PCN - Clinical Pharmacists

1. Patient-facing / Remote Medicines Support Deliver patient-facing medication review clinics, stratifying need across the full spectrum of review types from technical, medicines adherence reviews (including polypharmacy reviews) through to focal long-term condition reviews (see section 3) and holistic SMRs. Provide accessible support for patients with questions, queries, and concerns about their medicines. 2. Medicines-Related Clinical Support for Care Homes Deliver clinical medication reviews in collaboration with patients, care home staff, and the Ageing Well team, producing clear and evidencebased recommendations for the multidisciplinary team to support medicines optimisation, prescribing, and monitoring. Work collaboratively with care home staff and the Ageing Well team to optimise medicines management and promote safe, effective, and appropriate use of medicines, including updating medication at transfer of care and investigating and responding to requests for medication not on, or as on, repeat. This workstream is coordinated by the PCN's Pharmacy Hub for Assessment Services (PHASe), integrated within The Ageing Well Team, but practice-based pharmacists will need to liaise with the hub, communicating effectively, to ensure an efficienct and seamless care delivery service. 3. Long-Term Condition Clinics Deliver reviews to patients with single or multiple medical problems where medicine optimisation is required (e.g., respiratory, cardiovascular-reno-metabolic). Review the on-going need for each medicine, monitoring needs and support patients in getting the best use of their medicines (i.e. medicines optimisation). Make appropriate recommendations to Senior Pharmacists or GPs for medicine improvement. Contribute to QOF achievement and IIF targets related to long-term condition management. 4. Patient facing Domiciliary Medication Reviews Deliver medication reviews to patients in care home or domiciliary settings, working within the PCN's Pharmacy Hub for Assessment Services (PHASe), integrated within The Ageing Well Team. For care home patients, medicines reconciliation and medication review is coordinated through the centralised pharmacy hub. The post holder will work within this hub structure, contributing to and drawing on hub-led clinical oversight, supervision, and workflow support, and producing recommendations for the multidisciplinary team on prescribing, deprescribing, and monitoring. In some practices, medication reviews for care home patients may be delivered outside of the central hub, and some reviews for care home or housebound patients may require home visits. 5. Risk stratification Identify cohorts of patients at increased risk of harm from medicines using agreed, preprepared practice clinical system searches, including prescribing and clinical decision support software such as Eclipse Live Radar 500 searches. Risks may be patientrelated, medicinerelated, or a combination of both. Where appropriate, pharmacy technicians will be accountable for reviewing and acting on the outcomes of these searches within their scope of competence, in accordance with agreed protocols. Clinical pharmacists will provide supervision and support where the management of highrisk patients falls outside the pharmacy technicians competence, and will assume responsibility during periods of leave or in exceptional circumstances. 6. Unplanned hospital admissions Review the use of medicines most commonly associated with unplanned hospital admissions and readmissions through audit and individual patient reviews. Implement changes to reduce the prescribing of these medicines to high-risk patient groups. 7. Medicines Reconciliation Reconcile medicines following communications from other health settings (e.g., hospital discharges, clinical letters from secondary care, private healthcare providers etc) including identifying, resolving and appropriately escalating unexplained changes to medicines when required. Work collaboratively with patients, carers and the wider MDT to ensure timely access to medicines and continuity of care including those requiring medicines compliance aids and care home residents. Provide mentorship, supervision, and appropriate delegation of medicines reconciliation activities to pharmacy technicians and junior pharmacists, including foundation pharmacists, in line with their competence and agreed governance arrangements. 8. Medicine Information & Advisory Support Respond to relevant medicine-related enquiries from GPs, other network staff, other healthcare teams (e.g., community pharmacy) and patients with queries about medicines acting as a visible and accessible medicines expert within the PCN. Suggest and recommend evidence-based solutions. Provide appropriate follow-up where changes are made. 9. Signposting Ensure that patients are referred to the appropriate healthcare professional for the appropriate level of care within an appropriate time period e.g., pathology results, common/minor ailments, acute conditions, long-term condition reviews etc. Collaborate with and refer to relevant non-clinicians e.g. social prescribing link workers to connect patients with non-clinical community support where wider determinants of health are contributing to medicines non-adherence or health inequalities. 