Emergency Department Specialist Pharmacist, Band 8a (7.5 hours per week)
Now is an exciting time for an experienced clinical pharmacist to join our team as we further develop our clinical pharmacy service to Emergency Medicine. Gloucestershire Royal Hospital has a state-of-the-art Emergency Department following a £17.3 million new build and acute medical admissions across the county have been centralised to Gloucestershire Royal as part of our programme to establish a centre of excellence for delivering emergency care.

We are looking for an experienced and enthusiastic patient-orientated clinical pharmacist who embraces the challenge of working in busy environments as part of a multi-disciplinary team, is keen to further develop their clinical skills and focused on delivering high quality pharmaceutical care that has a valuable impact on patients. Our Emergency Department Pharmacy team are currently participating in the National Quality Improvement collaborative for the Safer Use of Time Critical Medicines, as we look to continuously improve our service.

With this post, you will join a supportive and friendly pharmacy team, and be provided with numerous opportunities for personal and professional development.

For further details or to arrange an informal visit, please contact David Richards (david.richards@nhs.net) Clinical Pharmacist Lead for Medicine. Tel: 0300 422 6841.

Main duties of the job

• The post-holder will be responsible for the development of the clinical pharmacy service to the Emergency Department (ED).
• Working within the ED team, they will provide expert pharmaceutical advice for the management of patients, deliver high quality pharmaceutical care, improve patient safety and patient flow.
• The post-holder will be an independent prescriber with health assessment skills (or working towards these qualifications), responsible for undertaking medicines reconciliation and medicines optimisation within the ED by utilising their prescribing qualification to review and prescribe patients' regular medication.
• They will also independently prescribe medication in order to facilitate discharges directly from the ED.
• To ensure safe prescribing within the ED, the post holder will be expected to produce and maintain policies and guidelines.
• They will monitor drug expenditure within the ED, promoting cost-effective prescribing, reducing medicines wastage and use pharmaceutical expertise to identify opportunities for cost minimisation.
• Deliver medicines reconciliation and medicines optimisation within the ED using independent prescribing qualification.
• Facilitate discharge from the ED, utilising independent prescribing qualification.
• They will act as the central point of contact between the Pharmacy Department and the ED.
• Participation in pharmacy department late night, weekend and bank holiday rotas will be required.

About us
With a team of over 9,000 employees, we are proud to be the largest employer in Gloucestershire and rank among the top 10 largest Trusts in the South West region. By joining our Trust, you will benefit from an excellent package that includes exclusive benefits, flexible working opportunities and the chance to gain valuable experience in one of our innovative hospitals. Both hospitals are located in the city centres with access to shops and cafes.

The pharmacy department has approximately 240 staff. The 2 sites provide dispensary services to inpatients & outpatients, medicines information, procurement services and full clinical service to wards; the onsite aseptic and manufacturing services are centralised at CGH.

Pharmacy is at the forefront of many exciting projects including an award-winning service provided by pharmacist prescribers in orthopaedic pre-admission clinic.

We are a friendly, inclusive department who wish to nurture and develop our staff at all grades, from a mentoring programme for band 6 pharmacists to the development of pharmacist prescribers.

Within the Pharmacy department at Gloucestershire Hospitals NHSFT, we are committed to supporting the South West Inclusive Pharmacy Practice manifesto (Apply through our website).

Job description
Job responsibilities
Provision of Clinical Pharmacy Service to the ED

• To lead the clinical pharmacy service for patients admitted to the ED to ensure safe, clinically effective and cost-efficient use of medicines in these patients
• To be responsible for implementing changes to clinical pharmacy practice and reducing variation in prescribing practice in the ED
• To reduce the time taken for medicines reconciliation to take place for patients admitted to in-patient wards within the hospital from the ED by using independent prescribing qualification to document, review and prescribe patients regular medication on Sunrise EPR whilst in the ED
• To utilise independent prescribing qualification to facilitate discharge of patients directly from the ED who require prescribed medication
• To develop the role of pharmacist non-medical prescriber within the ED

Obtain key pharmaceutical information on newly admitted patients. Information collected on a daily basis including:

