AGENDA FOR CHANGE
NHS JOB EVALUATION SCHEME
JOB DESCRIPTION
1. JOB IDENTIFICATION
Job Title: Lead Pharmacist – Clinical Specialties
Reports to (insert job title): Principal Pharmacist Clinical Pharmacy
Department, Ward or Section: Pharmacy
CHP, Directorate or Corporate Department: Pharmacy Services
Job Reference: DHNHSHINTGPHAR30
No of Job Holders:
Last Update:
March 2015
2. JOB PURPOSE
The application of advanced theoretical and practical knowledge, training and experience to
provide a highly specialist pharmacy service to identified clinical specialties/patient groups:
This will include:
 Lead and deliver a specialist clinical pharmacy service caring for one or more of the identified patient
groups in line with departmental and national strategies.
 Provide specialist expert advice promoting rational, effective and safe medication use in one or more
identified patient groups.
 Develop and implement guidelines for medication used in the treatment of one or more identified
patient groups.
 Work within the multidisciplinary team and liaise with community based health care professionals to
provide seamless care for one or more identified patient groups.
 Lead and develop clinical audit and undertake research associated with the provision of
pharmaceutical care to one or more identified patient groups.
 Organising, delivering and assisting in the provision of education to undergraduate medical students.
 Develop new teaching opportunities for interprofessional education (IPE) between undergraduate
pharmacy students and undergraduate medical students to be delivered within NHS Highland.
 Support NHS Highland consultants with the teaching they are currently undertaking for medical
student teaching.
 Review, update and improve teaching delivered to post-graduate pharmacy students (local and
international) by pharmacists working within NHS Highland.
 Develop links between academia and NHS Highland for the purposes of promoting NHS Highland as
a site of excellence for education, research and training.
3. DIMENSIONS
NHS Highland Total Population 310,530
Raigmore Hospital
 In contact with NHS Highland GP practices in order to obtain or pass on information about one or
more identified patient groups.
 In contact with community pharmacists who operate within NHS Highland in order to obtain or pass
on information about one or more identified patient groups.
 Annual Drugs budget for NHS Highland £76 million
 Supervise and allocate work to 2 rotational pharmacists and 1 pre-registration student.
NHS Highland
Population
Community Pharmacy Contracts
GP Practices:
Hospital Sites
Hospital Pharmacy Departments
Operational Units
Medicines budget
310,530
45
102
18
4
4
£76 million
Clinical
The clinical pharmacy section provides a service to 55% of occupied beds at Raigmore hospital, or
approximately 24,750 of the 45,000 inpatients cared for at Raigmore hospital each year.
Approximately 4,000 pharmaceutical care issues are dealt with each year, 84% of which demonstrate
benefit to patient care.
Clinical Specialties/Patient Groups
Cardiovascular
Care of the Elderly
Dermatology
Gastroenterology
Diabetes
Neurology
Rehabilitation
Respiratory
Rheumatology
4. ORGANISATIONAL POSITION
Area Principal
Pharmacist (Clinical
Pharmacy) & Deputy
to HOSPS (1)
Lead
Pharmacist
(This Post)
Area Renal
Pharmacist (1)
Area
Antimicrobial
Pharmacist (1)
Senior
Antimicrobial
Pharmacist
Senior
Directorate
Pharmacists (3)
Clinical
Pharmacist
Specialist
(Rotational)
(5)
Rotational
Pharmacists
(2.5)
Advanced
Pharmacist NonCancer Trials &
Research (Until
05/14) (0.6)
Senior
Pharmacy
Technician NonCancer Trials
(0.4)
Senior Pharmacist
Patient Service
(0.4)
5. ROLE OF DEPARTMENT
The function of the Pharmacy Service is to develop and provide integrated patient-focused
pharmaceutical care, which meets the present and anticipated needs of the population of NHS Highland,
in accordance with the Local Health Plan and national strategies. The intention of the service is to link all
branches of the profession, in order to better co-ordinate pharmaceutical care for patients and members
of the public. The focus is on active participation in and contribution to multi-disciplinary, multiprofessional and multi-agency teams in a fully integrated manner. The main responsibilities are:
 The development and operational delivery (managed services) of pharmaceutical care across NHS
Highland.
 The provision of expert advice on community pharmaceutical matters to the NHS Board and its
committees, to Raigmore Hospital and the Community Health Partnerships, and to senior managers
and prescribers.
 The implementation of robust clinical, corporate and staff governance systems to minimise risk and
assure patient and staff safety and well-being.
