Job description

Job responsibilities

Key clinical responsibilities

• Assess and triage patients, including same-day and urgent presentations, and provide definitive treatment or appropriate onward referral
• Undertake face-to-face, telephone and, where appropriate, digital consultations in practice, patients homes, care homes and other community settings
• Undertake comprehensive history taking, physical examination and clinical assessment for patients with acute, chronic, complex or undifferentiated presentations
• Formulate differential diagnoses, identify red flags, assess clinical risk and determine the appropriate level and place of care.
• Initiate emergency care and escalation when required, including referral to ambulance, urgent community, secondary care or specialist services
• Treat minor illness and minor injury within competence and agreed local pathway
• Undertake and interpret appropriate investigations within competence, which may include observations, ECGs, urinalysis, blood glucose/ketones, blood tests, swabs and other point-of-care or diagnostic procedures available within the PCN
• Request, review and act on investigations where authorised and competent to do so, ensuring appropriate follow-up and safety-netting.

• Provide health promotion, prevention and self-management advice and support shared decision-making
• 3. Home visiting, frailty and proactive care
• Provide an alternative model for urgent and same-day home visits across the PCN, prioritising workload according to clinical need and risk
• Assess housebound, frail and vulnerable patients, including those with multimorbidity, deterioration or complex health and social care needs
• Contribute to care home support and ward rounds where this forms part of the agreed PCN service model
• Support anticipatory and personalised care planning, including escalation planning and coordination with the wider multidisciplinary team
• Identify opportunities to prevent avoidable hospital attendance or admission while recognising promptly when escalation is clinically necessary
• Work with community, urgent care, virtual ward, ambulance, pharmacy, social care, voluntary sector and other services to coordinate appropriate care.
• 4. Medicines management and prescribing
• Administer medicines in accordance with legislation, local policies, Patient Group Directions (PGDs), Patient Specific Directions (PSDs) and professional scope of practice
• Where appropriately qualified as an independent prescriber, prescribe, review and deprescribe medicines within competence and in accordance with NICE guidance, local formularies, antimicrobial stewardship principles and PCN/practice policies
• Provide patients and carers with appropriate information about medicines, including purpose, adherence, side effects, interactions and when to seek further advice.
• Recognise personal limits in relation to medicines and seek advice from GPs, clinical pharmacists or other appropriate clinicians when required.
• 5. Multidisciplinary and integrated working
• Work as an integral member of the PCN multidisciplinary team, collaborating with GPs, nurses, pharmacists, pharmacy technicians, care coordinators, social prescribers, health and wellbeing staff, mental health practitioners and other allied health professionals
• Accept appropriate referrals and refer patients to other clinicians and services according to clinical need and agreed pathways.
• Communicate proactively and effectively with practices and partner organisations to ensure coordinated, person-centred care.
• Attend and contribute to PCN, practice, MDT, clinical, safeguarding, education and service-development meetings as required.
• Promote effective professional relationships across organisational boundaries and contribute to integrated neighbourhood working.

Person Specification

Clinical knowledge & skills

Essential

• Advanced history taking, clinical examination and assessment skills
• Ability to recognise deterioration, red flags and emergencies and escalate appropriately
• Ability to formulate differential diagnoses and evidence-based management plans within competence
• Understanding of safeguarding, consent, capacity, confidentiality and information governance
• Knowledge of medicines safety and relevant legal/professional frameworks
• Ability to document clearly, code accurately and provide robust safety-netting

Desirable

• Competence in ECG interpretation, phlebotomy and relevant point-of-care diagnostics
• Knowledge of frailty, anticipatory care, personalised care and admission avoidance pathways
• Knowledge of QOF/IIF and wider PCN contractual priorities

Other requirements

Essential

• Able and willing to travel between PCN sites and undertake home/community visits
• Ability to meet the physical and practical requirements of the role, with reasonable adjustments where required
• Satisfactory DBS and occupational health clearance as required

Desirable

• Full UK driving licence and access to a suitable vehicle, subject to reasonable adjustment and organisational policy

Qualifications

Essential

• Master Level (Level 7) or working towards it.
• Has been signed off formally within the clinical pillar competencies of the paramedic FCP/AP roadmap to practice.
• Degree/diploma in Paramedic Science/Paramedicine or equivalent recognised qualification/experience
• Has a further three years experience as a band 6 (or equivalent)
• paramedic
• Current HCPC registration as a Paramedic
• Meets current eligibility requirements applicable to the role and funding route
• Evidence of relevant CPD and maintenance of professional competence

Desirable

• Independent/non-medical prescribing qualification
• Masters-level qualification or modules relevant to advanced practice
• Formal evidence of FCP/AP roadmap completion or equivalent advanced-practice recognition