• Collecting, interpreting and documenting details of medication taken at home (the medication history)
• Confirming details of the medication history with the patient, carer(s), GP Surgery, the GP (occasionally), SCR, and by reviewing the patients own drugs from home if available, working alongside the Medicines Optimisation Pharmacy Technicians
• Confirming and documenting important factors affecting the patients ability to manage their medicines at home (e.g., sight, hearing, manual dexterity, and use of a compliance aid)
• Resolving any discrepancies and problems identified with patients medication independently as an independent prescriber to complete medicines reconciliation

Provide clinical pharmacy service through daily ED visit. During the visit the pharmacist will:

• Responsible for appropriate management of patients referred for medicine optimisation or medicine reconciliation, prescribing patients regular medication whilst they are in the ED before admission to in-patient wards
• Review prescriptions to ensure they are legal, safe, cost-effective, clinically necessary and appropriate, accurate, and complete
• Undertake Medicines Optimisation
• Arrange for drugs to be supplied to patients, ward(s) or department(s)
• Provide information and advice to ward and nursing staff on a daily basis, about drugs, doses, administration and potential side-effects
• Provide information and advice to junior medical staff on a daily basis, and to Consultants as and when needed, including suggestions for initiating and modifying treatment
• Educate patients as appropriate about changes to their medication, and how to take specific medicines (e.g. warfarin, inhaler devices)
• Access and interpret clinical information for specific patients (e.g. from the ePMA system (Sunrise Clinical Manager), the Patient administration system (TrakCare), Pharmacy computer system (EMIS) as well as case notes and Summary Care Record (SCR)), and use it to individualise and monitor treatment
• Document relevant clinical and pharmaceutical information during in-patient stay which may be used to prepare discharge prescription and/or communicated to patient, carer(s) or GP
• Review discharge prescriptions written by medical staff, using professional judgement to make a final decision about content and appropriateness of discharge prescriptions when a suitable prescriber cannot be contacted
• Participate in Consultant ward rounds as appropriate, providing pharmaceutical advice and information to medical staff, nursing staff, and patients as part of a multi- professional team
• Undertake risk management and ensure compliance with legislation and relevant national policies and guidelines, along with local policies and procedures including the Gloucestershire Joint Formulary
• Undertake regular controlled drug checks within the ED, monitor the use of controlled drugs within the ED and report any concerns relating to controlled drugs to the controlled drugs accountable officer
• Work in an effective team with technicians involved in Trust Medicines Management scheme in the ED and on designated wards
• Usually work unsupervised, although the post-holder can seek advice from a range of colleagues as and when required
• Complete all of the above using the Trust ePMA system (Sunrise Clinical Manager)

Prepare patients for discharge from the ED
Facilitate efficient prescribing and dispensing of medication for patients discharged directly from the ED to help improve patient flow within the ED. Daily tasks include:

• Communicate with junior medical staff (and Consultants) to clarify aspects of the prescription including drug, dosage, frequency, duration of treatment, and length of supply when necessary.
• Use professional judgement to make a final decision about content and appropriateness of discharge prescriptions when a suitable prescriber cannot be contacted.
• Acting as an independent prescriber, prescribe discharge medication on Sunrise EPR or outpatient prescription form (FP10 or hospital outpatient prescription) for patients discharged directly from the ED
• Communicating with patients, carers, community pharmacists as necessary to establish what medication is available at home, and/or to explain changes made to their prescription during ED admission.
• Able to assess and respond appropriately to individual patients needs for help with managing their medicines at home.
• Assessing the suitability of patients own drugs for re-use/continued use at home, if necessary.
• Supply pharmaceutical and clinical information to the patients family doctor (GP) including details of and reasons for medication changes, advice given to the patient, or monitoring needed by the GP.
• Fulfil requirements of the Discharge Medicines Service (DMS)
• Complete all of the above using the Trust ePMA system (Sunrise Clinical Manager)

Provide expert pharmaceutical advice to the Emergency Department
Responsibilities include:

• Collect relevant data, prepare reports for the ED and discuss with the Clinical Director, General Manager, and Divisional Accountant on their drug usage and expenditure as required.
• Monitor prescribing in order to make suggestions to managers and clinicians for ensuring rational and cost-effective prescribing.
• Develop, implement, monitor and revise policies and procedures relating to drug use.
• Represent the service, and occasionally the department, as part of multi-professional teams, and at meetings.
• Provide clinical or financial information about drugs on request by Consultants, Divisional Clinical Director, General Manager, or Accountant.

