Clinical Pharmacist

About Clinical Pharmacists

It is important to understand that clinical pharmacists in primary care currently could be working at different stages of their professional development and hence may have very different role and responsibilities within their work places.

As the role of clinical pharmacists develops so as the responbilities they undertake e.g. advanced Clinical Pharmacist takes the lead, in their clinical area of expertise, for the delivery, co-ordination, expertise and clinical skills needed to provide care to people who would previously have required hospital-based treatment. Thus far, the role and responsibilities below gives the general sense of capabilities of pharmacist within primary care.

Clinical pharmacists plays a leading role in progressing medicines safety and optimisation across a mature PCN. They ensure that appropriate processes and procedures are in place to reduce risks of medicines harm and work with other healthcare professionals and patients to ensure that their medicines are right for them. They are involved in quality improvement initiatives targeted at their local populations, supporting the delivery of the QOF.

Clinical Pharmacist Job Description

A pharmacist, who acts within their professional boundaries, supporting and working alongside a team of pharmacists in general practice. In this role you will be supported by a senior clinical pharmacist who will develop, manage and mentor them.

Working as part of a multi-disciplinary team, this position is a patient-facing role. The Clinical Pharmacist will take responsibility for areas of chronic disease management within the practice and undertake clinical medication reviews to proactively manage patients with complex polypharmacy.

Providing primary support to general practice staff with regards to prescription and medication queries. Clinical Pharmacists will help support the repeat prescription system, deal with acute prescription requests, and medicines reconciliation on transfer of care and systems for safer prescribing, providing expertise in clinical medicines advice while addressing both public and social care needs of patient in the GP practice (s).

The Clinical Pharmacist will provide clinical leadership on medicines optimisation and quality improvement and manage some aspects of the quality and outcomes framework and enhanced services.

The Clinical Pharmacist will ensure that the practice integrates with community and hospital pharmacy to help utilise skill mix, improve patient outcomes, ensure better access to healthcare and help manage workload. The role is pivotal to improving the quality of care and operational efficiencies so requires motivation and passion to deliver excellent service within general practice.

Primary Duties and Areas of Responsibility

• Long-term condition Clinics – See patients with single or multiple medical problems where medicine optimisation is required. 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.
• Clinical Medication Review – Undertake clinical medication reviews with patients and produce recommendations for senior clinical pharmacist, nurses and/or GP on prescribing and monitoring.
• 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.
• 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 – Managing caseload of patients with common/minor/self-limiting ailments while working within a scope of practice and limits of competence. Signposting to community pharmacy and referring to GPs or other healthcare professionals where appropriate
• Medicines support – 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.
• Medicine information to practice staff and patients – Answers relevant 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
• 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 – To 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 (e.g. those with medicine compliance aids or those in care homes).
• Signposting – 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 results, common/minor ailments, acute conditions, long term condition reviews etc.
• 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 – Identification of 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 (e.g. advice on treatment pathways and patient information leaflets).
• 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 GPs, feedback the results and implement changes in conjunction with the practice team.
• 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 – To support public health campaigns. To provide specialist knowledge on all public health programmes available to the general public.

Knowledge, Skills and Experience Required

• Completion of an undergraduate degree in pharmacy and registration with the General Pharmaceutical Council
  Minimum of 2 years’ experience as a pharmacist, demonstrated within a practice portfolio.
• Have experience and an awareness of common acute and long-term conditions that are likely to be seen in general practice
• May hold or be working towards an independent prescribing qualification.
  Recognises priorities when problem-solving and identifies deviations from normal pattern and is able to refer to seniors or GPs when appropriate
• Able to follow legal, ethical, professional and organisational policies/procedures and codes of conduct Involves patients in decisions about prescribed medicines and supporting adherence as per NICE guidelines.

Opportunities to develop within the role

There are a number of opportunities to working in general practice. Some of these include:

• Working as part of a multidisciplinary team
• Undertaking a patient facing role and building a rapport with patients
• Training and development including advanced clinical skills and independent prescribing