Clinical Pharmacy delivers direct pharmaceutical care, through the development and application of
evidence-based models of service provision, in order to improve the quality of patient care and medicines
management processes within a multidisciplinary setting.
The service is provided by a team of senior and junior clinical pharmacists through a multidisciplinary
clinical directorate structure. Clinical pharmacists provide pharmaceutical care to patients in the Medical,
Surgical and Woman and Child Health Directorates. And in addition some pharmacists provide input into
stand alone services e.g. the Lead Pharmacist Diabetes also provides specialist care to diabetic patients
attending the Highland Diabetes Centre within the Highland Diabetes Institute. The development and
application of integrated models of care within managed care processes enables the delivery of
evidence-based treatments and pharmaceutical care at the point of patient contact. Monitoring the costeffective use of medicines also forms part of the clinical pharmacist’s role, in order to inform the drug
budget setting process. Clinical pharmacists are also involved in training health care professionals on
issues relating to medicines management, to facilitate safe and effective prescribing.
The delivery of pharmaceutical care to patients is being systematically developed through the
modernisation processes detailed in national strategy documents for pharmacy. As such, clinical
pharmacists and technicians will be involved in reviewing patients’ treatment on wards as part of the
admission process, applying evidence-based treatment guidelines and formulary processes, planning for
discharge, providing patients with information about their treatment and improving communication across
health care interfaces and between health care professionals. Some clinical pharmacists are also
trained as supplementary prescribers. These skills are being targeted to areas of specialist care, thereby
improving clinical management processes and access for patients to appropriate drug treatments.
Examples include cardiovascular risk factor management in patients with aortic aneurisms in preadmissions clinics, and treatment of diabetes in out-patient clinics.
6. MAIN TASKS, DUTIES AND RESPONSIBILITIES
Leadership and Management
 Provide clinical pharmacy services to nominated patients to ensure the safe, clinically effective and
cost efficient use of medicines.
 Co-ordinate and implement clinical pharmacy service developments for patients in line with local and
national objectives, protocols and research evidence, ensuring compliance with professional
standards at all times.
 Identify and develop opportunities for pharmacist prescribing to promote pharmaceutical care of
patients acting as a specialist practitioner and role model.
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Work in a multidisciplinary team consisting of senior pharmacist, senior medical staff and
management ensuring that issues relating to the pharmaceutical care of patients are appropriately
represented within the clinical speciality and to management and that relevant pharmaceutical and
financial information is provided as required.
Participate in the development of policies and procedures for safe and clinically effective use of
medicines in the Clinical Specialty and improve awareness of these issues within the wide healthcare
community minimising the risk of adverse effects for patients.
Contribute to the development of the pharmaceutical service by assisting the Principal Pharmacist
Clinical Pharmacy.
Represent NHS Highland Pharmacy Services at national specialist interest groups relevant to the
care of specific patient groups.
Participate in the NHS Highland Personal Development Planning and Review process and be
responsible for reviewing rotational pharmacists as assigned by the Principal Pharmacist Clinical
Pharmacy.
Clinical Practice
 Work mainly at out-patient/ward level providing pharmaceutical care to patients.
 Develop pharmaceutical care planning for one or more patient groups and work closely with the
multidisciplinary team responsible for provision of care to these patients.
 Initiate a Pharmacist-Lead Specialist one or more specified patient groups.
 Attend multidisciplinary team meetings twice monthly to provide specialist pharmaceutical advice to
facilitate decisions about patients’ therapies.
 Apply specialist knowledge in own area of expertise and an expert level of clinical reasoning and
judgement, providing advice to other pharmacists when necessary.
 Provide a specialist clinical service to identified patients, ensuring that patients’ medicines are as
effective and safe as possible to reduce risk.
 Monitor medicine prescription charts as per standing operating procedure for individual patients
which may include e.g.:
 Ensuring the prescription is legally valid
 Ensuring the doses are accurate and correct
 Assessing the risks involved in using the medicine for both patients and staff
 Establishing whether there are any drug allergies or sensitivities recorded in the notes or kardex
 Establishing if there are any clinically significant drug interactions
 Records key interventions accurately in patients’ medical notes e.g. recording information that will
prevent harm to the patient
 Sign each entry in the prescription chart to indicate that a full pharmacy check, as detailed above
has been completed
 Prescribe medicines as part of a clinical team including:
 Facilitating direct patient care
 Improving effectiveness, efficiency and safety of patient care
 Improving effectiveness, efficiency and safety of the clinical/hospital service
Targeted Care Planning
 Identify, resolve and prevent medicine-related problems so that the desired therapeutic goal for each
medical condition being treated is achieved taking into account patient specific factors.