Specialist Clinical Pharmacist for the Emergency Department

• Specialist Clinical Pharmacist for the ED providing clinical support and guidance for colleagues as needed.
• Responsible for planning, managing, implementing and developing the clinical pharmacy service within the ED in conjunction with the Associate Pharmacy Director(s) and lead clinical pharmacist for medicine
• Manage rotational Clinical Pharmacists assigned to the ED.
• Manage and/or supervise MOPTs and ED based ATOs when carrying out ED- based activities.
• Audit and monitor the current service and any developments, and respond to the needs to the directorate within the capacity of the pharmacy department.
• Maintain an up-to-date knowledge of the therapeutics within specialist clinical area.
• Attend Consultant ward rounds and other ward rounds as appropriate to provide advice, request review of medication and influence rational and cost-effective prescribing.
• Provide a Clinical Pharmacy Service to ED/wards in order to; reduce risks associated with poor prescribing, ensure accurate assessment of drug histories, provide highly specialised advice on appropriate drug treatment in line with own professional judgement, experience, evidence-based medicines and treatment guidelines, on occasion, give a specialist opinion in areas where information is lacking and/or medical opinion differs, educate junior doctors on good prescribing practice, persuade senior/junior medical staff to follow agreed prescribing policies
• Initiate, collaborate in, analyse and report on multi-disciplinary audits and research involving the pharmacy service and/or the ED as required.

Development of Clinical Pharmacy Service in the Emergency Department

• Contribute to the clinical pharmacy service strategy including participation in the clinical pharmacy meetings.
• Prepare business plans for proposed new service developments.
• Plan, undertake and participate in project work and clinical audit to monitor and develop the service.
• Work with departmental leads to enhance service where appropriate in order to increase efficiency and modernise the department.

Prescribing
If post holder holds a Postgraduate Certificate in Non-Medical Prescribing they must practise within the boundaries of local strategy, professional guidance and the law.

• Prescribe medicines for agreed patients within their competency as a dependent (e.g. supplementary) prescriber in line with current legislation, local policies and within their own level of experience and competence
• Prescribe medicines in their competency as an independent prescriber in line with current legislation, local policies and within their own level of experience and competence

General Duties
Participation in Weekend/Bank Holiday Working/late night duty

• The post holder will be part of the weekend and bank holiday working rota at Gloucestershire Royal as per departmental arrangements.
• Participate in the dispensary late night rota and lock up the department at the end of the working day

Additional working pattern details: To compliment the current pattern of Emergency Department Pharmacist cover, a minimum of 5 hours of the 7.5 hours are required to be worked on a Monday.

Person Specification
Qualifications
Essential

• Registration with the General Pharmaceutical Council
• Postgraduate Diploma in Clinical Pharmacy or equivalent post graduate qualifications
• Independent prescriber qualification
• 4 year Vocational Masters degree with postgraduate competency assessment with examination to enter the register

Desirable

• Completion of an advanced clinical assessment module

Experience
Essential

• Significant clinical experience as a Pharmacist in UK hospital at band 7 level or above
• Experience covering acute admission areas
• Experience delivering and developing a clinical pharmacy service
• Working as part of a multi-disciplinary team
• Experience delivering education & training to a variety of healthcare professionals including the supervision and development of junior pharmacists

Knowledge/ Skills
Essential

• Excellent communication skills, both oral and written
• Excellent interpersonal skills
• Proficient in the use of Sunrise EPR and EMIS plus a wide range of standard IT programmes including MS Word, Excel and Outlook
• Provide evidence of Continuing Professional Development to comply with General Pharmaceutical Council (GPhC) requirements
• Adaptable to the changing needs of the service and capable of working in a demanding environment with frequent interruptions

Personal Attributes
Essential

• Self-motivated, able to use initiative & prioritise workload as well as work as part of a multi-disciplinary team
• Able to effectively and appropriately escalate concerns to reduce risk & promote safety

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.

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).

Employer details
Employer name: Gloucestershire Hospitals NHS Foundation Trust
Address: Gloucestershire Royal Hospital, Gloucester, GL1 3NN, United Kingdom
Employer's website: https://www.gloshospitals.nhs.uk/ (Opens in a new tab)

Employer contact details
For questions about the job, contact: Clinical Pharmacist Lead for Medicine, David Richards, david.richards@nhs.net, 03004226841