10. Repeat prescribing 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. Support the practice to reduce prescribing errors and promote safe, efficient repeat prescribing workflows. 11. Service development Contribute pharmaceutical expertise to the development and implementation of new services that have medicinal components (e.g., advice on treatment pathways and patient information leaflets). 12. Information management Analyse, interpret and present medicines data to highlight issues and risks to support decision making. 13. Medicines quality improvement Undertake clinical audits of prescribing in areas directed by the GPs and the PCN team, feedback the results and implement changes in conjunction with the relevant practice team. 14. Medicines safety Implement changes to medicines that result from MHRA alerts, product withdrawal and other local and national guidance. Contribute to the practice's and PCNs patient safety agenda by participating in significant event analysis (SEA), reporting incidents as appropriate, supporting learning from near-misses and medicines errors. Work with the practice team and PCN to embed a culture of medicines safety. 15. Implementation of local and national guidelines and formulary recommendations Monitor practice 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). 16. Education, Mentoring and Clinical Supervision Provide education and training to primary healthcare team on therapeutics and medicines optimisation. Mentor, supervise and delegate, as appropriate, clinical workflow to pharmacy technicians and more junior pharmacists (including foundation pharmacists), to optimise skill-mix and aid team development. 17. Care Quality Commission Work with the general practice teams to ensure the practices are compliant with CQC standards where medicines are involved. 18. Public health Support public health campaigns and provide specialist knowledge on all public health programs available to the general public. 19. Collaborative working arrangements As part of an integrated pharmacy team, foster and maintain collaborative working relationships with practice teams, ICB colleagues including medicines management pharmacy professionals, the Ageing Well Team and social prescribing team, and all other relevant services across the PCN and other stakeholders as needed for the collective benefit the practice and its patients. Job description Job responsibilities 1. Patient-facing / Remote Medicines Support Deliver patient-facing medication review clinics, stratifying need across the full spectrum of review types from technical, medicines adherence reviews (including polypharmacy reviews) through to focal long-term condition reviews (see section 3) and holistic SMRs. Provide accessible support for patients with questions, queries, and concerns about their medicines. 2. Medicines-Related Clinical Support for Care Homes Deliver clinical medication reviews in collaboration with patients, care home staff, and the Ageing Well team, producing clear and evidencebased recommendations for the multidisciplinary team to support medicines optimisation, prescribing, and monitoring. Work collaboratively with care home staff and the Ageing Well team to optimise medicines management and promote safe, effective, and appropriate use of medicines, including updating medication at transfer of care and investigating and responding to requests for medication not on, or as on, repeat. This workstream is coordinated by the PCN's Pharmacy Hub for Assessment Services (PHASe), integrated within The Ageing Well Team, but practice-based pharmacists will need to liaise with the hub, communicating effectively, to ensure an efficienct and seamless care delivery service. 3. Long-Term Condition Clinics Deliver reviews to patients with single or multiple medical problems where medicine optimisation is required (e.g., respiratory, cardiovascular-reno-metabolic). Review the on-going need for each medicine, monitoring needs and support patients in getting the best use of their medicines (i.e. medicines optimisation). Make appropriate recommendations to Senior Pharmacists or GPs for medicine improvement. Contribute to QOF achievement and IIF targets related to long-term condition management. 4. Patient facing Domiciliary Medication Reviews Deliver medication reviews to patients in care home or domiciliary settings, working within the PCN's Pharmacy Hub for Assessment Services (PHASe), integrated within The Ageing Well Team. For care home patients, medicines reconciliation and medication review is coordinated through the centralised pharmacy hub. The post holder will work within this hub structure, contributing to and drawing on hub-led clinical oversight, supervision, and workflow support, and producing recommendations for the multidisciplinary team on prescribing, deprescribing, and monitoring. In some practices, medication reviews for care home patients may be delivered outside of the central hub, and some reviews for care home or housebound patients may require home visits. 