Clinical Pharmacist

The role is pivotal to improving the quality of care and operational efficiencies so requires motivation and passion to deliver excellent service within general practice.

Weare looking for 1 WTE, enthusiastic and highly motivated clinicalpharmacists to join our team and work with our existing Senior ClinicalPharmacist, Clinical Pharmacists and Pharmacy Technicians.

We aim to create a clinical pharmacist teamto embed the role within our member practices. This is great opportunity todevelop a fulfilling and vital career in primary care within a supportedenvironment.

There will be opportunity to use your expertise to innovate; toadvise and influence our medicines management strategy; to implement measures thatensure quality and safety in prescribing.

Completion of an independentprescribing course is an essential criterion for the role. Completion of theCPPE pathway is preferred but not essential and there is opportunity to supportyou through the CPPE pathway.

Main duties of the job

The job description provided is wide ranging with some competencies involved will be subject to experience of the candidate.

All the primary duties and areas of responsibility listed can only be achieved by a clinical pharmacist team., Citrus Health Primary Care Network is recruitingfor a Clinical Pharmacist to be part of the new Primary Care Networkmultidisciplinary team.

The successful candidate will be workingacross 6 practices across the Sandwell place to provide :

1. Prescribing quality improvements and medicinesoptimisation.

2. Holistic approach, personalised centredcare to the patients within the PCN community.

3. Support to the wide multidisciplinary teamand proactive population health education.

Background

Citrus Health Primary Care Network delivers healthcare servicesto a population of 46,139. This is a unique opportunity to co-create the futureof the pharmacy workforce within the Primary Care Network.

The local community is rich blend of cultures and diversebackgrounds. There is an existing PCN pharmacy team, which has continuously evolved,and place-based pharmacy leads from the Black Country ICB.

The successful candidate will have a higherdegree in pharmacy and will be a registered GPhC independent prescriber. Also, theywill be expected to demonstrate evidence of completion of the national trainingpathway delivered by CPPE for ARRS.

They will perform face-to-face medicationreviews of patients with polypharmacy especially for older people, peopleresident in care homes and those with multiple co-morbidities.

Also, the successful candidate willhave a role in managing long-term conditions; working directly with patients toassess and treat conditions, as well as promote self-care.

The successfulapplicant will work as part of a multidisciplinary team to develop and runprocesses for repeat prescription reauthorisation, management of medicines ontransfer of care and systems for safer prescribing.,

• The post holder will work within their clinical 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 request, while addressing both the public health and social care needs of patients in the GP practice(s) that make up the PCN.


• The post holder will perform face-to-face medication review 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 and well as managing some aspects of the Quality and outcomes framework.

• The post holder will work as part of a multi-disciplinary team to manage repeat prescription authorisations and reauthorisation, acute prescription request, management of medicines on transfer of care and systems for safer prescribing, providing expertise in clinical medicines management while addressing both the public health and social care needs of patients in the GP practice(s).


• This role is pivotal to improving the quality of care and operational efficiencies so requires motivation and passion to deliver an excellent service within general practice.


• Key duties and responsibilities


• 1. Patient facing medicines support


• Hold clinics for patients requiring facetoface structured medication reviews a review of the ongoing need for each medicine, a review of monitoring needs and an opportunity to support patients with their medicine taking.


Provide a telephone support for patients with questions, queries and concerns about their medicines.

• 2. Medication review


• Undertake structured medication reviews with patients with multimorbidity and polypharmacy and implement own prescribing changes (as an independent prescriber) and order relevant monitoring tests


• 3. 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.

• 4. Longterm condition clinics


• See patients in multimorbidity clinics and in partnership with primary healthcare colleagues and implement improvements to patients medicines, including de-prescribing.


Manage own case load, run own long-term condition clinics where responsible for prescribing as an independent prescriber for conditions where medicines have a large component ( medicine optimisation for stable angina symptom control, warfarin monitoring and dose adjustment for patients requiring longterm anticoagulants).

Review the ongoing need for each medicine, a review of monitoring needs and an opportunity to support patients with their medicines taking.

• 5. 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 high-risk patient groups.

• 6. Repeat prescribing


• Produce 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.

