Detailed job description and main responsibilities

Job Purpose:

Lewisham and Greenwich NHS Trust, along with Lewisham ICT and Lewisham Borough have developed an integrated approach to medicines optimisation across the interface, community and care home settings as part of improved community management of chronic diseases and long term conditions.  This role will be to support the medicines management aspects of this initiative through working within the LIMOS service across the interface and community setting to visit patients at home. This role will work provide specialist advice to patients, and undertake full patient centred medication reviews to proactively manage people with complex polypharmacy and adherence concerns, with focus on older people, frail housebound, and those with multiple conditions including physical or mental health issues and learning disabilities. The role will also involve partnership working across health and social care interfaces in line with the current and further developing pathways for medicines support in Lewisham as part of the Neighbourhood approach to care.

 This is a specialised post, which involves analysing and interpreting complex clinical situations to develop, provide and communicate effective medicines management solutions and provide expert advice in this area.

 Key Result Areas & Performance:

 1.    To provide medicine management reviews for identified and targeted patients including those who have medication issues or adherence related problems, or are on multiple or high risk medications, in the interface and community settings.

 2.    To deliver quality improvement, while contributing to the delivery of the general practice quality and outcomes framework, other enhanced services and prescribing workstreams in the primary care setting.

 3.    To participate in clinical audit and collect appropriate outcome data.

 4.    To work with general practice colleagues and community pharmacy colleagues to support implementation of safe systems for repeat prescribing and reduction of waste within primary care.

 5.    To work with primary care healthcare professionals to ensure agreed changes in medication are implemented and sustained.

 6.    To provide expertise and clinical leadership on medicines optimisation as part of a team member within the community setting.

 7.  To provide support to improve adherence and help patients get the best from their medicines, reducing medicines related admissions (including falls), and promoting appropriate evidence-based and cost effective prescribing. This will involve advice on de-prescribing where appropriate.

 8.    To provide medicines management support to, and training for patients, carers and members of the multi-disciplinary community and general practice team.

9.    To contribute to the development of protocols to support improvement in systems around medication ordering and supply in the community setting in the context of improving safety and reducing waste.

Service Development

1.    To work with community staff to promote and embed the role pharmacists in the community setting and raise awareness of services available to patient 

2.    To provide recommendations and plan actions to proactively improve the quality of systems and processes to improve medicines optimisation across the primary care setting. 

3.  To provide training regarding medication related issues and policies/guidelines to staff in primary or secondary care in order to promote medicines optimisation and high quality and cost-effective prescribing as appropriate. 

4.    To provide operational and clinical support to medicines optimisation developments and prescribing initiatives as dictated by GP practice, ICB, and hospital Trust and service objectives. 

5.    To collate and feedback on electronic discharge related information to ensure continuing improvement of the hospital computerised discharge letter and process of communication. 

6.    To assist with the implementation of policies and guidelines to improve medicines optimisation across primary/ secondary care interface and into the general practice setting. 

7.    To provide training to staff across health and social care to promote medicines optimisation in practice. 

Clinical Services & Patient Care 

 1.    To provide medication review and optimisation of identified groups of patients to maximise the gain from medicines and provision of safe, clinically effective and cost-efficient use of drugs.

 2.    To provide information in medicines related issues to doctors, nurses and other members of the multidisciplinary team in general practice and where appropriate across primary and secondary care interfaces including to community pharmacies within the Borough.

 3.    To develop skills including management of both minor ailments and specified long term conditions as required to practice as a part of the multidisciplinary team so as to ensure clinically effective and cost efficient use of drugs. 

 4.  To reconcile information related to medicines across the interface setting, liaising with community and hospital colleagues to support the safe transfer of care for vulnerable patients with complex medicines management needs.

 5.  To work as an independent prescriber in line with competency and agreed area of practice as approved by the relevant Trust governance process through the non-medical prescribing committee with ratification by the MMC.

 6.    Provide patient facing and telephone support to patients those with questions, queries and concerns about their medicines.

 Information & Data Management

 1.    To accurately record clinical activity within patient notes and the relevant electronic clinical systems such as EMIS and iCARE or EPIC.

 2.    To undertake clinical audit in areas in collaboration with stakeholders, feedback results, implement changes and ensure learning is shared to ensure quality improvement is achieved.

 3.    To collate any quantitative and qualitative performance measures for the service as required.

 4.    To collect and support the review of audit data associated with monitoring outcomes of relevant work streams of medicines optimisation services in the interface or community setting.

 Education and Training

 1.    To provide education and training on medicines issues to staff working in hospital setting including members of social care, general practice teams and local community pharmacists

 2.    To commit to undertake relevant training to qualify as a pharmacist independent prescriber

 3.    To ensure continuous development of professional knowledge competencies by attendance at in house/external training programmes and appropriate self-education.             

 4.    To act as a tutor and educational supervisor for trainee pharmacists and pharmacy diploma practitioners

 5.    To provide support when required for junior and trainee pharmacists including provision of information, informal teaching and assessment of trainee pharmacists and diploma practitioners.

 6.    To provide teaching and training sessions on pharmacy related issues to pharmacy, ward and clinical staff. 

Financial

1.    To support the delivery of targets in the general practice and community setting in relation to medicines optimisation and service delivery within quality and outcomes framework areas and enhanced services as required.

To provide pharmaceutical advice on the use of more cost-effective drugs across the primary and secondary care interface and within the general practice setting, including the provision of advice and implementation of formulary recommendations and shared care guidance.

 Research & Development

1.    To participate in clinical audit in medicines optimisation initiatives to influence quality improvement around use of medicines within general practice and across local healthcare settings.

2.     To support the development and evaluation of local initiatives in the delivery of medicines optimisation

 Communications and Relationships

1.    To communicate information following assessing patient’s medicines needs with relevant members of the multidisciplinary team as required in the general practice, PCN and primary care setting. This will include close liaison with both community and hospital service colleagues in addition to GPs and other practice staff, carers, and other members of both primary and secondary care teams. 

2.    To communicate medication related issues to patients and relatives.  This includes medication history taking, medication review and medication counselling and overcoming barriers to understanding and communication such as language, hearing, visual or cognitive difficulties.  Communication is either verbal in the form of face to face contact, over the telephone or written in the form of medication reminder charts.

3.    To communicate verbal and written information across the primary and secondary care interface regarding patients therapy on admission and discharge, documenting key information in the  primary care record (EMIS) or Electronic Discharge Notification (EDN), and, where appropriate, resolving queries to support vulnerable patients with medicines management needs.

4.    To liaise with relevant ICB and PCN colleagues on prescribing related issues to ensure consistency of patient care.