Detailed job description and main responsibilities

PRIMARY DUTIES AND AREAS OF RESPONSIBILITY

1. Clinical - Long Term Conditions / Chronic Disease Management - via pharmacist led clinics, telephone and office based notes reviews

a.     Undertake disease focused medication reviews, particularly of high risk groups (elderly, renal/hepatic impairment, patients on high-risk medicines, etc.) to improve effectiveness and safety, and to ensure appropriate compliance with national and local guidelines.

b.     These may be patients with single or multiple medical problems where medicine optimisation is required (e.g. respiratory, hypertension).

c.     Ensure the care for patients taking high risk drugs e.g. DMARDs, anticoagulation, are safe and appropriate.

d.     Review the on-going need for each medicine.

e.     Titrate medication according to need and guidance.

f.      Review monitoring requirements and arrange appropriately, ensuring recalls are placed on the IT system.

g.     Use the opportunity to support patients with administration of their medicines.

h.     Telephone advice to patients with LTCs on specific medicines management issues.

i.       Provide health promotion where appropriate, including flu vaccinations.

j.       Discuss where necessary any recommendations or concerns with Senior Clinicians or GPs.

k.     Undertake audits and reviews of LTC groups where bulk changes are required.

2. Clinical - Repeat Prescribing and Medication Reviews

 Develop and quality-assure improved, safe and efficient repeat prescribing and medication review processes within the practices/PCN, and implement changes as required.

a.          Undertake focused and structured clinical medication reviews with individual patients and produce a management plan on future prescribing and monitoring, with a focus on maximising effectiveness and reducing harm.

b.          Review processes will update repeat prescribing in line with local and national policies to align to best practice and reduce wastage.

c.           Medication reviews will be undertaken via clinics in the practice, domiciliary visits and in residential and nursing homes. These may be face to face or records based reviews.

d.          Ensure computer records are updated and accurate, and recall / review dates are entered appropriately.

 3. Clinical - Acute Illness Pharmacist led clinics

 Pharmacists may be involved in clinics assessing patients who present with undifferentiated minor illness, working within their scope of practice and limits of competence.

a.          Undertake initial assessment of common general practice presentations, working through differential diagnosis, identifying potential serious disease and referring to GPs and other healthcare professionals where appropriate.

b.          triaging and managing minor illness, with particular focus on educating patients on self-care, and signposting to minor ailment schemes, minor eye complaints service, dental services, etc.

c.           telephone advice to patients with acute illness queries.

4. Risk Stratification around medication harm and avoidable hospital admissions

 Review the use of medicines most commonly associated with unplanned hospital admissions through audit and individual patient reviews with the intent of reducing avoidable admissions.

a.          Put in place changes to reduce the prescribing of these medicines to high‐risk patient groups

b.          Identification of cohorts of patients at high risk of harm from medicines through practice computer searches. This might include risks that are patient related, medicine related, or both.

5. Management of medicines at discharge from hospital

To reconcile medicines following discharge from hospitals, intermediate care and into/from 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.

a.          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).

b.          Reconcile patient’s computer records with discharge medication and discuss discrepancies or concerns with hospital doctors/pharmacists

c.           Ensure changes to discharge medication are in concordance with national and local policies, and to ensure optimisation of treatment and reduce inappropriate or wasteful prescribing.

d.          Ensure instructions and recommendations are enacted within the practice, including organising reviews, blood test monitoring and appropriate up/down titration.

e.           ensure patients are informed and aware of any changes to their medication.

6. MDTs and Case Conferences

 Attend and refer patients to multidisciplinary case conferences where appropriate.

7. Team Information, Education and Training

 Answers relevant medicines and prescribing related enquiries from GPs, other practice staff, other healthcare teams (e.g. community pharmacy) with queries about medicines.

a.          To consider the skills of the reception team and develop plans for training as necessary to ensure safe and efficient prescribing processes.

8.          Implementation of local and national guidelines, safety alerts and formulary recommendations

Implement changes to medicines and prescribing that result from MHRA alerts, product withdrawal and other local and national guidance

a.          Assessing the practice’s compliance with NICE guidance and advise on the implementation of new guidance

b.          Assist practices in maintaining and complying with a practice/PCN/Locality formulary.

c.           Monitor practice prescribing against the local health economy’s RAG list / formulary and make recommendations to GPs for medicines that should be prescribed by hospital doctors (red drugs) or subject to shared care agreements (ESCAs) for amber drugs.

d.          Provide newsletters or bulletins on important prescribing messages.

9. Audit and Monitoring

 To plan and undertake prescribing audits to identify areas where improvement is needed, develop action plans and implement appropriate changes.

a.          To provide regular support and feedback on prescribing action plans

b.          Analyse practice complex prescribing data to inform GPs and non-medical prescribers on their collective and individual performance.

c.           Analyse, interpret and present medicines management / prescribing data to highlight issues and risks.

d.          Lead on the identification, implementation and monitoring of medicines management targets and initiatives including QOF, QIPP and CCG prescribing targets

e.           Undertake specific audits on the effectiveness of the role, and where improvements or review of service/role are needed

f.            Assist with the implementation and monitoring of CCG medicines management targets and initiatives, including the medicines management QIPP plan and national prescribing targets.

g.           Support the implementation of actions resulting from audit findings when necessary.

h.          To agree all auditing and monitoring priorities in discussion with the practice.

10.        Service development

 Provide medicines management advice for the development and implementation of new services that have prescribing and therapeutics components.

11.        Regulators and Inspections

Work with the PCN and practices to ensure compliance with CQC standards, CCG and other contractual requirements where medicines are involved.