Pharmacist

Advanced Medicines Optimisation & Clinical Medication Review Conduct comprehensive clinical medication reviews for patients with multimorbidity and polypharmacy, including deprescribing and optimisation. Deliver domiciliary medication reviews for vulnerable or housebound patients at risk of medicinesrelated harm. Undertake traditional SMRs, CVD prevention, BP titration, and optimisation of therapy across longterm conditions. Review mental health medicines (e.g., antidepressants), manage crosstapers, side effects, adherence issues, and swallowing difficulties. Provide heart failure and cardiology medication followups, including HFpEF patients not eligible for specialist referral. Manage conditionspecific prescribing and acute presentations during medication reviews, ordering bloods, ECGs, troponins, or urine tests as clinically indicated. Conduct postdischarge medication reviews for highrisk patients, resolving discrepancies and ensuring safe continuation of therapy. Support respiratory management including MART initiation. Lead opioid reduction clinics and reviews of highrisk medicines. Provide reviews for SMIs, rheumatoid conditions, and other specialist cohorts. Complete GPrequested followups (e.g., SSRI/Gabapentinoid initiation reviews). Deliver comprehensive medicines support for care home residents across multiple highdemand homes. Participate in MDT case conferences and contribute to personalised care plans. Management of Common & SelfLimiting Conditions Assess and manage minor ailments within scope of practice, escalating to GPs or other clinicians when required. Provide effective signposting to community pharmacy and wider services. Support urgent clinical triage, including rapid assessment of complex cases (e.g., renal impairment, anticoagulation decisions, DVT pathway coordination) PatientFacing & Remote Medicines Support Run dedicated medicines support clinics for patients with treatment concerns or complex queries. Provide telephonebased medicines advice to improve accessibility and continuity of care. Offer realtime medicines information to GPs, paramedics, nurses, PAs, and community pharmacy teams. Maintain an opendoor policy for urgent medicines queries and clinical decision support. Reducing MedicinesRelated Harm & Preventing Hospital Admissions Develop and implement searches to identify highrisk patients at risk of unplanned admissions. Work with case managers, MDTs, hospital teams, and virtual wards to mitigate medicinesrelated risks. Lead initiatives to reduce prescribing of highrisk medicines in vulnerable groups. Identify missed diagnoses (e.g., diabetes, CKD) through searchbased surveillance. Monitor highrisk prescribing patterns (e.g., SABA overuse, benzodiazepines, NSAIDs in older adults, AF without anticoagulation). Medicines Reconciliation & Transfer of Care Perform medicines reconciliation following hospital discharge, intermediate care transitions, and care home admissions. Resolve discrepancies independently and ensure continuity of supply for highrisk patients, including those using compliance aids. Liaise with secondary care regarding discharge errors, inappropriate recommendations, and complex prescribing queries. Support seamless transfer of care through proactive communication with hospital pharmacy teams. Repeat Prescribing & LongTerm Condition Support Oversee the repeat prescribing process, including reauthorisations, monitoring requirements, and independent prescribing adjustments. Manage outofstock medicines, sourcing alternatives and prescribing clinically appropriate substitutes. Support the prescriptions team with complex cases, overdose risk, overordering, and controlled drug issues. Conduct hypertension reviews, deprescribing, and longterm condition optimisation. Use tools such as RADAR and Eclipse to identify and manage risk. Contribute to QOF, the Prescribing Incentive Scheme, and wider quality improvement programmes. Medicines Safety, Monitoring & Governance Monitor and implement actions relating to MHRA alerts, CAS notices, product withdrawals, and emerging evidence. Deliver drug monitoring in line with SPS, NICE, and licensing requirements (DMARDs, DOACs, lithium, amiodarone, ACE/ARB, aldosterone antagonists, metformin with low eGFR). Maintain regular safety searches (e.g., ciprofloxacin, omacor) and DOAC monitoring via Eclipse. Review prescribing against RAG lists and liaise with specialists regarding sharedcare responsibilities. Send safety notifications and updates to the clinical team. Information Management & Medicines Quality Improvement Analyse, interpret, and present medicines data to support clinical and strategic decisionmaking. Lead medicines optimisation and prescribing quality improvement initiatives. Conduct clinical audits and present findings at prescribing meetings. Contribute to local and national research on medicines use and safety. Support guideline development and implementation. Collaborative Working Relationships Maintain strong liaison with ICB/Medicines Optimisation teams and locality prescribing leads. Work collaboratively with GPs, nurses, paramedics, PAs, pharmacy technicians, and wider MDT colleagues. Build effective relationships with community pharmacy, optometry, dentistry, dietetics, social care, and community nursing teams. Strengthen integration between community and hospital pharmacy teams to support seamless care. Management & Leadership Linemanage pharmacy technicians and support staff. Demonstrate understanding of national priorities and their implications for service delivery. Apply principles of effective resource utilisation and safe workforce deployment. Identify, escalate, and resolve risk management issues. Contribute to service development, extending boundaries of practice and improving patient access. Education, Training & Development Act as a role model for professional and clinical standards. Support colleagues through mentorship and supervision. Deliver teaching and assessment for multidisciplinary learners, including GP registrars. Engage in CPD and work with senior pharmacists to identify development needs. Participate in formal education programmes and maintain awareness of current educational policy. Ensure appropriate clinical supervision is in place for safe practice development. Research & Evaluation Critically evaluate literature and apply evidencebased principles to practice. Identify gaps in evidence requiring further evaluation. Generate and present evidence at practice or locality level.