Clinical Pharmacist - HTN/CVD Clinic Role in Sutton Coldfield

Clinical Pharmacist - HTN/CVD Clinic Role

Primary care networks (PCNs)form a key building block of the NHS long-term plan.Bringing general practices together to work at scale has been a policy priorityfor some years for a range of reasons, including improving the ability ofpractices to recruit and retain staff; to manage financial and estatespressures; to provide a wider range of services to patients and to more easilyintegrate with the wider health and care system.

While GP practices have beenfinding different ways of working together over many years for example insuper-partnerships, federations, clusters and networks the NHS long-term planand the new five-year frameworkfor the GP contract, published in January2019, put a more formal structure around this way of working, but withoutcreating new statutory bodies.

Since 1 July 2019, all excepta handful of GP practices in England have come together in around 1,300geographical networks covering populations of approximately 3050,000 patients.This size is consistent with the size of primary care homes, which exist inmany places in the country, but much smaller than most GP federations. Around50 networks, usually in very rural areas, will cover a population of less than30,000, but most arebigger than 50,000.

Main duties of the job

The post holder will be responsible for supporting the Carshalton PCN to provide expert medicine management and optimisation, vaccinating and drawing up vaccines, whilst working within their area of clinical competence and as part of a multi-disciplinary team. They will be supported by a Senior Clinical Pharmacist and others who will develop, manage and mentor them. The role will be patient-facing and pharmacists will be involved in structured medication reviews, including poly-pharmacy reviews, managing chronic long term conditions and managing medications after transfer of care. They will also have access to appropriate clinical supervision.

The post holder will provide support and deliver patient services as determined by the Network Policy as well as local and national guidance. They will also provide leadership on quality improvement and clinical audit, manage some aspects of the Quality and Outcomes Framework and maximise cost-effective prescribing to improve the quality of patient care.

About us

Suttonhas a population of approximately 200000 residents registered to 21 practicesand there are currently 4 Primary Care Networks; CASS, Carshalton, Wallingtonand Central Sutton. Each serving a population of approximately 50000patients. Our Sutton PCNs areforward-looking, friendly and focused on providing a wide range of excellenthealthcare services to patients in Sutton and the surrounding area. Our PCNs between them are led 8 PCN ClinicalDirectors. The PCNs work together as they see the benefits of working togetherin a larger GP partnership and are delighted to be realising some of thosebenefits now. Because of our scale, not only are we more resilient andefficient but we are able to invest in continuous quality improvement, enhancedcare, new services and training and developing our workforce. We value thediversity of our colleagues and actively champion an inclusive culture and arecommitted to helping our colleagues achieve a work/life balance.

Carshalton PCN is looking to employ a ClinicalPharmacist for HTN/CVD Clinic project under the additional roles reimbursementscheme. They will be accountable to the ClinicalDirectors in Carshalton PCN and working closely with and supporting the GPPractices within the PCN.

Job responsibilities

HTN/CVD clinics

• Identify hypertension patients for review using Ardens searches
• Liaise with practice staff to check patients have up to date blood tests, uACR, weight, BP before review
• Admin team to book patients into CVD clinic, 20 minute slot per patient

Clinical pharmacist reviews medications in line with SWL and NICE guidance

In clinic, target optimisation of blood pressure and cholesterol

Arrange HBP/ABPM as needed

Discuss/liaise about patients with named clinical supervisor in practice

Book follow up appointments for hypertension patients as needed, for medication optimisation

Refer to Social Prescriber, Health & Wellbeing Coach, Mental Health Practitioner if needed

Liaise with practice secretaries if A&G from secondary care needed

• Review the ongoing need for each medicine, a review of monitoring needs and an opportunity to support patients with their medicines taking.

Clinical Medication Review

Undertake clinical medication reviews with patients (either patient facing or over the telephone).

Reduce inappropriate poly-pharmacy and wasteful prescribing.

Make appropriate recommendations on prescribing and monitoring of medications.

Management of medicines post hospital discharge

Reconcile medications following hospital discharge and outpatient clinics.

Identify any discrepancies and unexplained medication changes and work with the patients and community pharmacists to ensure patients receive the medications they need post discharge.

Ensure continuity of medicines supply to high-risk groups of patients is maintained (e.g. those with compliance aids or those in care homes).

Use pre-prepared emis searches to identify cohorts of patients who are on high risk medications (e.g. immunosuppressants, anticonvulsants etc).

Recall patients who are overdue their routine monitoring tests and inform them to have these tests done as soon as possible.

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.

Implement drug withdrawals and alerts

Liaise with the GP surgeries to implement MHRA drug withdrawals and medication alerts to improve medicines safety.