 Devise, implement and record a pharmaceutical care plan for each patient and monitoring patient’s
response accordingly.
 Pharmaceutical care planning involves the following steps:
 Construct a full medication history
 Identify patient and medication risk factors
 Prioritise pharmaceutical care issues
 Identify desired outputs and propose pharmaceutical actions (making recommendations on drug
selection; preventing, detecting and reporting adverse drug reactions and, where necessary,
individualising drug dosage requirements)
 Propose a monitoring strategy, including monitoring the prescription and progress towards
desired outputs
 Educate and counsel patients on their medication, taking steps where necessary to facilitate
compliance in collaboration with community colleagues
 Promote health
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Interpret blood serum levels and calculating an appropriate dose for those drugs with a narrow
therapeutic range that require dose adjustment.
Interpret blood biochemistry and full blood count to advise on appropriate choice of drug and dose
accordingly.
Provide evaluated information about medicines to all grades of medical staff, nurses and other
members of healthcare staff, using database information as appropriate, to enable informed
decisions about patients’ therapies.
Counsel patients and carers at ward or dispensary level, explain why their medicines have been
prescribed, how they work, warn of possible adverse effects and interactions and how they should be
used to maximise benefit.
Construct full medication histories using medical notes, GP’s and community pharmacist’s records of
the changes to medicines and doses taken by individual patients over a period of years to facilitate
decisions about future medicine therapies.
Submit reports of suspected adverse reactions to drugs to the Medicines and Healthcare Products
Regulatory Authority.
Identify those patients who may have particular problems taking their medicines due to limited
understanding (e.g. learning difficulties, confused), poor eyesight or limited manual dexterity and
institutes a suitable care plan to aid compliance by advising on medicines selection, organising the
supply of medicines in compliance aid boxes and supplying compliance charts.
Dispensary and Supply Activities
 Ensure necessary checks and documents are completed for medicines where special controlled
dispensing arrangements exist, such as Unlicensed Medicines and medicines supplied as part of a
Clinical Trial.
 Promote evidence-based good practice prescribing including the use of the Highland Joint Formulary.
Medicines Information (MI) Section
 Provide a medicines information enquiry answering service on an extensive range of subjects relating
to medicine use. Depending on the level of competence demonstrated, the post holder may have the
task of prioritising the section’s enquiry workload and allocating the work to pharmacists and
student(s) working within the section. Answer all medicine information enquiries seeking clarification
and support from other senior pharmacists only where experience and information available is limited.
 Ensure quality of own work and that of others by always checking and reviewing work to ensure it
meets the UKMI standards for enquiry answering prior to issuing information.
 To provide an enquiry answering service the post holder will:
 Receive and accurately record details of enquiries from a wide range of healthcare professionals
in NHS Highland, from NHS areas outside Highland or from patients.
 Elicit full background information to enquiries, negotiate realistic timescales for the enquiry with
the enquirer, identify and prioritise urgent enquiries and ensure that they are completed in a
timely manner.
 Identify and use appropriate MI information sources following locally agreed standard search
patterns and more complex search patterns as outlined in UKMI standards when answering
enquiries.
 From the information sources identify relevant information. Summarise and evaluate this
information to formulate an appropriate answer using knowledge of pharmaceutical patient care
and taking into account any relevant professional, legal and ethical issues. Tailor the answer to
the needs of the enquirer and their patient(s).
 Communicate answers effectively in verbal, electronic and written form, providing the answer in
the most appropriate format for the enquirer and the nature of the enquiry.
 Use tact, persuasive or reassurance skills to receive, handle and provide information when
necessary. Identify where there are barriers to understanding and take steps to address this.
 Document all enquiries following local procedures to allow full accountability of actions and
decisions.
Education and Training
 Provision of training for 6 specialist rotational pharmacists, 6 rotational pharmacists and 2 preregistration pharmacists in service provision to one or more of the identified patient groups.
 Provide input and supervision of training to multidisciplinary staff (nursing staff, medical students,
junior doctors) in pharmaceutical care in one or more of the identified patient groups.
 Record and participate in educational and training programmes and other activities to develop own
skills as part of commitment to continuing professional development in accordance with registration
with the General Pharmaceutical Council (GPhC).
 Demonstrate on-going learning and development in own specialist area of expertise.