Experience

Essential

• Substantial post-registration paramedic experience appropriate to autonomous primary care practice
• Experience assessing and managing a broad range of acute and undifferentiated presentations
• Experience of autonomous clinical decision-making and managing risk/uncertainty
• Experience of home/community visiting and managing patients with complex needs
• Experience of multidisciplinary working

Desirable

• Primary care/general practice experience
• Care home, frailty or urgent community response experience
• Experience of SystmOne
• Experience of audit, quality improvement, teaching or supervision

Personal attributes

Essential

• Able to work autonomously while recognising limits and seeking support appropriately
• Organised, adaptable and able to prioritise a variable workload
• Calm and effective under pressure
• Reflective, accountable and committed to continuous improvement
• Commitment to equality, diversity, inclusion and person-centred care

Desirable

• Evidence of contributing to service redesign or new models of care

Disclosure and Barring Service Check

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.

UK Registration

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

Employer details

Employer name

North Wilts Border PCN Ltd Company

Address

New Court Surgery

Borough Fields

Royal Wootton Bassett

Swindon

Wiltshire

SN4 7AX

United Kingdom

Employer's website

https://northwiltsborderpcn.nhs.uk/ (Opens in a new tab)

Job description

Job responsibilities

Key duties and responsibilities

• Patient facing Long term condition clinics (where appropriate).
• See (where appropriate) patients with single or multiple medical problems where medicine optimisation is required (e.g. COPD, asthma, Diabetes).
• 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 Senior Pharmacists or GPs for medicine improvement.

Telephone or Patient facing Clinical Medication Review

• Undertake clinical medication reviews with patients and produce recommendations for senior clinical pharmacist team leader, nurses and/or GP on prescribing and monitoring.

Telephone or Patient facing care home medication reviews

• Undertake clinical medication reviews with patients and produce recommendations for the senior clinical pharmacist, nurses or GPs on prescribing and monitoring. Work with care home staff to improve safety of medicines ordering and administration.
• Domiciliary clinical medication review
• Undertake clinical medication reviews with patients and produce recommendations for the senior clinical pharmacists, nurses and GPs on prescribing and monitoring. Attend and refer patients to multidisciplinary case conferences.

Management of common/minor/self-limiting ailments

• Managing caseload of patients with common/minor/self-limiting ailments while working within a scope of practice and limits of competence.
• Signposting to community pharmacy and referring to GPs or other healthcare professionals where appropriate
• Provide patient facing clinics for those with questions, queries and concerns about their medicines in the practice
• Telephone medicines support
• Provide a telephone help line for patients with questions, queries and concerns about their medicines.

Medicine information to practice staff and patients

• Answers 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.
• Providing follow up for patients to monitor the effect of any changes

Unplanned 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 highrisk patient groups.
• Management of medicines at discharge from hospital
• To reconcile medicines following discharge from hospitals, intermediate care and into care homes, including identifying and rectifying unexplained changes and working 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 highrisk groups of patients (e.g. those with medicine compliance aids or those in care homes).

Signposting

• Ensure that patients are referred to the appropriate healthcare professional for the appropriate level of care within an appropriate period of time e.g. pathology results, common/minor ailments, acute conditions, long term condition reviews etc.

Repeat prescribing

• Produce and implement a practice repeat prescribing policy.
• 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.

Risk stratification

• Identification of cohorts of patients at high risk of harm from medicines through pre-prepared practice computer searches. This might include risks that are patient related, medicine related, or both.

Service development

• Contribute pharmaceutical advice for the development and implementation of new services that have medicinal components (e.g. advice on treatment pathways and patient information leaflets).

Information management

• Analyse, interpret and present medicines data to highlight issues and risks to support decision making.

Medicines quality improvement

• Undertake clinical audits of prescribing in areas directed by the GPs, feedback the results and implement changes in conjunction with the practice team.

Medicines safety

• Implement changes to medicines that result from MHRA alerts, product withdrawal and other local and national guidance.
• Implementation of local and national guidelines and formulary recommendations
• Monitor practice prescribing against the local health economys RAG list and make recommendations to GPs for medicines that should be prescribed by hospital doctors (red drugs) or subject to shared care (amber drugs).
• Assist practices in seeing and maintaining a practice formulary that is hosted on the practices computer system.
• Auditing practices compliance against NICE technology assessment guidance.

Person Specification

Qualifications

Essential

• Bachelor's degree in Pharmacy,
• Registered with the General Pharmaceutical Council (GPhC)
• Commitment to undertaking the CPPE pathway training, followed by Independent Prescribing qualification.

Desirable

• CPPE (or equivalent) trained or already on the pathway
• Independent prescribing qualification

Experience

Desirable

• Experience in working with computerised health care systems.
• At least 1 year post-qualification experience in General Practice, hospital or community pharmacy.
• Previous experience of working in triage or an unscheduled care service.

Disclosure and Barring Service Check

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.

