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Job Purpose:

Lewisham Integrated Medicines Optimisation Service (LIMOS) provides a formal pathway for the referral of patients living in the community setting with medicine-related problems for assessment, support and follow-up by a specialist pharmacy team, working across the primary and secondary care interface and also health and social care boundaries. The post-holder will support the medicines management aspects of this initiative through working within the LIMOS service within care homes in Lewisham Borough.

The key objectives of the role are to ensure that  medicines care plans for care home residents are optimised by undertaking multidisciplinary clinical medication reviews, supporting the implementation of recommendations from the NICE guidance for Managing Medicines in Care Homes including around the safe transfer of care, and minimising unnecessary medicines-related hospital admissions The overarching aim is to improve the quality of life and care for these patients and to promote patient centered and cost-effective prescribing resulting in better patient outcomes and maximise the gain from medicines.

This is a highly specialised post, which involves analysing and interpreting highly complex clinical situations to develop, provide and communicate effective medicines management solutions.  They will lead the development of this highly specialist service and provide expert advice in this area.

Key Result Areas & Performance:

·         To undertake clinical medication review for residents of care homes, identifying areas where medicines use is sub-optimal and put in place solutions to support patients to take their medicines as prescribed.

·         To work with individuals and care home staff to determine the most appropriate way for medicines to be supplied and administered for that resident, allowing the resident to maintain independence wherever possible.

·         To review patients discharged from secondary care, or transferred from another care setting, to proactively identify any necessary changes and/or rectify any unintentional changes before they result in patient harm, and to identify where admissions may have been medicines related.

·         To liaise with relevant healthcare and allied professionals (e.g. community pharmacist, GP, care home staff, hospital staff), particularly when a resident transfers between care settings, to ensure seamless pharmaceutical care and provide specific medication advice where needed and support implementation of safe systems for repeat prescribing and reduction of waste across the healthcare environment

·         Participate in clinical audit and collect appropriate management data.

·         To ensure an individual medicines care plan is developed and implemented for each resident in partnership with a multidisciplinary team including GPs, community pharmacists, the individual and or their carer/family member, care home staff and other specialists as appropriate.

·         To analyse and interpret complex situations and problems involving medicines and devise possible solutions and changes to practice to ensure that ensure that people in care homes receive the same standards of health care as those living in their own home and that evidence based clinical guidelines and practice are applied to the frail older care home population.

·         Provide medicines management expertise and support to patients in the full range of intermediate care and service settings.

·         Provide support to improve adherence  and help patients get the best from their medicines, reducing medicines related admissions (including falls), and promoting appropriate evidence-based and cost effective prescribing. 

·         Liaise with the patient’s community pharmacist, relatives and formal carers as appropriate. Liaise with colleagues across health and social care, where necessary to optimize appropriate patient centred care in respect of medicines.  Reporting recommendations to and discussing with the patient’s hospital specialist and GP, and signposting or referring to other services as appropriate.

·         Provide highly specialist medicines management support to, and training for, nurses and other members of the multi-disciplinary primary care team caring for patients with chronic diseases/long term conditions in the community and hospital setting where necessary, including specialist and Community nurses, and other clinicians as needed..

·         Provide highly specialist medicines advice and training to patients, carers, and care home staff on medicines related issues in older people.

·         To develop protocols in collaboration with key stakeholders as necessary to support these initiatives.

·         To supervise the role of nominated pharmacy technicians and or band 7 pharmacists to ensure the delivery of quality improvement and where appropriate, designated prescribing workstreams within the care home or GP practice setting.

Service Development

·         To contribute to developing, implementing and monitoring new systems for Lewisham Integrated Medicines Optimisation Services across care homes with the desired outcome of improving medicines management for vulnerable (and older) patients with complex medicines management needs to contribute to reducing medicines related readmissions to hospital.

·         To work with the hospital admitting teams and colleagues from primary care to determine previous medication issues and therefore plan patient requirements to optimise medicines management in all care settings.

·         To proactively introduce and implement new/revised policies and guidelines to improve medicines optimisation across primary/ secondary care interface and into the general practice setting

·         To obtain feedback on electronic discharge related information to ensure continuing improvement of communications around medicines and associated information on discharge from hospital..

·         To provide training regarding medication related issues and good practice concerning systems and processes for managing medicines to pharmacy colleagues, nursing and medical staff, ranging from one to one communications to more formal presentations in order to promote medicines optimisation services and practice.

·         To initiate action related to improving the use of medicines for better outcomes and reducing medicines waste across the primary/ secondary care interface and if needed, within the general practice setting

·         To support care home staff to implement recommendations from the NICE guidance for Managing Medicines in Care Homes.

·         To support care home staff to develop a robust process for identifying, reporting, reviewing and learning from medicines errors involving residents.

·         To provide operational and clinical support to medicines optimisation developments and prescribing initiatives and objectives as dictated by the CCG, Trust, and where required, GP practice. d.

·         To plan action to continuously improve the quality of services provided within the Pharmacy department and to ensure a quality improvement approach is taken to medication optimisation throughout the Trust.

·         To facilitate the expansion and continual promotion of the use of patients own drugs in collaboration with primary care.

·         To work closely with band 7 pharmacists where needed to promote and embed the role of a pharmacist either in the care home or GP practice setting.

·         To evaluate with the Lead Pharmacist and Principal Pharmacist for Community Services & LIMOS, outcome measures associated with the Lewisham Integrated Medicines Optimisation Service and the resource requirements for extending the service to other areas or patient cohorts as dictated by Trust, departmental and service objectives.