 Develop a clinical pharmacy training package for the pharmaceutical care of patients in one or more
of the identified patient groups and to then train, supervise and assess junior grade pharmacists, preregistration pharmacists, undergraduate pharmacy students and pharmacy technicians in conjunction
with the Principal Clinical Pharmacist and Principal Pharmacy Technician, Education and Training.
 Lead, develop, co-ordinate and deliver teaching to students within the Highland Medical Education
Centre for one or more of the identified patient groups (Undergraduate medical student teaching
centre in Inverness for the University of Aberdeen).
 Develop and deliver a programme for one or more of the identified patient groups of interprofessional
education between undergraduate pharmacy students and undergraduate medical students in
Inverness.
 Lead, develop and co-ordinate pharmacy post-graduate student teaching for local and international
students.
 Act as Tutor for qualified pharmacists conducting Stage II Vocational Training Scheme, as instituted
by NHS Education for Scotland (NES).
 Act as Tutor for pre-registration pharmacist.
 Act as Tutor for those qualified pharmacists conducting post-graduate MSc in Clinical Pharmacy.
 Act as Tutor for qualified pharmacists who are undertaking an Independent Prescribing qualification.
 To participate and present at training sessions and seminars to specific patient groups, and other
members of the healthcare team including pharmacy staff, undergraduate medical students, junior
doctors and nursing staff.
 Ensure accurate, up to date clinical information is available and accessible to all pharmacists
performing out-of-hours duties.
 Undertake any other relevant duties, as may be required by the Director of Pharmacy.
Finance
 Regularly report financial information to the clinical teams in one or more of the identified patient
groups including drug expenditure, cost pressures and drug usage review data.
 Liaise with the clinical teams in one or more of the identified patient groups to ensure development of
effective strategies for the provision of high cost therapies.
Research and Development
 Initiate and participate in research and clinical audit within services delivered to one or more of the
identified patient groups. This involves collation of research results in order to improve prescribing
and minimise clinical risk to patients within service to one or more of the identified patient groups, and
to publish the results of such work, as appropriate.
 Demonstrate a critical approach towards pharmacy practice in services delivered to one or more of
the identified patient groups.
 Develop, implement, monitor and evaluate protocols and guidelines.
 Actively seek to improve the ward and clinical services provided.
 Maintain and further develop specialist information on the use of drugs in identified patients, in
conjunction
with
the
Medicines
Management
and
Information
Service.
General Duties
 Practice as a pharmacist in accordance with the Code of Ethics and Standards issued by the GPhC
and relevant legislation and associated regulations as stipulated by the GPhC.
 The post holder is a key holder on behalf of the Pharmacy Department and as such has a shared
responsibility for maintaining stock control and the security of medicines as well as security of the
Pharmacy Department.
 Jointly responsible with other pharmacy staff for ensuring that the security of medicines is maintained
at departmental level and promoting good practice regarding the security of medicines during transit
and at ward level.
 Participates in quality initiatives and in risk management, including clinical incident and Datix
reporting systems.
 Understands and appreciates all risks associated with handling all classes of medicines, including
cancer chemotherapy agents, medical gases and intravenous medicines.
 Complies with the departmental standard operating procedures at all times and develops standard
operating procedures.
 Contributes to the development of the pharmaceutical service by developing policies and protocols
which will impact on services across NHS Highland, in conjunction with other senior pharmacists.
 Participates in working groups and project groups.
 Undertakes any other relevant duties as may be required by the Director of Pharmacy.
Pharmacist additional duties and responsibilities undertaken Out of Hours (OOH), including
Weekends, Public Holidays and whilst on On-Call.
Pharmacists participate in weekend work and work on approximately half the Public Holidays.
Pharmacists participate in the on-call responsibilities as required, in agreement with pharmacy
management to maintain a 1 in 10 rota according to their contract. At any one time therefore,
approximately half of the Pharmacists participate in on-call work. The following paragraphs provide an
overview of the duties and responsibilities undertaken in OOH and on-call work within the various
sections of the Pharmacy Department. Whilst providing on-call the pharmacist is in a position of sole
responsibility for the on-call pharmacy service to all hospitals in northern NHS Highland.
Production
Rarely required to perform final release checks on aseptically dispensed cytotoxic chemotherapy and
extemporaneously dispense non-sterile pharmaceuticals e.g. creams or suspensions.
Quality Assurance
Rarely required to action an urgent alert or recall notice, received out of hours, for a defective or
potentially defective item. The same could apply to a serious or potentially serious defect identified by
NHS Highland staff.