5. Risk stratification Identify cohorts of patients at increased risk of harm from medicines using agreed, preprepared practice clinical system searches, including prescribing and clinical decision support software such as Eclipse Live Radar 500 searches. Risks may be patientrelated, medicinerelated, or a combination of both. Where appropriate, pharmacy technicians will be accountable for reviewing and acting on the outcomes of these searches within their scope of competence, in accordance with agreed protocols. Clinical pharmacists will provide supervision and support where the management of highrisk patients falls outside the pharmacy technicians competence, and will assume responsibility during periods of leave or in exceptional circumstances. 6. Unplanned hospital admissions Review the use of medicines most commonly associated with unplanned hospital admissions and readmissions through audit and individual patient reviews. Implement changes to reduce the prescribing of these medicines to high-risk patient groups. 7. Medicines Reconciliation Reconcile medicines following communications from other health settings (e.g., hospital discharges, clinical letters from secondary care, private healthcare providers etc) including identifying, resolving and appropriately escalating unexplained changes to medicines when required. Work collaboratively with patients, carers and the wider MDT to ensure timely access to medicines and continuity of care including those requiring medicines compliance aids and care home residents. Provide mentorship, supervision, and appropriate delegation of medicines reconciliation activities to pharmacy technicians and junior pharmacists, including foundation pharmacists, in line with their competence and agreed governance arrangements. 8. Medicine Information & Advisory Support Respond to relevant medicine-related enquiries from GPs, other network staff, other healthcare teams (e.g., community pharmacy) and patients with queries about medicines acting as a visible and accessible medicines expert within the PCN. Suggest and recommend evidence-based solutions. Provide appropriate follow-up where changes are made. 9. Signposting Ensure that patients are referred to the appropriate healthcare professional for the appropriate level of care within an appropriate time period e.g., pathology results, common/minor ailments, acute conditions, long-term condition reviews etc. Collaborate with and refer to relevant non-clinicians e.g. social prescribing link workers to connect patients with non-clinical community support where wider determinants of health are contributing to medicines non-adherence or health inequalities. 10. Repeat prescribing 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. Support the practice to reduce prescribing errors and promote safe, efficient repeat prescribing workflows. 11. Service development Contribute pharmaceutical expertise to the development and implementation of new services that have medicinal components (e.g., advice on treatment pathways and patient information leaflets). 12. Information management Analyse, interpret and present medicines data to highlight issues and risks to support decision making. 13. Medicines quality improvement Undertake clinical audits of prescribing in areas directed by the GPs and the PCN team, feedback the results and implement changes in conjunction with the relevant practice team. 14. Medicines safety Implement changes to medicines that result from MHRA alerts, product withdrawal and other local and national guidance. Contribute to the practice's and PCNs patient safety agenda by participating in significant event analysis (SEA), reporting incidents as appropriate, supporting learning from near-misses and medicines errors. Work with the practice team and PCN to embed a culture of medicines safety. 15. Implementation of local and national guidelines and formulary recommendations Monitor practice 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). 16. Education, Mentoring and Clinical Supervision Provide education and training to primary healthcare team on therapeutics and medicines optimisation. Mentor, supervise and delegate, as appropriate, clinical workflow to pharmacy technicians and more junior pharmacists (including foundation pharmacists), to optimise skill-mix and aid team development. 17. Care Quality Commission Work with the general practice teams to ensure the practices are compliant with CQC standards where medicines are involved. 18. Public health Support public health campaigns and provide specialist knowledge on all public health programs available to the general public. 19. Collaborative working arrangements As part of an integrated pharmacy team, foster and maintain collaborative working relationships with practice teams, ICB colleagues including medicines management pharmacy professionals, the Ageing Well Team and social prescribing team, and all other relevant services across the PCN and other stakeholders as needed for the collective benefit the practice and its patients.