Job responsibilities
Management of medicines at discharge from hospital
To
reconcile medicines following discharge from hospitals, intermediate care and
into care homes; identify and rectify unexplained changes; manage these changes
without referral to the 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. 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). Work in partnership
with hospital colleagues (e.g. 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.
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.
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 highrisk
patient groups.
Repeat prescribing
Review, update 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.
Telephone and patient facing medicines support
Provide a telephone help line for patients with
questions, queries and concerns about their medicines. Hold clinics for
patients requiring face to face clinical medication reviews (CMRs) i.e. a
review of the ongoing need for each medicine, a review of monitoring needs and
an opportunity to support patients with their medicine taking.
Medication review
Undertake
clinical medication reviews with patients with multi-morbidity and polypharmacy
and implement own prescribing changes (within competencies as an independent
prescriber) and order relevant monitoring tests.
Care home medication reviews
Manage own
caseload of care home residents or as part of multidisciplinary team. Undertake
clinical medication reviews with patients with multimorbidity and polypharmacy and implement own
prescribing changes (within competencies as an independent prescriber) and
order relevant monitoring tests. Work with care home staff to improve safety of
medicines ordering and administration.
Domiciliary clinical medication review
Manage own
caseload or as part of multidisciplinary team, of vulnerable housebound
patients at risk of hospital admission and harm from poor use of medicines.
Implement own prescribing changes (within competencies as an independent
prescriber) and ordering of monitoring tests. Attend and refer patients to
multidisciplinary case conferences.
Long term condition clinics
See
patients in multi-morbidity clinics and in partnership with primary healthcare
colleagues and implement improvements to patients medicines, including de-prescribing.
Run own long term condition clinics where
responsible for diagnosis and prescribing within competencies as an independent
prescriber and make dose adjustments to repeat prescriptions when required.
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 (e.g.
new oral anticoagulants for stroke prevention in atrial fibrillation).
Care Quality Commission
Provide
leadership to the practice manager and GPs to ensure the practice is compliant
with CQC standards where medicines are involved.
Public health
To devise and manage public
health campaigns to run at the practice. To provide specialist knowledge on
immunisation.
Cost saving programmes
Support and implement cost
saving changes to medicines and appliances identified by CCG practice support
teams designed to save on medicine costs where a medicine or product with lower
acquisition cost is now available. These may be identified within the annual
Prescribing Improvement Plan.
Medicine information to practice staff and patients
Answers all
medicine related 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.
Information management
Analyse,
interpret and present medicines data to highlight issues and risks to support
decision making.
Medicines quality improvement
Identify
and provide leadership on areas of prescribing requiring improvement. Either
conduct own audits and improvement projects or work with colleagues. Present
results and provide leadership on suggested change. Contribute to national and
local research initiatives where indicated.
Training & Shared Learning
Provide
education and training to primary healthcare team on therapeutics and medicines
optimisation. Provide training to visiting medical students.
Facilitate
shared learning across clinicians within the practice on medication related
issues.
Offer
professional support, leadership and share learning with other clinical
pharmacists and those working in associated local practices, especially with
those developing this role within a practice.
Implementation of local and national guidelines and
formulary recommendations
To provide
input into the development of a Primary Care Network Medicines Optimisation
Plan (MOP).
Monitor
practice prescribing against the local health economys Red/Amber/Green and Do
Not Prescribe lists for medicines that either should not be prescribed in
primary care or should be prescribed by hospital doctors only or subject to
shared care. Liaise directly with hospital colleagues where prescribing needs
to be returned to specialists.
Based on
consideration of the content of the Gloucestershire Joint Formulary, assist
practices in setting up 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.
Proactively
provide internal practice communications 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.
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.