Senior Practice Based Clinical Pharmacist

• 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 and run 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 medicine taking, ensuring they get the best use of their medicines (i.e. medicines optimisation).
• 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
• 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.
• 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. Identifying key areas of need for vulnerable patients and formulating care plans.
• Managing caseload for 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.
• Manage own caseload for patients and diagnose people with long-term and/or acute/common conditions/ailments while remaining within scope of practice and limits of competence.

• Referring to GP and/or other healthcare professionals where appropriate.
• Provide patient facing clinics for those with questions, queries and concerns about their medicines in the practice
• Provide a telephone help line for patients with questions, queries and concerns about their medicines.
• Provide out of hours/on call/extended services for the practice and the patients. These can include patient facing and telephone consultations

• Signposts to other services and/or healthcare professionals where appropriate, while working within a scope of practice and limits of competency.
• Answers all 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.
• 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.
• 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.
• 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 test results, common/minor ailments, acute conditions, long term condition reviews etc
• 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.
• 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.
• Develop and manage new services that are built around new medicines or NICE guidance, where a new medicine/recommendations allow the development of a new care pathway (e.g. new oral anticoagulants for stroke prevention in atrial fibrillation).
• Analyse, interpret and present medicines data to highlight issues and risks to support decision-making.
• Identify and provide leadership on areas of prescribing and medicines optimisation.

• Conduct clinical audits and improve projects or work with colleagues such as GP registrars, practice managers etc.

• Present results and provide leadership on suggested changes. Contribute to national and local research initiatives.
• Identify national and local policy and guidance that affects patient safety when using medicines, including MHRA alerts, product withdrawals, and emerging evidence from clinical trials.

• Manage the process of implementing changes to medicines and guidance for practitioners.
• Provide leadership to the general practice team to ensure the practice complies with CQC standards where medicines are involved.
• Undertake risk assessment and management and ensure compliance with medicines legislation.
• 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.
• Provide education and training to primary healthcare team on therapeutics and medicines optimisation.
• Provide training to visiting medical, nursing, pharmacy and other healthcare students where appropriate.
• To support public health campaigns. To provide specialist knowledge on all public health programmes available to general public.
• Manage a group of pharmacists and pharmacy technicians within the GP federation. Help to grow the overall pharmacy team alongside the Lead Pharmacist.

·    Recognises the roles of other colleagues within the organisation 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

·         Actively work toward developing and maintaining effective 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' GPS, nurses, and other practice staff.