Clinical Pharmacist

Do you enjoy making a difference for patients whilst being part of a dedicated and highly motivated team of professionals? You will work and be based in a great part of the country with access to an array of experiences and connections.

Cheltenham Peripheral PCN is an established team working within 5 GP Practices that wrap themselves around the town of Cheltenham and the neighbouring communities.

We pride ourselves on being creative, caring and innovative, a motivated group of GP's and Health Care Professionals, one of our top priorities include Our People, it is important for us to support and grow our staff, providing opportunities to work independently and develop in new areas of interest.

We are looking for an individual with character, compassion, empathy and a desire to succeed, balanced with a good clinical and pharmaceutical knowledge eager for a new challenge.

We welcome applicants from hospital, community or primary care background. Consideration given to newly qualified pharmacists.

Main duties of the job This position offers the potential to develop a long term career in a Primary Care environment. Whilst prescribing experience is desirable we are willing to recruit pharmacists without the IP qualification as they can develop through the CPPE Pathway.

The job purpose is to fulfil the requirements of the PCN DES contract by:

• Working with the practices to ensure that medicines management is optimised to achieve highly effective, safe and patient centred prescribing.
• Undertaking telephone-based and face to face patient consultations, reviewing patients with potential medication issues and long term conditions. This will include Structured Medication Reviews (SMR) and de prescribing within the context of polypharmacy and frailty.
• Working with Care Homes in Multidisciplinary Teams (MDT) to optimise the medicines management of residents

About us The existing pharmacy team supports 5 GP practices located on the edge of Cheltenham - Leckhampton, Charlton Kings, Bishop's Cleeve and Winchcombe. The combined patient population is 54,000.

The role will report directly to the Lead. The Lead in turn is accountable to the PCN's Clinical Director who is a GP at one of the practices.

The practices enjoy a very good working relationship. Communication is strong and regular meetings are held to encourage the sharing of ideas and to plan projects. We are keen to develop and train our staff.

Job responsibilities Management of medicines at discharge from hospital

Toreconcile medicines following discharge from hospitals, intermediate care andinto care homes; identify and rectify unexplained changes; manage these changeswithout referral to the GP; perform a clinical medication review; produce apost discharge medicines care plan including dose titration and booking of follow uptests, and working with patients and community pharmacists to ensure patientsreceive the medicines they need post discharge. Set up and manage systems toensure continuity of medicines supply to high risk groups of patients (e.g.those with medicine compliance aids or those in care homes). Work in partnershipwith hospital colleagues (e.g. care of the elderly doctors and clinicalpharmacists) to proactively manage patients at high risk of medicine relatedproblems before they are discharged to ensure continuity of care.

Design,development and implementation of computer searches to identify cohorts ofpatients at high risk of harm from medicines. Responsibility for management ofrisk stratification tools on behalf of the practice. Working with patients andthe primary care team to minimise risks through medicines optimisation.

Unplanned hospital admissions

Devise andimplement practice searches to identify cohorts of patients most likely to beat risk of an unplanned admission and readmissions from medicines. Work withcase managers, multidisciplinary (health and social care) review teams,hospital colleagues and virtual ward teams to manage medicines related risk forreadmission and patient harm. Put in place changes to reduce the prescribing ofthese medicines to highriskpatient groups.

Repeat prescribing

Review, update and implement a practice repeat prescribingpolicy. Manage the repeat prescribing reauthorisation process by reviewingpatient requests for repeat prescriptions and reviewing medicines reachingreview dates; make necessary changes as an independent prescriber, and ensurepatients are booked in for necessary monitoring tests where required.

Telephone and patient facing medicines support

Provide a telephone help line for patients withquestions, queries and concerns about their medicines. Hold clinics forpatients requiring face to face clinical medication reviews (CMRs) i.e. areview of the ongoing need for each medicine, a review of monitoring needs andan opportunity to support patients with their medicine taking.

Medication review

Undertakeclinical medication reviews with patients with multi morbidity and polypharmacyand implement own prescribing changes (within competencies as an independentprescriber) and order relevant monitoring tests.

Care home medication reviews

Manage owncaseload of care home residents or as part of multidisciplinary team. Undertakeclinical medication reviews with patients with multimorbidity and polypharmacy and implement ownprescribing changes (within competencies as an independent prescriber) andorder relevant monitoring tests. Work with care home staff to improve safety ofmedicines ordering and administration.

Domiciliary clinical medication review

Manage owncaseload or as part of multidisciplinary team, of vulnerable houseboundpatients at risk of hospital admission and harm from poor use of medicines.Implement own prescribing changes (within competencies as an independentprescriber) and ordering of monitoring tests. Attend and refer patients tomultidisciplinary case conferences.

Long term condition clinics

Seepatients in multi morbidity clinics and in partnership with primary healthcarecolleagues and implement improvements to patients medicines, including de prescribing.Run own long term condition clinics whereresponsible for diagnosis and prescribing within competencies as an independentprescriber and make dose adjustments to repeat prescriptions when required.

Develop andmanage new services that are built around new medicines or NICE guidance, wherenew medicine/recommendations allow the development of a new care pathway (e.g.new oral anticoagulants for stroke prevention in atrial fibrillation).

Care Quality Commission

Provideleadership to the practice manager and GPs to ensure the practice is compliantwith CQC standards where medicines are involved.

Public health

To devise and manage publichealth campaigns to run at the practice. To provide specialist knowledge onimmunisation.

Cost saving programmes

Support and implement costsaving changes to medicines and appliances identified by CCG practice supportteams designed to save on medicine costs where a medicine or product with loweracquisition cost is now available. These may be identified within the annualPrescribing Improvement Plan.

Medicine information to practice staff and patients

Answers allmedicine related enquiries from GPs,other practice staff and patients with queries about medicines: Suggesting andrecommending solutions. Providing follow up for patients to monitor the effectof any changes.

Information management

Analyse,interpret and present medicines data to highlight issues and risks to supportdecision making.

Identifyand provide leadership on areas of prescribing requiring improvement. Eitherconduct own audits and improvement projects or work with colleagues. Presentresults and provide leadership on suggested change. Contribute to national andlocal research initiatives where indicated.

Training & Shared Learning

Provideeducation and training to primary healthcare team on therapeutics and medicinesoptimisation. Provide training to visiting medical students.

Facilitateshared learning across clinicians within the practice on medication relatedissues.

Offerprofessional support, leadership and share learning with other clinicalpharmacists and those working in associated local practices, especially withthose developing this role within a practice.

Implementation of local and national guidelines andformulary recommendations

To provideinput into the development of a Primary Care Network Medicines OptimisationPlan (MOP).

Monitorpractice prescribing against the local health economys Red/Amber/Green and DoNot Prescribe lists for medicines that either should not be prescribed inprimary care or should be prescribed by hospital doctors only or subject toshared care. Liaise directly with hospital colleagues where prescribing needsto be returned to specialists.

Based onconsideration of the content of the Gloucestershire Joint Formulary, assistpractices in setting up and maintaining a practice formulary that is hosted onthe practices computer system. Suggest and develop computer decision supporttools to help remind prescribers about the agreed formulary choice and localrecommendations.

Auditingpractices compliance against NICE technology assessment guidance.
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