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NHS GRAMPIAN JOB DESCRIPTION 1. JOB IDENTIFICATION Job Ref: RJ4096 Job Title: Practice Pharmacist Department(s): Moray CHSCP Pharmacy Service 2. JOB PURPOSE To deliver a clinical pharmacy service to patients in Moray by providing a major input to the pharmaceutical care of patients and medicines management systems to ensure, safe, effective, economic medicines use. This involves assimilation of clinical information, medicines information and patient information, the writing and reviewing of prescriptions, and the provision of pharmaceutical advice to patients and health care professionals. 3. ORGANISATIONAL POSITION Lead Pharmacist Moray CHSCP Other practice pharmacists Practice pharmacist (this post) Primary Care pharmacy technician GP practice based pharmacy assistants 4. SCOPE AND RANGE Moray CHSCP comprises 14 GP practices, 5 community hospitals, has an annual drug spend of approximately £17million, and provides health services to approximately 87,000 people. This post provides a pharmaceutical service to Ardach Health Centre, Buckie, which has 7 GP partners, a patient list of approximately 10,000, and an annual practice drug spend of approximately £1.8million. 1 5. MAIN DUTIES/RESPONSIBILITIES Provision of pharmaceutical care to individual patients 60% To be responsible for the provision of specialist advice on medicines selection and use, side-effects and potential interactions to medical, nursing and other healthcare professionals attached to the practice. Ensure that clinicians are aware of appropriate therapeutic monitoring required to minimise risk to patients. To review medication of individual patients to ensure medicines are safely and appropriately prescribed, in particular for patients with chronic medical conditions or those on complex medication regimes. Document changes required in patients’ notes or computer records, altering computer drug records as required. Prescribe medication to individual patients if pharmacist prescriber. Monitor outcome at appropriate intervals. As part of medication review, monitor patients’ blood results to ensure appropriate dosage, adverse effects are minimised and other monitoring is being carried out appropriately adequate eg. Blood pressure, peak flow, spirometry and urinalysis. To contribute to decision making in individual patients’ care by discussion of therapy with the prescriber and provision of advice on appropriate selection of medication to ensure that treatments are evidence based. To provide counselling and advice on medicines use to patients and carers (verbal and written) to help patients use their medication to obtain greatest benefit. This is particularly important if they are elderly, confused or distressed, if their medication regime is complex or if they have multiple disease pathologies. Undertake direct patient consultations to optimise management of chronic disease or discuss and resolve specific pharmaceutical care related issues. This can be as part of a pharmacy led clinic in a specific disease area or an individual review of a patient identified by a member of the practice team or the pharmacist themselves. To ensure patients are provided with appropriate advice on health improvement and lifestyle changes as part of disease management and in order to optimise health outcomes. To respond to queries and provide accurate and timely drug information to General Practitioners and other members of the primary health care team, both for individual patients and groups of patients. To improve the patients journey between secondary and primary care by implementing seamless care. This may involve liaison with secondary care ward, GP, community nursing staff, community pharmacists and staff of care homes. Ensure medicines use is safe, appropriate and cost-effective 25% Play a key role in risk management and ensure implementation of local and national guidelines, policies and procedures and provide advice on their relevance to safe and effective medicines use. As part of the clinical team contribute to decision making in the development of practice specific protocols related to prescribing and medicine use. Take the lead in development, management and review of repeat prescribing systems within the practice, ensuring systems are robust, waste is minimised and related standards of the GMS contract are met. Promote the use of the Grampian Joint Formulary (GJF) by all prescribers. Install and maintain electronic versions of the formulary on practice computer system and provide training to prescribers. Through provision of advice and training, ensure compliance with medicines legislation and contractual and statutory requirements of the GMS contract related to the storage, prescribing, dispensing, recording and disposal of drugs including controlled drugs. 2 Monitor compliance through audit. Act as a resource to support members of the practice meet the demands of the quality and outcomes framework by identification of groups of patients for review (through interrogation of computer prescribing systems), and assistance to set up systems for monitoring and review of these patients. Analyse prescribing data and provide feedback on practice prescribing trends and prescribing indicators; providing recommendations for change in prescribing behaviour. To provide information on drug expenditure by practice, e.g. cost of prescribing in different clinical categories, impact on budget and preferred first line taking into account GJF, local policies and guidelines. Training and Audit10% In collaboration with practice colleagues, devise and carry out audit in clinical areas to monitor quality of medication prescribing and use, ensuring recommendations are discussed and actioned. Contribute to training of practice admin staff in areas related to repeat prescribing policies and systems and basic medicines information. Contribute to training of nurses in specific disease areas e.g. drugs used in hypertension, diabetes, requirements for drug monitoring, etc. Tutoring staff in dispensing practices who are working towards a dispensing qualification. Pharmaceutical Services5% Responsible for providing advice on legislation covering the storage of drugs (including controlled drugs) within the practice, monitoring compliance through audit. Responsible for providing advice on stock control procedures and the range of drugs that are appropriate to be held in the practice both for routine and emergency use. 6. SYSTEMS AND EQUIPMENT IT skills relating to use of Microsoft products; for communication, reports, data analysis and presentations. Internet / intranet for searching of on-line databases for highly specialised medicines information and access to local guidelines. GP clinical patient record systems (paper or computerised) – documentation of pharmaceutical care interventions and updating patients’ medication records. Interrogation of GP computer clinical database to identify specific patient groups. Installation and maintenance of the electronic Grampian Joint Formulary for EMIS. Interrogation and manipulation of data from the Prescribing Information System for Scotland (PRISMS) to provide feedback on prescribing patterns to the practice. 