Clinical Pharmacist

Job description Job responsibilities Working within the practice based team to undertake medication reviews particularly in high risk groups such as:

• Frail elderly
• Poly-pharmacy
• Renal impairment
• Hepatic impairment
• Substance misuse
• Patients on high risk

medicines

• STOPP/START identified

patients

Revolving door Hospital admissions

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 GPs for medicine improvement.

Undertake structured medication reviews with patients and produce recommendations for nurses and/or GPs on prescribing and monitoring. This would be a level 3 clinical medication review looking at the patient’s full clinical condition, blood monitoring, interface care arrangements, social isolation etc. including reducing inappropriate polypharmacy and wasteful prescribing.

Undertake structured medication reviews and produce recommendations for nurses or GPs on prescribing and monitoring. Work with care home staff to improve safety of medicines ordering and administration.