TLCP PCN Senior Clinical PharmacistinLondoninLondonPUBLISHED FRI 13 SEP 2024

Primary care clinical pharmacy is developing, and we are looking for a motivated individual who is flexible to respond to the developing nature of the role and the needs and priorities of individuals requiring support. This role involves supporting the Care First/PCN, to manage and achieve the clinical contractual requirement.

Under the direction of the Care first/PCN, we expect that you will be able to work independently and manage your own workload. You will need excellent communication skills to be able to liaise with patients, primary care staff, community pharmacists and other partners.

As part of their employment, the post holder will achieve qualifications from an accredited training pathway, including independent prescribing, equipping the clinical pharmacist to be able to practice and prescribe safely and effectively in a primary care setting.

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• Work as part of a multi-disciplinary team in a patient facing role to clinically assess and treat patients using their expert knowledge of medicines for specific disease areas.
• Be responsible for the care management of patients with chronic diseases and undertake clinical medication reviews to proactively manage people with complex polypharmacy, especially the elderly, people in care homes, those with multiple co-morbidities (in particular frailty, COPD and asthma) and people with learning disabilities or autism (through STOMP Stop Over Medication Programme);
• Provide specialist expertise in the use of medicines whilst helping to address both the public health and social care needs of patients at the PCN and to help in tackling inequalities;
• Provide leadership on person-centred medicines optimisation (including ensuring prescribers in the practice conserve antibiotics in line with local antimicrobial stewardship guidance) and quality improvement, whilst contributing to the quality and outcomes framework and enhanced services;
• Through structured medication reviews, support patients to take their medications to get the best from them, reduce waste and promote self-care;
• Have a leadership role in supporting further integration of general practice with the wider healthcare teams (including community and hospital pharmacy) to help improve patient outcomes, ensure better access to healthcare and help manage general practice workload;

About us

Additional Responsibilities

• Senior Clinical Pharmacist has the following additional key responsibilities to those outlined above in delivering health services:
• Assess and triage patients, including same day triage, and as appropriate provide definitive treatment (including prescribing medications following policy, patient group directives, NICE (national) and local clinical guidelines and local care pathways) or make necessary referrals to other members of the primary care team
• Manage undifferentiated undiagnosed condition and identify red flags and underlying serious pathology and take appropriate action
• Use complex decision making to inform the diagnosis, investigation, complete management of episodes of care within a broad scope of practice
• Actively take a personalised care approach and population centred care approach to enable shared decision making with the presenting person

Secondary Responsibilities

In addition to the primary and additional key responsibilities, the Senior Clinical Pharmacist may be requested to:

• Support delivery of QOF, incentive schemes, QIPP and other quality or cost effectiveness initiatives
• Agree and review prescribing formularies and protocols and monitor compliance levels
• Improve the data quality of medicines records and linking to conditions
• Deliver training, mentoring and guidance to other clinicians and staff on medicine issues
• Working in partnership with pharmacists and clinicians hospitals, improve the safety and quality of prescribing after discharge from hospital admissions and attendance
• Provide leadership and support to prescription administrative or dispensary staff
• Produce pharmacy or prescribing newsletters or bulletins on a quarterly basis
• Develop a specialist area of interest Work with community pharmacists, hospital pharmacists and other stakeholders in the medicines supply chain to improve patient experience and manage incidents
• Support virtual and remote models of consultation and support including e-consultations, remote medication review and telehealth and telemedicine
• Undertake any tasks consistent with the level of the post and the scope of the role, ensuring that work is delivered in a timely and effective manner

Develop relationships and work closely with other pharmacy professionals across PCNs and the wider health and social care system;

• Take a central role in the clinical aspects of shared care protocols, clinical research with medicines, liaison with specialist pharmacists (including mental health and reduction of inappropriate antipsychotic use in people with learning difficulties), liaison with community pharmacists and anticoagulation; and
• Be part of a professional clinical network and have access to appropriate clinical supervision.
• High risk drug monitoring, and Get involved in audits, set by CCG or towards borough wide aims and targets. Run searches for local and national medication alerts/shortages.

