Clinical Pharmacist inImmingham inImmingham PUBLISHED MON 6 JAN 2025

We are excited to be expanding our already well complemented team through participation in the NHSE National PCN Pilot Programme as part of Meridian Health Group Primary Care Network.

The clinical pharmacists at The Roxton Practice are an integral part of the team, using and sharing pharmacy expertise to support the practice in effective medicines management and optimal patient care.

Medication Review and Optimisation

Care Home Medication Reviews

Long Term Condition Clinics

Medicines Reconciliation

Unplanned Admission Prevention

Medicines Information/Education

Prescribing Systems and Policies

Medicines Safety

Liaison with community and hospital pharmacies

Teaching/Training

About us

Medication Review and Optimisation:

Face to face clinics:

i. To discuss medication issues with patients as needed and appropriate.

ii. To carry out medication reviews.

iii. To review and continue repeat medications for new patients who have just registered with the practice and PCN, and suggest GP medication review where appropriate.

To discuss medication issues with patients as needed and appropriate by telephone, e.g. adverse effects/interactions, overdose/inadvertent ingestion, OTC remedies, queries from practice and PCN dispensary, queries from care homes.

To respond to dispensary queries to include, re-authorise repeats where there are queries, clarify doses, clarify products, give appropriate alternatives when availability issues.

To discuss specific patient and prescribing issues (e.g. complicated regimes/polypharmacy, compliance difficulties, multiple adverse effects, medication reduction regimes) with other clinicians as necessary.

To support the completion of medication administration forms for district nurses for GPs to sign.

Care Home Medication Reviews:

Manage own caseload of care home residents.

Undertake clinical medication reviews with patients with multi-morbidity and poly-pharmacy 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.

Long Term Condition Clinics:

According to experience and training.

i. Hypertension (lifestyle advice and medication initiation and optimisation);

ii. Diabetes (joint clinic with practice nurse, with referral to GP/community diabetes nurse specialist/secondary care diabetes advice line);

iii. CHD (medicines optimisation, with referral to GP where necessary).

iv. Respiratory (advise practice nurse, including interpretation of spirometry)

v. Chronic pain management (responding to patient or GP requests for review).

Medicines Reconciliation:

To review secondary care requests for new medication (as communicated by discharge summaries, outpatient letters, etc.) and raise any queries with relevant GP, and discuss how to respond when inappropriate prescribing requests arise.

To deal with anticoagulant start/stop requests from secondary care and contact patients who have defaulted on INRs.

Unplanned Admission Prevention

Devise and implement practice/PCN 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.

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

Medicines Information / Education:

To monitor and inform colleagues as relevant about ongoing prescribing issues, e.g. new guidelines (national and local), new products being asked for by secondary care, manufacturing and supply problems, new prescribing restrictions or contraindications, and individual and systematic errors made by colleagues.

To advise on cost effective prescribing and prescribing budget issues.

To keep the prescribing folder on the practice/PCN intranet up to date, with admin support.

To train nursing home staff in medicines management.

Prescribing Systems and Policies:

To identify patients in need of medication review and develop the system of patient invitation with the admin team.

To liaise with dispensary, admin and clinical staff in discussing, developing, and implementing medicines management systems in the practice.

To work with the GPs, dispensary manager and dispensary team to review, develop and implement prescribing policies and strategies for the whole practice/PCN.

To suggest and design audits in relation to prescribing targets, implementation of locality policies and the Quality Outcomes Framework (QOF).

To work with the GPs, practice manager, PCN staff, and dispensary manager on choosing and delivering targets for the local Prescribing Quality Schemes.

To monitor the practices and PCNs prescribing performance and suggest changes to practice prescribing as appropriate.

To support the delivery of electronic prescribing.

To work with the dispensary team and lead dispensing GP to maximize profitability and to perform audits.

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 from clinical trials.

Liaison with community and hospital pharmacies:

To support further integration of the practice within Community and hospital pharmacies and proactively manage patients at risk of medicine related problems on discharge to provide continuity of care.

To support and advise dispensary when needed.