Bank staff
Waltham Forest GP Federated
Job title: Clinical Pharmacist Independent Prescriber for DOAC service
We have an exciting opportunity for Bank staff - Part time for clinics across four different broughs:
Waltham Forest
Tower Hamlets
Havering
Newham
Location: Primary Care Hubs and Community Settings (with optional home visits)
Hours: Bank Shifts
Reports to: Clinical Lead, Anticoagulation Service
Responsible to: Service Manager / Lead Pharmacist / Clinical Governance Lead
Base: Across Borough or Multi-Borough (as required)
Bank staff: Pay rate to be confirmed depending upon experience
Job Purpose:
Waltham Forest Federated GP Network are supporting the Primary Care Networks across the borough to recruit Clinical Pharmacists
The Clinical Pharmacist will be an independent prescriber and will have a key role in supporting delivery of the new Network Contract DES Service specifications.
Pharmacists have a vital role to play in the area of anticoagulation. There are many pharmacist counselling points associated with the dispensing of DOAC, including dosage times, scheduling and administration recommendations.
Pharmacists are Ideally placed to monitor patients for signs of bleeding – including any unexplained bruising. Pharmacists can also advise on the prescribing of concomitant medication that may interact with the DOAC and place the patient at risk, and they can also give appropriate advice and offer alternatives In relation to over the counter sales of NSAIDS.
The Service Clinician— will be delivering safe, effective, and patient-centered care
The post holder will contribute to the delivery of a comprehensive Warfarin Monitoring Service and Direct Oral Anticoagulant (DOAC) Initiation and Review Service, operating across primary care hubs, GP practices, and community settings. Some staff will also undertake home visits for patients who are unable to attend clinic appointments due to mobility or health constraints.
This flexible and dynamic role involves close collaboration with GPs, pharmacists, nurses, and administrative colleagues to ensure continuity of care, safe prescribing, and robust follow-up. The clinician will be responsible for maintaining high standards of clinical governance, supporting quality improvement initiatives, and helping to develop and expand the service.
The service’s overarching aim is to ensure all patients prescribed anticoagulants receive timely, accurate, and evidence-based care, minimising risk and optimising therapeutic outcomes
- Provide specialist expertise in the use of medicines while helping to address both the public health and social care needs of patients in the network.
- Provide leadership on person centred medicines optimisation (including ensuring prescribers in the practice conserve antibiotics in line with local antimicrobial stewardship guidance) and quality improvement, while contributing to the quality and outcomes framework and enhanced services.
- Through structured medication reviews, support patients to take their medications to get the best from them, reduce waste and promote self-care.
- Support further integration of general practice with the wider healthcare teams (including community and hospital pharmacy) to help improve patient outcomes, ensure better access to healthcare and help manage general practice workload.
- Develop relationships and work closely with other pharmacists across networks and the wider health system.
- Take a central role in the clinical aspects of shared care protocols, clinical research with medicines, liaison with specialist pharmacists (including mental health and reduction of inappropriate antipsychotic use in people with learning difficulties) and anticoagulation.
2. Key Responsibilities
2.1 Clinical Duties
Warfarin Monitoring and Management
- Perform point-of-care (POC) INR testing in clinic settings or during home visits (for those in the home-visiting role).
- Record and interpret INR results accurately, following local or national dosing protocols.
- Adjust Warfarin doses under approved protocols and within the clinician’s professional scope of practice.
- Communicate INR results and dosing changes promptly to patients, carers, and GPs.
- Escalate out-of-range INR results, bleeding risks, or potential adverse events to the Clinical Lead or prescribing clinician.
- Support patient adherence, education, and follow-up scheduling.
DOAC Initiation and Ongoing Review
- Conduct baseline clinical assessments prior to DOAC initiation, including renal and hepatic function review, drug interactions, and clinical suitability checks.
- Educate patients and carers about DOACs, including how to take medication safely, recognition of side effects, and adherence strategies.
- Review existing DOAC patients to ensure ongoing appropriateness of therapy, correct dosing, and safe monitoring intervals.
- Record all interventions, test results, and recommendations in the clinical system (e.g. INRstar, EMIS, or SystmOne).
- Identify and escalate any issues requiring prescriber intervention (e.g. declining renal function, new contraindications, or potential drug interactions).
Patient Care and Communication
- Deliver compassionate, patient-centred care with an emphasis on education and empowerment.
- Use clear communication tailored to the patient’s understanding, language, and cultural needs.
- Support self-management and encourage patients to take an active role in their anticoagulation therapy.
- Coordinate care with GP practices, community services, and hospital anticoagulation clinics to maintain continuity.
Clinical Safety and Governance
- Maintain meticulous and contemporaneous records, ensuring compliance with data protection regulations and information governance standards.
- Adhere to local clinical governance frameworks, ensuring all activity aligns with agreed protocols and best practice.
- Report adverse drug reactions, significant events, and near-misses through the appropriate reporting mechanisms.
- Ensure equipment calibration, maintenance, and infection control procedures are consistently upheld.
- Participate in clinical audit and contribute to quality improvement cycles focused on safety and effectiveness.
3. Service Development and Quality Improvement
- Support the ongoing development of the Anticoagulation Service in line with national guidance (e.g. NICE, BSH, MHRA).