Clinical Pharmacy
Rarely required to provide clinical pharmacy service OOH but frequently provides a clinical pharmacy
service during on-call. Elements could include advice on the pharmaceutical care of individual patients,
for example: drug choice, medication dosing, administration or monitoring; clarification of medication
histories for patients on complex medication regimens; discharge medication counselling for patients with
concordance/adherence problems; or the management of adverse drug reactions.
Dispensary
Frequently required to receive, clinically screen, label, dispense and despatch prescriptions as required.
Within on-call, the pharmacist is solely responsible for the accurate completion of all prescriptions
received; under all other circumstances dispensing is checked by a second qualified member of staff.
This situation significantly increases the responsibility of all on-call pharmacists.
Distribution
Frequently required to review orders for medicines and associated medical sundries, process the orders
on the Pharmacy Department computer, pick the items and distribute them. This may require the
organisation of emergency transport OOH, including taxis, hospital drivers and air transport that requires
communication with the Duty Manager and other hospital(s) staff.
Medicines Information
Occasionally required to answer simple medicine information enquiries. Rarely required to answer more
complex enquiries which may require advice and support from more experienced staff.
Procurement
Rarely required to obtain urgent stock from manufacturers, wholesalers or other hospital pharmacy
departments out with Highland. This requires contacting on-call pharmacy staff in other hospitals and
arranging ad hoc transport arrangements. Discussions frequently involve clinical input in discussing the
situation with senior medical staff.
Security
 When in the Pharmacy Department providing OOHs or on-call services the pharmacist is on their
own and has sole responsibility for security of the department and medicines stored within.
 Maintain safe systems of work in accordance with the Safety, Health and Environmental Manual.
 Understand and appreciate all risks associated with handling of all classes of medicines, including
cancer chemotherapy agents, medical gases and intravenous medicines.
 Comply with departmental standard operating procedures at all times.
7a. EQUIPMENT AND MACHINERY
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Computer and visual display unit (VDU)
Personal laptop
Data projector
CD burner
Telephone and answering machine
Radiopager
Fax machine
Photocopier
Laser printer
Scales and balances
Volumetric measuring cylinders
Assorted extemporaneous dispensing equipment (ointment slab and spatula, mortar and pestle).
7b. SYSTEMS
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JAC pharmacy stock control and dispensary IDL (incremental discharge letter) computer system to
input and retrieve information in connection with clinical and dispensing practice and to produce
management reports.
Intranet - NHS Highland Hospital Information System. To access: E-library for access to databases,
e-books and e-journals for internet enquiries; WeBNF electronic version of the BNF annotated with
local formulary choices; results reporting to access laboratory and microbiology reports for individual
patients.
Internet - Search the Internet to obtain quality information that is reputably referenced.
Use IDL computer system for in-patient discharge prescriptions.
Use Microsoft Office package on a daily basis: Word for word processing of letters, guidelines,
documents etc.; PowerPoint for presentations; Outlook for email; Excel/Access for patient care
planning.
Access to SCI-DC and SCI-CHD databases to clinically manage patients.
Acts as key holder, performs security checks, sets and deactivates department intruder alarm when
required for emergency duty commitment.
Uses the pneumatic tube system to send information and prescriptions or stock items to various
wards and departments.
Formulary and medicines management systems
Create, maintain and store pharmaceutical care plans daily for patients on haemodialysis, peritoneal
dialysis and current admission under consultants.
Use patient notes daily on the ward or clinic to: retrieve information to contribute to pharmaceutical
care planning, often involving interpreting information from previous admissions, clinic visits etc.;
provide information, e.g. advice about a particular drug dose to be used, review of patients regular
medication.
Create, maintain and store paper filing systems for condition specific protocols, condition specific
drug product information, condition specific multidisciplinary team meetings, condition specific
services working group, etc.
8. ASSIGNMENT AND REVIEW OF WORK
The post-holder is guided by the Principal Pharmacist Clinical Pharmacy.
 Function as the lead clinical pharmacy specialist in own area of practice, applying an expert level of
knowledge.
 Work autonomously within a framework agreed with the Principal Pharmacist Clinical Pharmacy.
 Plan and prioritise own workload to meet both the needs of patients and the department.
 Accountable for own professional actions and outcomes – guided by legislation, national and local
protocols, local formulary, lead clinicians and peers, assessment of budgetary and statistical figures,
the quality control/assurance systems.
