Clinical Pharmacist (Primary Care)

Job description Job responsibilities The Primary Care Clinical Pharmacist is a clinical practitioner working as part of the multidisciplinary team to optimise medicines use, improve patient outcomes and support safe, evidence-based prescribing across general practice. The role combines direct patient care with medicines optimisation, chronic disease management and collaborative working across primary care.1. Clinical ResponsibilitiesPatient CareLong-term condition clinics Run long-term condition clinics for chronic diseases such as atrial fibrillation, asthma, COPD, chronic kidney disease, diabetes, depression, heart failure, hypertension, HRT and womens health, reviewing patients with single or multiple medical problems where medicines optimisation is required. Make appropriate recommendations to GPs and other members of the practice team to optimise medicines use, and implement changes directly where these fall within the post holder's scope of practice and competence.Clinical medication reviews (including Structured Medication Reviews) Undertake clinical medication reviews with patients, producing recommendations for prescribing and monitoring. Establish the ongoing need for each medicine, review monitoring needs, and support patients with their medicines taking to ensure they get the best use of their medicines. Where indicated, deliver Structured Medication Reviews (SMRs) in line with the national SMR specification, prioritising patients on the PCN's target cohorts (e.g. care home residents, patients with complex polypharmacy, and those on high-risk medicines).Independent prescribing duties (for those who hold independent prescribing qualification only) Undertake independent prescribing consultations face to face, telephone or video for patients with acute and long-term conditions, taking responsibility for clinical decision-making, diagnosis and management within their scope of practice. Initiate, titrate, adjust and stop medicines within their competence, including for chronic disease management within their scope of practice. Order and interpret relevant diagnostic tests to support clinical decision-making. Work within a defined scope of practice, recognising own competency limits, and refer to GPs or specialists where appropriate.Medicines advice and information Undertake clinics for those with questions, queries and concerns about their medicines in the practice, including face to face, telephone and video appointments. Answer relevant medicine-related enquiries from GPs, other practice staff, other healthcare teams (e.g. community pharmacy) and patients with queries about medicines, suggesting and recommending solutions and arranging appropriate follow up to patients to monitor the effect of any changes.Blood Results Management Review and provide advice to patients and clinical staff on abnormal blood results, such as HbA1c, lipids, thyroid function, renal function, and other relevant blood tests, in line with the post holder's scope of practice and competence. Recommend and implement appropriate action or medication changes in response to abnormal results, escalating to GPs or senior clinicians where requiredShared decision making Support patients to make informed decisions about their medicines through shared decision making, respecting patient preferences and values in line with NICE guidance on shared decision making.Care home medication reviews Undertake medication reviews for care home residents in line with the Network Contract DES care home requirements, working closely with care home staff, community pharmacy and, where relevant, the multidisciplinary care home team to manage complex and high-risk polypharmacy.Repeat and acute prescription processing Support implementation and ongoing development of repeat prescribing systems and processes. Manage the repeat prescribing reauthorisation process by reviewing patient requests for repeat prescriptions and reviewing medicines reaching review dates and flagging up those needing a review. Ensure patients have appropriate monitoring tests in place when required. Process acute prescription requests in line with practice protocol. Management of minor and common ailments Where competent to do so, assess and manage patients presenting with minor or self-limiting ailments, signposting or referring appropriately, to help release GP appointment capacity for patients with more complex needs.Digital tools, documentation and safety-netting Use practice clinical systems and associated digital tools (e.g. SystmOne, Ardens, AccuRx) and other approved digital tools to record accurate and timely clinical documentation, ensure appropriate safety-netting and follow-up plans are in place, and triage to identify opportunities for proactive medicines optimisation.Medicines SafetyUnplanned 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.Medicines reconciliation Reconcile medicines following discharge from hospitals, intermediate care and care homes, identifying and rectifying unexplained changes. Work 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 those in care homes).Monitoring of high-risk medicines Undertake and maintain oversight of monitoring for high-risk medicines such as DMARDs, lithium and anticoagulants, ensuring patients have appropriate blood tests and clinical reviews in place at the required intervals, and taking action where monitoring is overdue or results indicate a need for dose adjustment, referral, or discontinuation.Medicines alerts Action MHRA drug alerts, product recalls, and other local and national safety alerts, implementing changes as required.Antimicrobial stewardship Support the practice team in promoting appropriate antimicrobial prescribing in line with local and national antimicrobial guidance, contributing to audit and feedback on antimicrobial stewardship indicators.2. Service Delivery and ImprovementInformation management Analyse, interpret and present medicines data to highlight issues and risks to support decision making.Risk stratification and proactive case-finding Use searches and risk stratification tools to proactively identify patients at risk of medicines-related harm (e.g. those on high-risk drug combinations or missing monitoring), and prioritise outreach and review accordingly.Medicines quality improvement Undertake clinical audits of prescribing in areas directed by GPs, practice managers or ICB. Feedback the results and implement changes in conjunction with the practice team.Implementation of local guidelines and formulary recommendations Analyse practice prescribing against local ICB criteria (e.g. prescribing dashboards, high cost drugs, and specials) and engage with members of the practice team where prescribing patterns do not align with local ICB policies, guidance, and prescribing standards. Support cost-effective and evidence-based prescribing in line with ICB formulary guidance and local prescribing policies. Liaise with hospital colleagues where prescribing needs to be returned to specialists (red drugs) or subject to shared care (amber drugs).QOF medicines-related targets Support the practice team(s) in delivering medicines related QOF targets.ICB Prescribing targets Contribute to the delivery of ICB prescribing-related targets, including the annual Medicines Optimisation Enhanced Service (MOES) scheme. Monitor practice performance against MOES indicators, identifying areas of underachievement and supporting action to address these. Provide regular updates and reporting on progress against MOES and other prescribing targets to the Neighbourhood Pharmacy Lead/Head of Clinical Pharmacy. Work collaboratively with GPs and the wider practice team to embed MOES priorities into routine clinical practice.Care Quality Commission (CQC) Support compliance with CQC standards relating to medicines management, prescribing and governance.Health inequalities and Public health Proactively address medicines-related health inequalities, including access to medicines, adherence support, and prevention activity (e.g. cardiovascular disease prevention, immunisation uptake) targeted at underserved populations Support wider public health campaigns such as vaccinations (e.g. flu, pneumonia, shingles) and smoking cessation.ARRS and DES performance Contribute to the PCN's performance against Additional Roles Reimbursement Scheme (ARRS) requirements and relevant Directed Enhanced Service (DES) indicators, including accurate recording of activity data to support PCN reporting and evidencing of impact.3. LeadershipEducation and Training Provide education and training to the primary healthcare team on medicines and medicines optimisation.Multidisciplinary team working Attend and contribute to practice and PCN multidisciplinary team (MDT) meetings, sharing medicines-related insights and contributing to holistic patient care planning.Supervision of pharmacy technicians and trainees Where appropriate to the post holder's experience and grade, provide clinical supervision and support to pharmacy technicians and trainee pharmacists, contributing to their development within the practice/PCN team.Professional leadershipAct as a professional role model, promoting evidence-based practice and continuous improvement.