- Work with the Clinical Lead to design, test, and implement new care pathways or digital solutions that enhance patient care and efficiency.
- Contribute to audits such as Time in Therapeutic Range (TTR) analysis, patient satisfaction surveys, and adverse event reviews.
- Help identify and address service gaps, risks, or inefficiencies through proactive feedback and innovation.
- Participate in regular multidisciplinary meetings to discuss complex cases and review clinical data.
- Promote best practice in anticoagulation and ensure the service remains evidence-based and patient-focused.
4. Teamworking and Collaboration
- Collaborate effectively with the multidisciplinary team, including GPs, nurses, pharmacists, HCAs, and administrative staff.
- Work across multiple primary care hubs or boroughs, sharing expertise and ensuring consistency in service delivery.
- Attend regular team meetings, contributing to clinical discussions and service improvement planning.
- Provide mentorship and informal training for new or junior staff within the anticoagulation team.
- Liaise with secondary care anticoagulation clinics, ensuring smooth transitions for newly discharged patients or complex cases.
5. Professional Standards and Governance
- Maintain appropriate professional registration (e.g. NMC, GPhC) and comply with respective codes of conduct and scope of practice.
- For HCAs, work within clearly defined competency frameworks under appropriate supervision.
- Participate in annual appraisals, clinical supervision, and personal development planning.
- Undertake mandatory and role-specific training, ensuring competence in clinical governance, safeguarding, and infection prevention.
- Uphold patient confidentiality at all times in compliance with GDPR and information governance standards.
- Contribute to clinical governance structures, including participation in root cause analyses and incident reviews.
6. Home Visiting (Where Applicable)
- Provide safe and professional anticoagulation monitoring services to housebound patients.
- Manage portable INR testing devices and supplies safely, ensuring equipment integrity and infection control standards.
- Follow lone working and risk assessment policies to ensure personal and patient safety.
- Document outcomes immediately after visits and communicate findings to the wider team.
- Treat patients and carers with respect and sensitivity within their home environment.
Note: Not all staff will undertake home visits. Allocation will depend on individual contracts and local service configuration.
7. Flexible Working and Mobility
- Work flexibly across hubs, boroughs, or practices according to service demand.
- Participate in extended hours or weekend clinics if required to support patient access.
- Be adaptable to new models of care, including digital and virtual consultations.
- Provide cover for colleagues during absences to ensure service continuity.
8. Leadership and Support of the Clinical Lead
- Support the Clinical Lead in maintaining a safe, effective, and high-quality anticoagulation service.
- Assist with implementing quality improvement initiatives and clinical governance actions.
- Provide feedback from frontline service delivery to inform leadership decisions and strategic planning.
- Represent the service professionally at local or borough-level meetings when delegated.
9. Data, Systems, and Record Management
- Use clinical systems (e.g. INRstar, EMIS, SystmOne) to record results, doses, and patient communications accurately.
- Ensure data integrity and contribute to regular audits of record quality.
- Support collection and reporting of performance indicators, such as number of patients reviewed, INR control, and safety incidents.
- Comply with data security and confidentiality standards at all times.
10. Education, Training, and Patient Empowerment
- Deliver patient education regarding Warfarin and DOAC therapy, including dietary guidance, side effects, and red-flag symptoms.
- Provide written and verbal advice to support medication adherence and lifestyle choices.
- Participate in staff training, peer review, and clinical updates to ensure continuous learning.
- Keep up to date with current anticoagulation evidence, national standards, and device innovations.
- Support or deliver internal training sessions for new team members or students under supervision.
11. Equality, Diversity, and Inclusion
- Provide equitable and accessible care to all patients, respecting cultural and linguistic diversity.
- Adapt communication and educational materials to meet varying literacy levels and patient needs.
- Promote inclusion within the team and uphold the organisation’s equality and diversity policies.
12. Health, Safety, and Infection Control
- Follow infection prevention and control procedures at all times, both in clinics and home visits.
- Maintain safe disposal of sharps and clinical waste according to policy.
- Conduct dynamic risk assessments for patient interactions and report safety concerns promptly.
Ensure personal safety through adherence to lone working and incident reporting procedures
PERSON SPECIFICATION
Education/ Qualifications
Criteria
Essential
Qualifications
Independent Prescriber Registered Pharmacist (GPhC)
Pharmacist: Independent prescriber
Experience
Experience in clinical or patient-facing roles within primary or community care.
Skills
Excellent communication, IT literacy, accuracy, ability to follow clinical protocols.
Knowledge
Understanding of anticoagulant therapy, medicines management, and patient safety principles.
Personal Attributes
Compassionate, organised, proactive, flexible, and team-oriented.
Desirable
Additional anticoagulation qualification (e.g. BSH competency certificate, INRstar accreditation).
Direct experience in anticoagulation management or chronic disease monitoring.
Competence in interpreting INR results and making dose adjustments within protocol.
Knowledge of NICE and BSH guidelines, and local anticoagulation pathways.
Car driver with access to own transport (for home-visiting roles).
Job Types: Part-time, Zero hours contract
Pay: £30.00 per hour
Licence/Certification:
Work Location: In person