 Supervise and carry out checks on the work of technical staff in accordance with standard operating
procedures.
 Participate in the NHS Highland Personal Development Planning and Review process and
responsible for reviewing junior clinical pharmacists annually as assigned by the Principal
Pharmacist Clinical Pharmacy.
 Be guided by the Director for Medical Undergraduate Education in the Highland Medical Education
Centre (HMEC) with regards to teaching and training of undergraduate medical students.
 The Principal Pharmacist Clinical Pharmacy carries out formal Personal Development Planning.
9. DECISIONS AND JUDGEMENTS
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Apply an expert level of knowledge and experience to assimilate and critically appraise information,
which may be conflicting or limited, in order to advise on pharmaceutical care issues and make
recommendations to senior clinicians: for example most clinical trials are conducted in stable not
critically ill patients within one or more of the identified patient groups so existing evidence must be
evaluated and transferred to the immediate situation as appropriate, or where there is potential for
drug interactions between new drugs when little or conflicting evidence is available, or where narrow
therapeutic indices and/or abnormal physiological and pharmacological parameters make drug
toxicity likely in severely ill patients.
Required to provide expert pharmaceutical advice on drug selection for the NHS Highland
Formulary.
Required to provide expert pharmaceutical advice on new protocol/guideline use to the Area Drug
and Therapeutics Committee.
Required to provide expert pharmaceutical advice on medicines being reviewed by the expensive
medications group.
Manage, interpret, analyse and advise on medical treatment protocols, reviewing the clinical and
cost effective aspects to promote safe and rational prescribing and use of medicines: for example for
new drug therapies targeted at one or more of the identified patient groups, deciding their place in
treatment, also negotiating how many and which patients should be targeted.
Anticipate potential problems and take appropriate action to resolve foreseen difficulties: for example
if a particular pharmaceutical product is to be discontinued to advise on an alternative and inform
relevant clinicians and nursing staff.
Assess and inform Principal Pharmacist Clinical Pharmacy of changing demand for clinical
pharmacy service for one or more of the identified patient groups.
Problem solving with regard to the legalities surrounding the supply and dispensing of medication
requiring use of personal judgement in interpretation of legal statutes and ethical standards.
During Personal Development Planning and Review sessions with junior pharmacists, make
decisions and judgements about training requirements.
Frequently required to make decisions and judgements concerning the selection and storage of
drugs as a qualified independent prescriber. Required to formulate such highly complex decisions
on the direct pharmaceutical care of such patients, from several component strands of often
conflicting and/or incomplete information and to take full legal responsibility for such decisions and
judgement when practising as an independent prescriber.
Decide on the most appropriate method of teaching undergraduate medical students to convey
complex prescribing decisions regarding medications.
Manage, interpret and analyse the feedback from teaching to develop and improve the clinical
teaching delivered by all pharmacists to medical students.
Undertake problem solving exercised to ensure that IPE can be delivered within NHS Highland for
undergraduate pharmacy and medical students.
10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB
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Developing and delivering clinical pharmacy in an area where there had been no formal service
provision.
Developing a novel way of teaching undergraduate medical and pharmacy students from different
universities together as part of IPE at a centre which is geographically distinct from where the
universities are based.
Design and deliver effective, stimulating and up-to-date clinical pharmacology and clinical pharmacy
teaching to a range of undergraduate students and different stages of training.
Providing mentorship for qualified pharmacist undertaking a Masters in Clinical Pharmacy.
Establish, develop and implement medicines management policies and guidelines in conjunction
with Medicines Management to ensure the rational, cost-effective use of medicines for one or more
of the identified patient groups.
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Working to tight timescales to ensure that each patient’s medication regimen is appropriate for its
intended purpose and is supplied on time, where there is frequently limited information to guide
decisions.
Use advanced negotiating and influencing skills to challenge the decisions of practitioners from other
professions to ensure that each patient’s medication regimen is evidence-based requiring continual
update of clinical pharmacy knowledge.
Effectively communicate highly complex drug or medicine related information to prescribers,
clinicians, patients, relatives; patients may have language difficulties, physical or mental disabilities,
other professionals may challenge advice.
Assess highly complex information often limited and incomplete and relating the information to
senior clinical staff to guide prescribing decisions for critically ill patients in a tight timescale.
Practising as an independent prescriber, taking full ethical, clinical and legal responsibility for
prescribing decisions when prescribing potent and potentially toxic pharmacological interventions.
