PCN Clinical Pharmacist
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FedBucks is a federation of 45 GP practices covering a population of over 485,000 patients across Buckinghamshire. We began in 2016 and now employ around 200 members of staff across our head office sites, and our planned and unplanned care services.
As a GP Federation, we are proud to represent our member practices and to champion primary care by working with local general practice and system partners in the provision of community-based healthcare services. We are dedicated to providing safe and compassionate care to our patients across our range of planned and unplanned healthcare services in Buckinghamshire and believe in continuous commitment to quality service delivery and positive patient outcomes.
Patients are at the heart of everything we do, and we pride ourselves in ensuring our patients feel safe, supported, communicated with and respected, at a time when they may be feeling vulnerable. Our vision is to provide high quality, seamless health care that enables people to lead healthier lives, whilst feeling supported and cared for.
Aylesbury Central Primary Care Network (PCN) is a collaboration of two practices in central Aylesbury, Whitehill Surgery and Berrycroft Community Health Centre, collectively we care for a patient population of 41,000. The successful applicant will be working with a team of clinical pharmacists and become part of a fast-moving PCN looking for innovative ways to meet our patient needs.
- Clinical pharmacists will 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.
- They will be prescribers, or will be completing training to become prescribers, and will work with and alongside the general practice team. They will take responsibility for the care management of patients with chronic disease 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).
- They will provide specialist expertise in the use of medicines whilst helping to address both the public health and social care needs of patients in the PCNs practices and to help tackling inequalities.
- Clinical Pharmacists will provide leadership on person centred medicines optimisation (including ensuring prescribers in the practices conserve antibiotics in line with antimicrobial stewardship guidance) and quality improvement, whilst contributing to the quality and outcomes framework and enhanced services. Through structured medication reviews, clinical pharmacists will support patients to take their medicines and to get the best from them, reduce waste and promote self-care.
- Clinical pharmacists will have a leadership role in supporting further integration of general practices with the wider healthcare teams (including community and hospital pharmacy) to help improve patient outcomes, ensure better access to healthcare and to help manage general practice workload. The role has the potential to significantly improve quality of care and safety for patients.
- They will develop relationships and work closely with other pharmacy professionals across Primary Care Networks and the wider health and social care system
- Clinical pharmacists will 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.
- All clinical pharmacists will be part of a professional clinical network and will have access to appropriate clinical supervision as outlined in the Network Contract DES guidance. As the number of clinical pharmacists working in PCNs increases, this should be on a ratio of one senior clinical pharmacist to five junior clinical pharmacists, and in all cases appropriate peer support and supervision must be in place.
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.
Patient facing care home medication reviews: Undertake clinical medication reviews with patients and produce recommendations for the senior clinical pharmacist, nurses or GPs on prescribing and monitoring. Work with care home staff to improve safety of medicines ordering and administration.
Patient facing domiciliary clinical medication review: Undertake clinical medication reviews with patients and produce recommendations for the senior clinical pharmacists, nurses and GPs on prescribing and monitoring. Attend and refer patients to multidisciplinary case conferences.
Management of common/minor/self-limiting ailments: Manage caseload of patients with common/minor/self-limiting ailments while working within a scope of practice and limits of competence. Signpost to community pharmacy and refer to GPs or other healthcare professionals where appropriate.
Patient facing medicines support: Provide patient facing clinics for those with medicines queries.
Telephone medicines support: Provide a telephone help line for patients with questions, queries and concerns about their medicines.
Medicine information to practice staff and patients: Answer relevant medicine-related enquiries from GPs, other practice staff, other healthcare teams (e.g. community pharmacy) and patients with queries about medicines. Suggest and recommend solutions. Provide follow up for patients to monitor the effect of any changes.
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 high‐risk patient groups
Management of medicines at discharge from hospital: 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 patients are referred to the appropriate healthcare professional for the appropriate level of care within an appropriate period of time.
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.
Risk stratification: Identify 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.
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 Accountable Clinical Director (ACD) for the network, feedback results and implement changes in conjunction with the ACD.
Medicines safety: Implement changes to medicines that result from MHRA alerts, product withdrawal and other local and national guidance.
Implementation of local and national guidelines and formulary recommendations: Monitor practice prescribing against the local health economy’s 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 practices in seeing and maintaining a practice formulary that is hosted on the practice’s computer system. Auditing practice’s compliance against NICE technology assessment guidance. Provide newsletters or bulletins on important prescribing messages.
Education and Training: Provide education and training to primary healthcare team on therapeutics and medicines optimisation.
Care Quality Commission: Work with the general practice team to ensure the practice is compliant with CQC standards where medicines are involved.
Public health: Support public health campaigns. Provide specialist knowledge.
Education / Qualification / Experience
- Masters Degree in Pharmacy (MPharm) or equivalent
- Registered with GPhC
- Member of RPS
- Specialist knowledge through a Postgraduate Diploma and qualifications (eg clinical, community, therapeutics) or equivalent
- Evidence of recent and relevant Continuing Professional Development
- Independent prescriber status or a commitment to undertake the course
- At least 2 years post registration experience in a hospital, community or general practice setting
- Experience of undertaking medication or medicine use reviews, and patient counselling
- Experience of working with clinicians and multidisciplinary/multiagency work
- Experience of facilitating change to improve clinical practice
- Experience of delivering training sessions to varied groups
- Experience in undertaking clinical audit
Skills & Knowledge
- Capacity to be innovative and develop the role of a practice pharmacist
- Effective interpersonal, communication (both written and oral) presentation and influencing skills
- Ability to work with a range of clinical and non-clinical personnel as part of a team
- Ability to communicate medicines and service-related information to decision makers at all levels and have advice challenged
- Ability to work independently and effectively with a high degree of motivation for long periods
- Ability to prioritise and work to deadlines, often with frequent interruptions and urgent requests
- Ability to motivate people and facilitate change
- Ability to define, collate, analyse and interpret data
- Able to utilise databases and information technology, including word processing, spreadsheets and presentation packages effectively
- Ability to communicate information to patients and carers in an appropriate manner, using well developed empathy skills
- Ability to deal with occasionally distressing or emotional circumstances, including contact with terminally ill patients and their carers or relatives
- Accepts responsibility for own work with freedom to take action based on own interpretation of broad clinical/professional policies
- Professional approach to work demonstrating excellent interactive patient skills. Guided by professional code, accountable and responsible for own professional actions
- Ability to gain the confidence and credibility of a range of professionals
- Able to work under pressure and prioritise tasks to ensure urgent work is completed on time
- Able to engage rapidly with existing stakeholder and networks
- Builds credibility (personal and organisational) and rapport quickly
- Able to communicate effectively and engage with individuals from other agencies, including patients and the public
- Ability to travel between sites in a timely manner if required