• 7. Triage


• Ensure that patients are referred to the appropriate clinician for the appropriate level of care within an appropriate period of time pathology results, common / minor ailments, acute conditions, long term conditions.


• 8. Medicines safety and quality improvement


• Identify and provide leadership on areas of prescribing requiring improvement. Conduct own audits and improvement projects and work with colleagues.


Present results and provide leadership on suggested change. Demonstrate continuous QI activity focused upon prescribing safety as specified in the QOF guidance.

This work for example might include the PINCER tool. Contribute to national and local research initiatives. Provide leadership to the practice manager and GPs to ensure the practice is compliant with CQC standards where medicines are involved.

• 9. Care home medication reviews


• Manage own caseload of care home residents. Undertake clinical medication reviews with patients with multimorbidity and polypharmacy and implement own prescribing changes (as an independent prescriber) and order relevant monitoring tests.


Work with care home staff to improve safety of medicines ordering and administration.

• 10. Domiciliary clinical medication review


• Manage own caseload of vulnerable housebound patients at risk of hospital admission and harm from poor use of medicines.


Implement own prescribing changes (as an independent prescriber) and ordering of monitoring tests. Attend and refer patients to multidisciplinary case conferences.

• 11. 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 ( new oral anticoagulants for stroke prevention in atrial fibrillation).


• 12. Care Quality Commission


• Provide leadership to the practice manager and GPs to ensure the practice is compliant with CQC standards where medicines are involved.


• 13. Population and Public Health


• To devise and manage population and public health campaigns to run within the network. To provide specialist knowledge on immunisation.


• 14. Cost saving programmes


• Make recommendations for, and manage pharmacy technicians to, make changes to medicines (switches) designed to save on medicine costs where a medicine or product with lower acquisition cost is now available


• 15. Medicine information to practice staff and patients


• Answers all medicinerelated 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.

• 16. Information management


• Analyse, interpret and present medicines data to highlight issues and risks to support decision making.


• 17. Training


• Provide education and training to primary healthcare team on therapeutics and medicines optimisation. Provide training to visiting medical, nursing and other healthcare students where appropriate.


• 18. Management of medicines at discharge from hospital


• To reconcile medicines following discharge from hospitals, intermediate care and into care homes, including identifying and rectifying unexplained changes manage these changes without referral to a 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 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 ( those with medicine compliance aids or those in care homes).


Work in partnership with hospital colleagues ( 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

• 19. Implementation of local and national guidelines and formulary recommendations


• Monitor practice prescribing against the local health economys RAG list for medicines that should be prescribed by hospital doctors (red drugs) or subject to shared care (amber drugs).


Liaise directly with hospital colleagues where prescribing needs to be returned to specialists. Assist practices in setting 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. Provide newsletters 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.

• 20. 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.

• Collaborative working arrangements


• Works collaboratively with their PCN clinical director and PCN leads


• Recognises the roles of other colleagues within the network and their role to patient care


• Demonstrates use of appropriate communication to gain the co-operation of relevant stakeholders (including patients, senior and peer colleagues, and other professionals, other NHS / private organisations ICB)


• Demonstrates ability to lead a team


• Is able to recognise personal limitations and refer to more appropriate colleague(s) when necessary


• Liaises with colleagues including ICB Pharmacists on prescribing related matters to ensure consistency of patient care and benefit


• Liaises with colleagues including ICB Clinical Leads and Heads of Medicines Management / Optimisation to benefit from peer support


• Liaises with network GP Practices and neighbouring networks as needed for the collective benefit of patients


• Including but not limited to :


• 1. Patients and their representatives


• 2. GP, nurses and other practice staff


• 3. Social prescribers, first contact physiotherapists, physicians associates and paramedics.


• 4. Community pharmacists and support staff


• members of the medicines management (MM) team including pharmacists, Pharmacy Technicians and Dieticians


• 6.Locality / GP prescribing lead


• 7.Locality managers


• 8.Community nurses and other allied health professionals


• 9.Hospital staff with responsibilities for prescribing and medicines optimisation, The post-holder must co-operate with all policies and procedures designed to ensure equality of employment. Co-workers, patients and visitors must be treated equally irrespective of gender, ethnic origin, age, disability, sexual orientation, religion etc


• Respect for Patient Confidentiality


• The post-holder should respect patient confidentiality at all times and not divulge patient information unless sanctioned by the requirements of the role.