Implement local and national guidelines and formulary recommendations

Monitor practice prescribing against local, national and formulary guidelines and make recommendations to GPs for medicines that should be prescribed only by the hospital or subject to shared care agreements.

Work with GPs and patients to implement NICE and other evidence based guidelines to improve the quality, safety and cost effectiveness of prescribing.

Medicine information to practice staff and patients

Answer relevant medicine-related queries from GPs, other network staff, healthcare teams (e.g. Community pharmacy) and patients.

Suggest and recommend solutions and/or possible alternatives e.g. around out of stock medications.

Signposting

Ensure patients are referred to the appropriate healthcare professional if you are not the correct person to deal with their query/condition.

Undertake clinical audits of prescribing in areas directed by the GPs, feedback the results and implement changes in conjunction with the relevant practice team.

Education and Training

Provide education and training to the broader primary healthcare team on medicines optimisation.

Care Quality Commission

Work with the general practice teams to ensure the practices are compliant with CQC standards where medicines are involved.

Public Health

Support public health campaigns and provide specialist knowledge on all public health programmes available to the general public.

Other Responsibilities:

Participate in PCN MDT where appropriate.

Liaise with CCG colleagues including CCG pharmacists on prescribing related matters to ensure consistency of patient care and to benefit from peer support.

Maintain strong links with all services across the PCN and neighbouring networks.

Explore the potential for collaborative working and take opportunities to initiate and sustain such relationships.

Liaise with other stakeholders as needed for the collective benefit of patients, including but not limited to;

Patients and their representatives

GP, nurses and other practice staff

Social prescribers, first contact physiotherapists, physicians associates and paramedics.

Community pharmacists and support staff

Other members of the medicines management (MM) team including pharmacists, Pharmacy Technicians and Dietitians

GP prescribing leads

PCN Clinical Directors and other PCN staff

Practice managers

Community nurses and other allied health professionals

Hospital staff with responsibilities for prescribing and medicines optimisation

Responsibility for administration

Provide regular support and feedback to practices on prescribing action plans

Update and maintain accurate patient medication records on the practices clinical computer systems, including advice given and action taken.

Advise the primary health care team on the safe and secure handling of controlled drugs and other medicines, ensuring compliance with medicines legislation.

Support practices to update and implement their prescribing policies eg. repeat prescribing, safe prescribing, polypharmacy, over the counter medications, etc.

This role may evolve to include

• Managing a caseload of patients with common, minor or self-limiting conditions
• Signposting to community pharmacy and referring GPs to other healthcare professionals
• Working on additional pharmacist projects as the PCN scheme matures eg. anticoagulation services, diabetes management in the community

National Service Specifications

To assist PCNs in meeting these and any that are added at a later date

• Structured medication review and optimisation
• Enhanced health in care homes and implementation of the Vanguard model
• Anticipatory care for high need patients typically experiencing long term conditions, joined up with community services
• Supporting early cancer diagnosis
• Personalised care, implementation of the NHS comprehensive model
• Tackling neighbourhood inequalities

Person Specification

Experience

• Minimum 2 years post qualification experience in a hospital, community or general practice setting.
• Knowledge of the breadth of common acute and long term conditions that are likely to be seen in general practice
• Experience of collaborative working and of building relationships across a variety of organisations
• Able to undertake medication or medicine use reviews, and offer patient counselling
• Experience of facilitating change to improve clinical practice
• Experience in undertaking clinical audit
• Working knowledge of IT NHS.
• Experience of IT applications in primary care including Emis

Qualifications

• You MUST have completed the 18 month national pathway or equivalent
• Be a pharmacist Independent Prescriber (prescriber in Hypertension and lipid management)
• Full UK driving license as travel will be required to surgeries, care homes, and patients in the PCN area.
• Meet the GPhC CPD requirements for registration on an annual basis
• Proven post graduate experience as a clinical pharmacist
• Membership with the Royal Pharmaceutical Society of Great Britain
• Training in safe guarding vulnerable adults and children

Criminal Background Check

• Meet DBS reference standards and has a clear criminal record (not subject to the Rehabilitation of Offenders Act 1974)
• The post holder will participate in any training programme implemented by the practice as part of this employment, with such training to include but not limited to:
• Participation in an annual individual performance review, including taking responsibility for maintaining a record of own personal and/or professional development
• Taking responsibility for own development, learning and performance and demonstrating skills and activities to others who are undertaking similar work
• Adhere to organisational policies and procedures, including all necessary mandatory training

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.

£49,000 to £52,000 a yearDepending on experience