Clinical Pharmacist - North Oxfordshire Rural Alliance (NORA) PCN in Banbury

The purpose of this role is to provide a comprehensive Clinical pharmacist service to patients of North Oxfordshire Rural Alliance Primary Care Network (PCN). This role is pivotal to improving quality of care and operational efficiencies so requires motivation and passion to deliver an excellent service within general practice. Please note, the base surgery and employer will be Bloxham and Hook Norton Surgery.

Main duties of the job:

• The post holder is a Pharmacist, who acts within their professional boundaries, and will work as part of a multi-disciplinary team in a patient-facing role. In this role they will be supported by a Senior Clinical Pharmacist (SCP) who will develop and mentor them.
• The post holder will take responsibility for areas of chronic disease management within the Practice(s) and undertake clinical medication reviews to proactively manage patients with complex polypharmacy, especially for older people, people in residential care homes, hospital discharges and those with multiple co-morbidities.
• The post holder will assist the SCP and team to provide clinical leadership on medicines optimisation, quality improvement and manage some aspects of the quality and outcomes framework and enhanced services.
• The post holder will work with the SCP and team to 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.
• The post holder will be supported to develop their role to become an independent prescriber on completion of the CPPE pathway.

About us:

Come and join our incredibly friendly PCN, nestled near to and within the Cotswold countryside in an area of outstanding natural beauty. NORA PCN consists of five rural surgeries. Collectively, we serve a population of approximately 51,000 patients. We have diverse patient population with a high proportion of elderly patients. We have a fantastic PCN Clinical Pharmacy team, one of the largest in Oxfordshire - which includes a Senior Clinical Pharmacist, five Clinical Pharmacists and a PCN Pharmacy technician. The team have monthly group teaching and discussion sessions together, as well as regular social events.

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 patients with queries about medicines. Suggest and recommend solutions. Provide follow up for patients to monitor the effect of any changes.
• Patient facing clinical medication review: Undertake clinical medication reviews with patients with multimorbidity and polypharmacy and implement own prescribing changes (as an independent prescriber) and order relevant monitoring tests.
• Review the ongoing 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).
• Patient facing medicines support: Provide patient facing clinics for those with questions, queries and concerns about their medicines in the practice as appropriate and with 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 medication reviews: Manage own caseload of care home residents. Undertake clinical medication reviews with patients with multimorbidity 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.
• Patient facing domiciliary/home visits: Manage own caseload of vulnerable house-bound 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 when appropriately qualified to do so.
• To work with the SCP and team to develop and manage new services 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 of computer searches to identify cohorts of patients at high risk of harm from medicines across the PCN.
• Assist the SCP with the management of risk stratification tools on behalf of the PCN.
• Work with patients, SCP and CPs across the PCN and primary care teams to minimise risks through medicines optimisation.
• Information management: To assist SCP and CP team to analyse, interpret and present medicines and risks to support decision-making across the PCN. Use of data to highlight issues.
• Medicines Quality Improvement programmes: Work with the SCP and CP team to identify and provide support on areas of prescribing and medicines optimisation, including QOF and QI requirements. Conduct appropriate clinical audits and projects or work with colleagues such as SCP, CPs, GP registrars, and practice managers across the 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 general practice team to ensure the practice is compliant with CQC standards where medicines are involved. Undertake appropriate risk assessments and management and ensure compliance with medicines legislation.
• Implementation of local and national guidelines and formulary recommendations: Assist with monitoring 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 computer system.
• Work with SCP and CP team to suggest and develop computer decision support tools to help remind prescribers about the agreed formulary choice and local recommendations. Assist SCP and CP team with auditing at both practice and PCN level compliance against NICE technology assessment guidance. Provide updates on PCN intranet 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.
• Supervision: Work with SCP to ensure that PCN Pharmacy Technicians and Foundation Trainees receive appropriate supervision, mentoring, appraisal and access to relevant training & development programmes.
• Education and Training: Assist SCP and CP team provide education and training to primary healthcare teams across the PCN on therapeutics and medicines optimisation. 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 health campaigns across the PCN. To assist SCP and CP team with providing specialist knowledge on all public health programmes available to general public across the PCN.
• 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.
• 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.
• 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 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.
• Telephone triage: 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.

Other information: While we are happy to consider flexible working, PCNs need to provide patients with enhanced access and you may therefore on occasion be required to work weekday evenings 18:30 - 20:00.

Person Specification:

• Experience: Has experience and an awareness of common acute and long term conditions that are likely to be seen in general practice. 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. Recognises the roles of other colleagues within the PCN and general practice organisations and their role to patient care. Demonstrates use of appropriate communication to gain the cooperation of relevant stakeholders, including patients, senior and peer colleagues, and other professionals, other NHS/private organisations eg ICBs. Demonstrates ability to work as a member of a team both within the PCN CP team and the general practice team. Is able to recognise personal limitations and refer to more appropriate colleagues when necessary. Actively work toward developing and maintaining effective working relationships both within and outside the PCN, 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 ICB colleagues including ICB Pharmacists on prescribing related matters to ensure consistency of patient care and benefit. Liaises with ICB pharmacists and Heads of Medicines Management / Optimisation to benefit from peer support. Liaises with other GP Practices across the PCN and staff as needed for collective benefit of patients including but not limited to Patients, GP, nurses and other practice staff, other healthcare professionals including ICB pharmacists, pharmacy technicians, optometrists, dentists, health and social care teams and dieticians etc Locality / GP prescribing lead, Locality managers, Community nurses and other allied health professionals, Community and hospital pharmacy teams, Hospital staff with responsibilities for prescribing and medicines optimisation.
• Qualifications: Completion of an undergraduate degree in pharmacy and registration with the General Pharmaceutical Council. Has experience and an awareness of common acute and long term conditions that are likely to be seen in General Practice. Is already enrolled on/agrees to undertake the CPPE pathway for CPs, this is a mandatory part of the terms and conditions of employment with the PCN. May hold or be working towards an independent prescribing qualification.
• Leadership: Is prepared to work with the SCP and CP team to develop the following: Demonstrate understanding of the pharmacy role in governance and is able to implement this appropriately within the workplace; Demonstrate understanding of, and contributes to, the workplace vision; Demonstrate ability to improve quality within limitations of service; Demonstrate ability to motivate self to achieve goals; Promote diversity and equality and leads by example. Review yearly progress and develops clear plans to achieve results within priorities set by others. Engage with Patient Participation Groups (PPGs) and involves PPGs in development of the role and practices.
• Management: Is prepared to work with the SCP and CP team to develop the following: Demonstrate understanding of the implications of national priorities for the team and/or service; Demonstrate understanding of the process for effective resource utilisation; Demonstrate understanding of, and conforms to, relevant standards of practice; Demonstrate ability to identify and resolve risk management issues according to policy/protocol; Follows professional and organisational policies/procedures relating to performance management. Demonstrate ability to extend boundaries of service delivery within the team. Provide support in the development of a pharmacy technicians.
• Education Training and Development: Demonstrate ability to conduct teaching and assessment effectively according to a learning plan with supervision from more experienced colleague. Demonstrates self-development through continuous professional development activity; working alongside senior clinical pharmacist to identifying areas to develop. Participate in the delivery of formal education programmes. Demonstrate an understanding of current educational policies relevant to working areas of practice and keeps up to date with relevant clinical practice. Ensure appropriate clinical supervision is in place to support development. Enrolled into review and appraisal systems within the practice. Demonstrate understanding of the mentorship process.
• Disclosure and Barring Service Check: This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.