UK Registration

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

Employer details

Employer name

North Wilts Border PCN Ltd Company

Address

Tinkers Lane Surgery

Tinkers Field

Royal Wootton Bassett

Swindon

Wiltshire

SN4 7AT

United Kingdom

Employer's website

https://northwiltsborderpcn.nhs.uk/ (Opens in a new tab)

Job description

Job responsibilities

Main duties of the job

Prescribing & Medicines Optimisation

• Lead improvements in prescribing to ensure safe, cost-effective best practice that enhances patient care.
• Conduct medication switches in line with practice and ICB protocols, reviewing and updating patient records and informing patients accordingly.
• Promote and implement electronic repeat dispensing and online ordering.
• Manage shared care protocols and escalate complex cases to Clinical Pharmacists.
• Optimise dosages and synchronise medications during patient record reviews.
• Minimise clinical risk and reduce medicine waste through better prescribing processes.
• Assist in implementing national prescribing policies, QIPP initiatives, QOF targets, and locally commissioned enhanced services.
• Support the Medicines Optimisation strategy of the ICB and PCN.
• Maintain relevant databases and reporting systems for prescribing data, medicines optimisation, and outcomes.
• Complete audits around patient safety and cost-effective prescribing and present the information for sharing with the clinical team.

Collaboration & Support

• Work closely with the PCN Clinical Pharmacist to deliver the Clinical Pharmacy in General Practice (CPGP) model.
• Liaise with ICB Medicines Optimisation team, community, and hospital pharmacy colleagues.
• Participate in practice meetings, patient participation groups, and stakeholder engagements to promote pharmacy technician contributions.
• Support the development and review of practice policies in line with CQC and safeguarding requirements.
• Support GP practices in containing prescribing expenditure and propose cost-saving changes where necessary.
• Support quality improvement initiatives and contribute to the effectiveness of PCN-wide service delivery.

Monitoring & Reporting

• Use GP clinical systems (e.g. SystmOne) to conduct and report on prescribing audits.
• Maintain and utilise relevant information systems and databases for medicines optimisation, prescribing data, cost savings, and patient outcomes.
• Report key performance indicators to demonstrate value in line with NICE guidance.
• Respond to MHRA drug alerts, advising practices on medication changes where appropriate.

Professional Development & Supervision

• Engage in ongoing learning and development to maintain required knowledge and skills, including annual performance reviews and continuous personal/professional development.
• Demonstrate new skills and procedures to others as required.
• Receive clinical supervision and day-to-day support from a named individual within the PCN.
• Manage own time, workload, and resources effectively to meet deadlines and priorities.

Governance, Quality and Compliance

• Maintain confidentiality in line with the Data Protection Act, Caldicott Guidelines, and Confidentiality Code of Conduct.
• Undertake clinical audits and share outcomes to support quality improvement.
• Maintain appropriate safeguarding knowledge and comply with organisational safeguarding policies and practices.
• Report any infection prevention and control issues to the relevant lead.
• Equality, Diversity, and Inclusion

• Promote equality, diversity, and the rights of patients, carers, and colleagues.
• Behave in a non-judgemental, respectful, and inclusive manner that upholds dignity and individual values.
• Support a culture that recognises and promotes diversity and fairness.

Other Duties

• Carry out other relevant duties within the scope of the post as service needs evolve.
• Ensure the principles of openness, transparency and candour are observed and upheld in all working practices.
• The post holder will have, or acquire through training provided by the organisation, the appropriate level of safeguarding and knowledge, skills and practice required for the post and be aware of and comply with the organisations safeguarding protection policies and procedures.
• Ensure that any infection prevention and control issues are reported to the line manager/Infection Prevention and Control

Person Specification

Qualifications

Essential

• Registered with GPhC as Pharmacy Technician
• BTEC/NVQ level 3 or equivalent in pharmaceutical sciences

Desirable

• Previous Pharmaceutical experience
• Experience of Microsoft Office
• Experience in General Practice/NHS setting
• Experience of SystmOne computer system

Experience

Essential

• Experience with medicines reconciliation and repeat prescribing processes
• Familiarity with electronic prescribing systems
• Reliable with a good attendance record
• Ability to work on own initiative and as part of a team
• Ability to work with attention to detail and accuracy
• Excellent communication skills (verbal & written)
• Ability to work effectively in a busy environment.
• Highly motivated and willing to attend training

Desirable

• Experience working in a GP practice or PCN
• Knowledge of QOF, IIF, or other NHS performance frameworks
• Experience of working with multi-disciplinary teams (MDTs)

Disclosure and Barring Service Check

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.

UK Registration

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

Employer details

Employer name

North Wilts Border PCN Ltd Company

Address

Tinkers Lane Surgery

Tinkers Field

Royal Wootton Bassett

Swindon

Wiltshire

SN4 7AT

United Kingdom

Employer's website

https://northwiltsborderpcn.nhs.uk/ (Opens in a new tab)