• Special Working Conditions


• The post-holder is required to travel independently between practice sites (where applicable), and to attend meetings etc hosted by other agencies.


• The post-holder will have contact with body fluids , wound exudates; urine etc while in clinical practice.
  
  The candidate will haveexcellent written and verbal communication skills, experience of influencingothers and conducting clinical medication reviews.


The successful candidate will provideleadership on quality improvement and clinical audit, as well as managing someaspects of the Quality and Outcomes Framework and PCN Network Contract.

Thesuccessful candidate should have a minimum of 2-years experience working inGeneral Practice or a PCN.,
• Has an experience / awareness of the breadth of common acute and long-term conditions that are likely to be seen in a general medical practice.


• Minimum of 5 years post graduate experience in pharmacy, as demonstrated within a practice portfolio


• Holds an independent prescribing qualification


• Able to plan, manage, monitor, advise and review general pharmaceutical care programmes for patients across core areas, including disease states / long term conditions.


• Accountable for delivering professional expertise and direct service provision


• Uses skills in a range of routine situations requiring analysis or comparison of a range of options.


• Recognises priorities when problem-solving and identifies deviations from normal pattern and is able to refer to seniors or GPs when appropriate.


• Able to follow legal, ethical, professional and organisational policies / procedures and codes of conduct


• Involves patients in decisions about prescribed medicines and supporting adherence as per NICE guidelines.


• NB : it is anticipated that the level of qualification held may vary according to the level of position and the components of the role being carried out, see person specification


• Leadership


• Demonstrate understanding of the pharmacy role in governance and is able to implement this appropriately within the workplace.


• Demonstrate understanding of, and contributes to, the workplace vision


• Demonstrates ability to improve quality within limitations of service


• Demonstrates ability to improve quality within limitations of service


• Reviews yearly progress and develops clear plans to achieve results within priorities set by others.


• Demonstrate ability to motivate self to achieve goals


• Demonstrates ability to lead a team and provide support to other clinical pharmacists


• Management


• Demonstrate understanding of the implications of national priorities for the team and / or service and manage the team through these changes


• Demonstrate understanding of the process for effective resource utilisation


• Demonstrate understanding of, and conforms to, relevant standards of practice


• Demonstrates ability to identify and resolve risk management issues according to policy / protocol


• Follows professional and organisational policies / procedures relating to performance management


• Demonstrate ability to extend boundaries of service delivery within the team


• Lead and mentor a team of differing abilities


• Education Training and Development


• Understands and demonstrates the characteristics of a role model to members in the team and / or service.


• Demonstrates understanding of the mentorship process.


• Demonstrates ability to conduct teaching and assessment effectively according to a learning plan with supervision from more experience colleague.


• Demonstrates self-development through continuous professional development activity.


• Participates in the delivery of formal education programmes.


• Demonstrates an understanding of current educational policies relevant to working areas of practice and keeps up to date with relevant clinical practice.


• Research and Evaluation


• Demonstrates ability to critically evaluate and review literature.


• Demonstrates ability to identify where there is a gap in the evidence base to support practice.


• Demonstrates ability to generate evidence suitable for presentations at practice and local level.


• Demonstrates ability to apply research evidence base into working place.


• Demonstrates understanding of principles of research governance.


• Health and Safety / Risk Management


• The post-holder must comply at all times with the Practices Health and Safety policies, in particular by following agreed safe working procedures and reporting incidents using the organisations Incident Reporting System.


• The post-holder will comply with the Data Protection Act (2018) and the Access to Health Records Act (1990)
  
  Citrus Health is a primary care network of 6 GP surgeries covering a patient population of 46139 patients in the southwest of the Sandwell & West Birmingham CCG footprint.


We are a dynamic and friendly team already experienced at working together to deliver excellent care of our patients.

Our Member Practices are :

Portway Family Practice

Haden Vale Medical Practice

The Practice Old Hill

Hawes Lane Surgery

Black Country Family Practice

Smethwick Medical Centre