Patient facing Long-term condition Clinics

• See (where appropriate) patients with single or multiple medical problems where medicine optimisation is required (e.g. COPD, asthma).
• Review the on-going need for each medicine, a review of monitoring needs and an opportunity to support patients with their medicines taking ensuring they get the best use of their medicines (i.e. medicines optimisation). Make appropriate recommendations to Senior Pharmacists or GPs for medicine improvement

Patient facing Clinical Medication Review

• Undertake clinical medication reviews with patients and produce recommendations for senior clinical pharmacist, nurses and/or GP on prescribing and monitoring.
• Support the pharmacist team to provide clinical medication review in care home/domiciliary

Management of common/minor/self-limiting ailments

• Managing caseload of patients with common/minor/self-limiting ailments while working within a scope of practice and limits of competence.
• Signposting to community pharmacy and referring to GPs or other healthcare professionals where appropriate

Patient facing medicines support

• Provide patient facing clinics for those with questions, queries and concerns about their medicines in the practice

Medicine information to practice staff and patients

• Answers relevant medicine-related enquiries from
• GPs, other practice staff, other healthcare teams (e.g. community pharmacy) and patients with queries about medicines.
• Suggesting and recommending solutions
• Providing follow up for patients to monitor the effect of any changes
• Do appropriate database searches, in keeping MHRA and NICE alerts/ guidance to support safe patient care.

Unplanned hospital admissions

• Review the use of medicines most commonly associated with unplanned hospital admissions and readmissions through audit and individual patient reviews.
• Put in place changes to reduce the prescribing of these medicines to highrisk patient groups.
• 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 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.

Signposting

• Ensure that patients are referred to the appropriate healthcare professional for the appropriate level of care within an appropriate period of time e.g. pathology results, common/minor ailments, acute conditions, long term condition reviews etc.

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 and flagging up those needing a review.
• Ensure patients have appropriate monitoring tests in place when required.
• Be involved in the repeat prescribing system of the practice

Risk stratification

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

Service development

• Contribute pharmaceutical advice for the development and implementation of new services that have medicinal components (e.g. advice on treatment pathways and patient information leaflets).
• Comply with local medicines management requirements.

Information management

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

Medicines quality improvement

• Undertake clinical audits of prescribing in areas directed by the GPs, feedback the results and implement changes in conjunction with the practice team.
• Present audit findings to improve service delivery as appropriate.

Medicines Management

• Implement changes to medicines that result from MHRA alerts, product withdrawal and other local and national guidance.
• Implementationoflocalandnationalguidelinesandformulary recommendations
• Monitor TLCP prescribing against the local health economys RAG list and make recommendations to GPs for medicines that should be prescribed by hospital doctors (red drugs) or subject to shared care (amber drugs).
• Assist TLCP in seeing and maintaining a practice formulary that is hosted on the practices computer system.
• Auditing practices compliance against NICE technology assessment guidance.

Care Quality Commission

• Work with the general practice team to ensure the practice is compliant with CQC standards where medicines are involved.

Public health

• To support public health campaigns.
• To provide specialist knowledge on all public health programmes available to the general public.

Collaborative Working Relationships

• Recognises the roles of other colleagues within the primary care 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 e.g. CCGs) Demonstrates ability to work as a member of a team
• Can recognise personal limitations and refer to more appropriate colleague(s) when necessary
• Activelyworktowarddevelopingandmaintainingeffective working relationships both within and outside the practice and locality
• Foster and maintain strong links with all services across locality
• Explores the potential for collaborative working and takes opportunities to initiate and sustain such relationships
• Demonstrates ability to integrate general practice with community and hospital pharmacy teams
• Liaises with CCG colleagues including CCG Pharmacists on prescribing related matters to ensure consistency of patient care and benefit
• Liaises with CCG pharmacists and Heads of Medicines Management/ Optimisation to benefit from peer support
• Liaises with other stakeholders as needed for the collective benefit of patients including but not limited to Patients, GP, nurses and other practice staff
• Other healthcare professionals including PCN pharmacy technicians, social prescribers, physician associates, dentists, health and social care teams and dieticians etc.
• Locality / GP prescribing lead Locality managers
• Community nurses and other allied health professionals
• Community and hospital pharmacy teams
• Hospital staff with responsibilities for prescribing and medicines optimisation
• To support in the delivery of enhanced services and other service requirements on behalf of the PCN

Duties may vary from time to time without changing the general character of the post or the level of responsibility