11. COMMUNICATIONS AND RELATIONSHIPS
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Communicate daily with other members of the pharmacy department to promote an effective and
efficient pharmacy service to one or more of the identified patient groups.
Communicate daily with all members of the multidisciplinary team including senior nursing and
medical staff to provide an expert level knowledge within area of expertise and to develop and
implement clinical pharmacy services.
Communicate daily with patients and their carers in acute clinical environments on wards and critical
care areas where there is often a highly sensitive and emotionally charged atmosphere and
antagonism towards effective communication mechanisms. This requires the post-holder to have a
high level of interpersonal and communication skills on an ongoing basis, to ensure complex
therapeutic problems and information are communicated verbally to patients in a way that can be
easily interpreted and understood.
Communicate daily with General Practitioners, Community Pharmacists and other healthcare
workers in the Community Healthcare Division to implement procedures for the seamless
pharmaceutical care of identified patients.
Attend appropriate conferences and communicate with colleagues working in the same field of
practice regarding issues relevant to pharmaceutical services to one or more of the identified patient
groups.
Communicate effectively in a manner in keeping with the professional operation of the department.
Represents the NHS Highland Pharmacy Service with regard to services with one or more of the
identified patient groups at local and national level and works closely with the consultant medical staff
in the relevant disciplines within NHS Highland as required.
Takes pharmaceutical lead as part of the multidisciplinary Team in developing policy and guidelines
for one or more of the identified patient groups.
Communicate effectively with senior medical staff and senior managers when attending the Area
Drug and Therapeutics Committee and making decisions on therapeutic policy application and
changes which have a direct impact on delivery of service to patients.
Develop policy for nurse lead service in conjunction with senior nursing and medical staff, according
to current medicines legislation e.g. Patient Group Directions and deliver associated training.
Deliver pharmaceutical care clinical teaching to medical students.
Co-ordinate all other senior pharmacists and senior medical staff in the delivery of undergraduate
pharmacy and medical student teaching.
Develop and maintain effective working relationships with Clinical Teaching Fellows from within the
HMEC. This is made challenging due to the 1 year duration of their post.
Communicate effectively with the Director of Undergraduate Medical Education, HMEC, to provide
effective, stimulating education and training for undergraduates studying within NHS Highland.
12. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB
Physical Effort/Skills
 Advanced computer keyboard skills used daily.
 Lifting and handling skills used occasionally each week to lift and move boxes and containers
weighing up to 10 kilograms.
 Standing for periods of time to perform checks on dispensed prescription items or manufactured
products on a weekly basis.
 Walking around the wards and also between the wards and the pharmacy on a daily basis.
 Sitting down and standing up frequently when reviewing patients’ medicines, analysing drug
kardexes, and patient notes.
Mental Effort/Skills
 Frequent periods of concentration required when reviewing prescribed medicines, counselling
patients or performing checks on dispensed items where an undetected error could result in serious
patient harm. This is frequently carried out in busy multidisciplinary clinical areas in the wards and in
the busy and noisy Pharmacy Department.
 A high degree of speed, accuracy and attention to detail is expected in all duties.
 Tasks are frequently interrupted to deal with queries or requests for advice from all grades of
medical, nursing, pharmacy and other staff, on telephone and pager, often at the same time and
often that have to be dealt with immediately which require a continual changing of priorities.
 Ability to carry out complex calculations accurately, e.g. to determine dose required by a patient in
relation to blood results, which would have serious implications for the patient if not correct.
 Frequent distraction due to sharing an office, frequently interrupted by other members of staff who
come to speak to myself or the others I share an office with.
 High level of clinical knowledge required to design clinical teaching for pharmacy and medical
students as well as post-graduate pharmacists studying for further qualifications.
 Ability to react to questions posed by members of teaching groups to assimilate appropriate clinical
answers to complex clinical questions.
Emotional Effort/Skills
 Frequent direct contact with patients, some of whom may be physically or emotionally distressed;
aggressive or suffering from serious disease/terminal illness, e.g. acutely ill, dying patients; may have
disfigurements, handicaps or communication difficulties.
 Indirectly when checking chemotherapy/TPN/outpatient/discharge prescriptions.
 Dealing with anxious students prior to examinations.
Working Conditions
 Potential exposure to toxic pharmaceutical materials including cytotoxics.
 Frequent direct patient contact involving exposure to environmental risk at ward level.
 Frequently working in the vicinity of blood circulating through haemodialysis machines.
 Occasionally in the vicinity of foul smells, body fluids, lice, foul linen and unpleasant sights on the
ward but not having to deal personally with them.
13. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB
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Master of Pharmacy Degree or equivalent.
Currently registered as a practicing pharmacist with the General Pharmaceutical Council (GPhC) and
able to demonstrate a high level of professional practice.
Formal postgraduate qualification in clinical pharmacy or pharmacy practice to a minimum of diploma
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level (or equivalent).
Attainment of pharmacist prescribing qualification.
Attainment of registration as a Pharmacist Prescriber with the GPhC.
Post-graduate qualification in the management of identified staff groups (desirable).
Post-graduate PgC/PgD/MSc/MEd in clinical education (desirable).
Required to have a minimum of four years qualified experience, with significant clinical pharmacy
experience in relevant patient group.
Have experience of formulary management and decisions.
Have experience of designing and implementing protocols and procedures for safe, efficacious and
cost-effective use of medicines.
Experience of teaching undergraduate medical and pharmacy students.
Experience of development and adaptation of teaching materials for the delivery of effective
education and training.
Knowledge and understanding of issues, protocol and policy affecting the clinical management of
identified patient groups.
Wide ranging knowledge and understanding of pharmacy practice, including legal and ethical
requirements.
Must demonstrate expert clinical knowledge, clinical reasoning and judgement in all matters relating
to Clinical Pharmacy and the therapeutic use of drugs.
A working understanding of Scottish Government and NHS priorities, policies, processes, structures,
systems and clinical practices.
Knowledge/experience of negotiating and contracting arrangements with health services purchasers.
Excellent interpersonal, influencing and presentational skills plus the ability to use them effectively in
the multidisciplinary team.
Excellent communication skills (oral and written).
Advanced mathematical skills.
Computer literate with knowledge and ability to use information technology.
Proven track record of successful team working.
Ability to identify need for change and develop systems to improve service delivery.
Active involvement in service development/change management processes.
Demonstrable ability to work well under pressure by prioritising and managing time effectively.
Previous experience of delivering training to pharmacy staff, other hospital staff and patients at
different levels and in different formats.
Ability to motivate self and others.
Experience in drug usage review, clinical audit and research and development.
14. JOB DESCRIPTION AGREEMENT
I agree that the above Job Description is an accurate reflection of my duties and
responsibilities at the date of signing.
Job Holder’s Signature:
Date:
Manager’s Signature:
Date:
POST OF : Lead Pharmacist in one or more of the following clinical specialties
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Cardiovascular
Care of the Elderly
Dermatology
Gastroenterology
Diabetes
Neurology
Rehabilitation
Respiratory
Rheumatology
REF:
BASED: Pharmacy Department, Raigmore Hospital
Attributes
1. Qualifications
Essential
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Member GPhC
PgD/MSc in Clinical
Pharmacy
Practice certificate in
Pharmacist
Independent
Prescribing with
professional registration
as a prescriber
Desirable
- Advanced Clinical Skills
Training
- MRPharmS
2. Experience
- Significant broad hospital
clinical pharmacy experience,
including care of the elderly
- Some management,
organisational or
administrative experience
- Teaching at undergraduate
and postgraduate level
- Drug budgeting
- Formulary/medicines
management
- Protocol design and
development
- Project management
- Patient group directions
-Pharmacy practice research
- Experience of designing new
teaching
3. Skills/Knowledge
- Principles of direct
pharmaceutical care
- Good knowledge of
pharmaceutical care required
for frail elderly
- Networking skills
- Excellent communication
and interpersonal skills
- Good organisational skills
- Computer literate
- Good mentoring skills
- I/V drug administration,
equipment and procedures
- Negotiation skills
- Influencing skills
4. Personal Characteristics
- Enthusiasm and
commitment
- Training ability
- Team player
5. Other
- Management potential
- Commitment to continuing
professional development
- Physically fit to meet
- Experience of multidisciplinary work on clinical
effectiveness
- Peer review experience
requirements of job
- Research and audit
experience
Job Plan: Lead Clinical Pharmacist, Care of the Elderly
The specialities covered are Care of the Elderly, Orthogeriatrics and Stroke.
Type of Work
Time commitment
Clinical Practice
Approx 60%
Provide clinical pharmacy service to one or
more of clinical areas.
Areas to be covered are – Care of the
Elderly, Orthogeriatrics/Orthopaedics and
Stroke.
This may include outpatient clinics
Leadership and Management
Approx 20%
Education, training, research and
Approx 10%
development.
Finance and other duties
Approx 10%