Clinical Pharmacist - North Oxfordshire Rural Alliance (NORA) PCN

Clinical Pharmacist - North Oxfordshire Rural Alliance (NORA) PCN The purpose of this role is to provide a comprehensiveClinical pharmacist service to patients of North Oxfordshire Rural AlliancePrimary Care Network (PCN).

This role is pivotal to improving quality of care andoperational efficiencies so requires motivation and passion to deliver anexcellent service within general practice.

Please note, the initial base surgery and employer will beeither Chipping Norton Health Centre or Deddington Health Centre.

Main duties of the job The post holder is a pharmacist who acts within theirprofessional boundaries and will work as part of a multi-disciplinary team in apatient-facing role. In this role, they will be supported by a senior clinicalpharmacist who will develop and mentor them.

The post holder will take responsibility for areas ofchronic disease management within the Practice(s) and undertake clinicalmedication reviews to proactively manage patients with complex polypharmacy,especially for older people, people in residential care homes, hospitaldischarges, and those with multiple co-morbidities.

The post holder will assist the Senior Clinical Pharmacist(SCP) and team to provide clinical leadership on medicines optimisation andquality improvement, and manage some aspects of the quality and outcomesframework and enhanced services.

The post holder will work with the SCP and team to ensurethat the practice integrates with the community and hospital pharmacy to helputilise skill mix, improve patient outcomes, ensure better access to healthcare,and help manage workload. The role is pivotal to improving the quality of careand operational efficiencies, so it requires motivation and passion to deliverexcellent service within general practice.

The post holder will be supported to develop their role tobecome an independent prescriber on completion of the CPPE pathway.

About us Come and join our incrediblyfriendly PCN, nestled near to and within the Cotswold countryside in an area ofoutstanding natural beauty. NORA PCN consists of five rural surgeries.Collectively, we serve a population of approximately 51,000 patients. We havediverse patient population with a high proportion of elderly patients.

We have a fantastic PCN ClinicalPharmacy team one of the largest in Oxfordshire - which includes a SeniorClinical Pharmacist, seven Clinical Pharmacists and a PCN Pharmacy technician.The team have monthly group teaching and discussion sessions together andregular social events too.

Job responsibilities Medicine information to PCN, practice staff and patients

Answer medicine related enquiries from PCN, GPs &practice staff, other healthcare teams (e.g. community pharmacy) and patientswith queries about medicines. Suggest and recommend solutions. Provide followup for patients to monitor the effect of any changes.

Patient facing clinical medication review

Undertake clinical medication reviews with patients withmultimorbidity and polypharmacy and implement own prescribing changes (as anindependent prescriber) and order relevant monitoring tests.

Review the on-going need for each medicine, a review ofmonitoring needs and an opportunity to support patients with their medicinestaking ensuring they get the best use of their medicines (i.e. medicinesoptimisation).

Patient facing medicines support

Provide patient facing clinics for those with questions,queries and concerns about their medicines in the practice as appropriate andwith safety in mind during the pandemic.

Telephone medicines support

Provide a telephone help line for patients with questions,queries and concerns about their medicines.

Patient facing care home/residential clinical medicationreviews

Manage own caseload of care home residents. Undertakeclinical medication reviews with patients with multimorbidity and polypharmacyand implement own prescribing changes (as an independent prescriber) and orderrelevant monitoring tests.

Work with care home staff to improve safety of medicinesordering and administration.

Patient facing domiciliary/home visits

Manage own caseload of vulnerable housebound patients atrisk of hospital admission and harm from poor use of medicines.

Implement own prescribing changes (as an independentprescriber) and ordering of monitoring tests when appropriately qualified to doso.

Attend and refer patients to multidisciplinary caseconferences. Identifying key areas of need for vulnerable patients andformulating care plans.

To work with the SCP and team to develop and manage newservices across the PCN 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).

Assist with design, development and implementation ofcomputer searches to identify cohorts of patients at high risk of harm frommedicines across the PCN.

Assist the SCP with the management of risk stratificationtools on behalf of the PCN.

Work with patients, SCP and CPs across the PCN and primarycare teams to minimise risks through medicines optimisation.

Information management

To assist SCP and CP team to analyse, interpret and presentmedicines and risks to support decision-making across the PCN. Use of data tohighlight issues.

Medicines Quality Improvement programmes

Work with the SCP and CP team to identify and providesupport on areas of prescribing and medicines optimisation, including QOF andQI requirements.

Conduct appropriate clinical audits and projects or workwith colleagues such as SCP, CPs, GP registrars, and practice managers acrossthe PCN etc.

Present results and provide leadership on suggested changes.Assist CP team to contribute to national and local research initiatives.

Care Quality Commission

Assist SCP and CP team provide leadership to the generalpractice team to ensure the practice is compliant with CQC standards wheremedicines are involved.

Undertake appropriate risk assessments and management andensure compliance with medicines legislation.

Implementation of local and national guidelines andformulary recommendations

Assist with monitoring practice prescribing against thelocal health economys RAG list for medicines that should be prescribed byhospital doctors (red drugs) or subject to shared care (amber drugs).

Liaise directly with hospital colleagues where prescribingneeds to be returned to specialists. Assist practices in setting andmaintaining a practice formulary that is hosted on the practices computersystem.

Work with SCP and CP team to suggest and develop computerdecision support tools to help remind prescribers about the agreed formularychoice and local recommendations.

Assist SCP and CP team with auditing at both practice andPCN level compliance against NICE technology assessment guidance. Provideupdates on PCN intranet on important prescribing messages to improveprescribers knowledge and work with the team to develop and implement othertechniques known to influence implementation of evidence such as audit andfeedback.

Supervision

Work with SCP to ensure that PCN Pharmacy Technicians alsoreceive appropriate supervision, mentoring, appraisal process and access torelevant training & development programmes.

Education and Training

Assist SCP and CP team provide education and training toprimary healthcare teams across the PCN on therapeutics and medicinesoptimisation.

Assist with providing training to visiting medical, nursing,pharmacy and other healthcare students where appropriate.

Public health

To assist SCP and CP team with supporting public healthcampaigns across the PCN.

To assist SCP and CP team with providing specialistknowledge on all public health programmes available to general public acrossthe PCN.

Unplanned hospital admissions

Devise and implement practice searches to identify cohortsof patients most likely to be at risk of an unplanned admission andreadmissions from medicines.

Work with case managers, multidisciplinary (health andsocial care) review teams, hospital colleagues and virtual ward teams to managemedicines-related risk for readmission and patient harm.

Put in place changes to reduce the prescribing of thesemedicines 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 rectifyingunexplained changes manage these changes without referral to a GP.

Perform a clinical medication review, produce a postdischarge medicines care plan including dose titration and booking of follow uptests and working with patients and community pharmacists to ensure patientsreceive the medicines they need post discharge and working with patients andcommunity pharmacists to ensure patients receive the medicines they need postdischarge.

Set up and manage systems to ensure continuity of medicinessupply to high- risk groups of patients (e.g. those with medicine complianceaids or those in care homes).

Work in partnership with hospital colleagues (e.g. care ofthe elderly doctors and clinical pharmacists) to proactively manage patients athigh risk of medicine related problems before they are discharged to ensurecontinuity of care.

Telephone triage
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