Groups of GP
Practices in Waltham Forest have recently come together to form 7 Primary Care
Networks (PCNS) each covering a total population of between 34,000-56,000. The purpose of these PCNs is to enable GP
practices to work together collaboratively to develop and deliver network-based
services that respond to the needs of the local population. Some of the PCNs in
Waltham Forest are seeking to recruit a PCN Clinical Pharmacist to develop and
support medicines optimisation work within general practice.
Clinical
Pharmacists will be part of the clinical staff in general practice managing
self-limiting conditions, long-term conditions and providing health promotion
and preventative care. The role will also improve clinical quality and outcomes
through medicines optimisation.
Clinical
pharmacists have a key role in supporting delivery of the new network contract
Directly Enhanced Service (DES) specifications.
The post holder will be working closely with the Clinical Director,
reviewing and standardising processes within the practices to ensure efficiency
and establish pathways. The Clinical Pharmacist will work within their clinical
competencies as part of a multi-disciplinary team to provide expertise in
clinical medicines management, provide face to face structured medication
reviews, manage long term conditions, management of medicines on transfer of
care and systems for safer prescribing, manage repeat prescription
authorisations and reauthorisation, acute prescription request, while
addressing both the public health and social care needs of patients in the GP
practices that make up the PCN. The post holder will work proactively with
other healthcare professionals as part of a multidisciplinary team across the
PCN.
WF GP FedNet is a not-for-profit Federation of 36 GP Practices in Waltham Forest. We are a private limited company who provides NHS Services based in Primary Care, pooling the skills and resources of local GPs to provide large scale services as part of the local NHS Strategy to bring more services into the Community to help people stay well and at home.
Job description
Job responsibilities
The post holder
will perform face-to-face medication review of patients with polypharmacy
especially for older people, people in
residential care homes and those with multiple comorbidities. The post holder
will provide leadership on quality improvement and clinical audit and well as
managing some aspects of the Quality and outcomes framework.
The post holder
will work as part of a multi-disciplinary team to manage repeat prescription
authorisations and reauthorisation, acute prescription request, management of
medicines on transfer of care and
systems for safer prescribing, providing expertise in clinical medicines
management while addressing both the public health and social care needs of
patients in the GP practices.
This role is
pivotal to improving the quality of care and operational efficiencies so
requires motivation and passion to deliver an excellent service within general
practice.
Core Duties:
Job roles could
include the following, in line with the priorities of each practice you will be
working with:
Patient
facing medicines support
Hold clinics
for patients requiring face-to-face structured medication reviews 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. Provide a telephone
support for patients with questions, queries and concerns about their
medicines.
Medication
review
Undertake
structured medication reviews with patients with multi-morbidity and
polypharmacy and implement own prescribing changes
(as an independent prescriber) and order relevant monitoring tests
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.
Long-term
condition clinics
See patients in
multi-morbidity clinics and in partnership with primary healthcare colleagues
and implement improvements to patient's medicines, including de-prescribing.
Manage own case load, run own long-term condition clinics where responsible for
prescribing as an independent prescriber for conditions where medicines have a
large component (e.g. medicine optimisation for stable angina symptom control,
warfarin monitoring and dose adjustment for patients requiring long-term
anticoagulants). Review the ongoing need for each medicine, a review of
monitoring needs and an opportunity to support patients with their medicines
taking
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 high-risk patient groups.
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; make necessary changes as an
independent prescriber, and ensure patients are booked in for necessary
monitoring tests where required.
Triage
Ensure that
patients are referred to the appropriate clinician for the appropriate level of
care within an appropriate period of time e.g. pathology results, common/minor
ailments, acute conditions, long term conditions.
Medicines
safety and quality improvement
Identify and
provide leadership on areas of prescribing requiring improvement. Conduct own
audits and improvement projects and work with colleagues. Present results and
provide leadership on suggested change. Demonstrate continuous QI activity
focused upon prescribing safety as specified in the QOF guidance. This work for
example might include the PINCER tool. Contribute to national and local
research initiatives.
Care home
medication reviews
Manage own
caseload of care home residents, undertake clinical medication reviews with
patients with multi-morbidity and polypharmacy 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.
Domiciliary
clinical medication review
Manage own
caseload of vulnerable housebound patients at risk of hospital admission and
harm from poor use of medicines. Implement own prescribing changes (as an
independent prescriber) and ordering of monitoring tests. Attend and refer
patients to multidisciplinary case conferences.
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.
Population
and Public Health
To devise and
manage population and public health campaigns to run within the network. To
provide specialist knowledge on immunisation.
Cost saving
programmes
Make
recommendations for, and manage pharmacy technicians to, make changes to
medicines (switches) designed to save on medicine costs where a medicine or
product with lower acquisition cost is now available.
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.
Training
Provide
education and training to primary healthcare team on therapeutics and medicines
optimisation. Provide training to visiting medical, nursing and other
healthcare students where appropriate.
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 manage these
changes without referral to a 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 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.
Implementation
of local and national guidelines and formulary recommendations
Monitor
practice prescribing against the local health economy's RAG list for medicines
that should be prescribed by hospital doctors (red drugs) or subject to shared
care (amber drugs). Liaise directly with hospital colleagues where prescribing
needs to be returned to specialists. Assist practices in setting and
maintaining a practice formulary that is hosted on the practice's computer
system. Suggest and develop computer decision support tools to help remind
prescribers about the agreed formulary choice and local recommendations.
Auditing practice's compliance against NICE technology assessment guidance.
Provide newsletters 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.
Collaborative
working arrangements
Works
collaboratively with their PCN clinical director.
Recognises the
roles of other colleagues within the 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 lead a team
Is able to
recognise personal limitations and refer to more appropriate colleague(s) when
necessary