 hours of the 7.5 hours are required to be worked on a Monday.