7. DECISIONS AND JUDGEMENTS The post-holder is an independent professional who is responsible for their own professional and clinical decisions. All pharmacists must work within the Code of Ethics and Standards laid down by the General Pharmaceutical Council. Work at practice level is unsupervised using professional discretion The pharmacist has a high degree of autonomy and independent working regarding prescribing advice and decisions regarding individual patients and is accountable for 3 recommendations made and information provided. The pharmacist must be alert to the needs of individual patients, groups of patients and must identify actual and potential medication problems and lead to their resolution. Using prescribing data and performance against indicators to influence future prescribing, improve patient outcomes and promote cost-effective patient care. Pharmaceutical care with a focus at an individual patient level, responding to patient’s comorbidity to advise on safety and efficacy of medicines The pharmacist must be aware of the activities of the pharmaceutical industry at practice, hospital and national level and advise colleagues on an appropriate course of action. Interpretation of local and national guidelines is required to provide advice on their implementation and adaptation at local level. The pharmacist will have to explain the evidence base for medicine information provided and justify viewpoints offered where opinion differs or there is a lack of published evidence. The pharmacist will have to respond to urgent needs and be responsible for advice offered and action taken as a result e.g. CSM guidance, drug alerts and actions from critical incidents. 8. COMMUNICATIONS AND RELATIONSHIPS Pharmacy Profession Working as part of the integrated NHS Grampian Pharmacy Service, communicating and liasing with Pharmacy Managers and other colleagues to deliver the Pharmacy strategy Communication with Community Pharmacists regarding patient specific pharmaceutical care issues to improve patient outcomes Other Healthcare Professionals Communicate with allied health professionals with regards to individual patient care. Practice based training of nurses, GPs and other health care professionals on medicines and pharmaceutical issues to ensure evidence based practice and compliance with local, national and legal requirements Patients and Carers Provide advice on medicines related issues in a professional and empathetic manner to promote the safe and effective use of their medicines taking into account any possible barriers to understanding. Pharmacy Students Participation in undergraduate pharmacy students training to develop the pharmacy profession. 9. PHYSICAL DEMANDS OF THE JOB Skill, accuracy and prolonged periods of intense concentration are vital when reviewing medication, analysing prescribing data, compiling reports and interpreting clinical papers / guidelines. Light physical effort only required, but there may be a need multi-site working (driving between different locations), hot-desking and prolonged periods of computer use. Dealing with patients with a wide range of medical conditions including palliative care e.g. cancer which will involve dealing with emotionally distressed patients and relatives Responding to urgent requests for advice relating to a wide range of subjects on a adhoc basis 4 Driving Use of patient monitoring equipment. 10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB Necessity to communicate with, negotiate and influence many different professionals, including general practitioners, nursing staff, allied health professionals and social work staff to facilitate optimal care for the Patient with the Primary Care environment Managing own time despite increasing demands for pharmacist’s skills. Developing and delivering pharmaceutical care and economic medicines management for optimal patient outcome, particularly for patients with multiple pathologies/complex medicine regimens. Communicating with patients who may be confused, aggressive or emotional and responding to their anxieties about their health and medication can be stressful. 11. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB Clinical & Professional Skills Professional qualification at Master Degree level or equivalent Registered with General Pharmaceutical Council Member of Royal Pharmaceutical Society of Great Britain Extensive clinical pharmaceutical knowledge, preferably with postgraduate diploma Preferably Pharmacist prescriber, or willingness to undertake training Minimum 4 years relevant post registration experience. Experience / understanding of community and hospital pharmacy Knowledge of policies, practices and procedures within NHS Grampian Commitment to personal CPD Interpersonal Skills Communication skills Analytical skills Motivational skills Negotiating and influencing skills Miscellaneous skills IT skills (see section 6, systems and equipment) Current full driving licence 5 12. JOB DESCRIPTION AGREEMENT This page will be removed before submission to the Matching Panel. All Job Holder(s) Signature: Date: Head of Department Signature: Date: 6 NHS Grampian PERSON SPECIFICATION Job Title: PRACTICE PHARMACIST/ CHANGE FUND PHARMACIST AfC 8a Department: MORAY CHSCP PHARMACY SERVICE Factor Essential Desirable 1. Degree in Pharmacy GPhC registration Membership RPharmS ATTAINMENTS: eg education, qualifications, or training Evidence of postgraduate studies, eg Diploma. Pharmacist Prescriber 2. KNOWLEDGE: eg procedures, techniques, legislation, new technology Pharmacy Law and Ethics 3. WORK EXPERIENCE: eg level, knowledge acquired as a result of training/education responsibilities Practising pharmacist SKILLS: eg secretarial, manual, mechanical, computer, supervisory, management, specialised Clinical pharmacy skills DISPOSITION: eg decisiveness, stress tolerance, initiative, judgement, persistence, dependability Ability to work under pressure 4. 5. 6. INTERESTS: eg intellectual, physical, social, artistic 7. OTHER: eg health, appearance, manner, car driver, special demands of post, eg to work unsocial hours on-call/areas covered Previous practice pharmacy experience. Experience of community pharmacy. Knowledge of use of medication in care of the elderly Computer skills Ability to work with other health care professionals Self motivated Adaptable Dependable Good general health Pleasant manner when dealing with people Smart appearance Car driver 7 Knowledge of practice computer systems