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Clinical Services

Clinical Pharmacy teams support patients to get the most out of their medicines working as part of an effective multidisciplinary team. We promote best use of medicines, minimise side effects and improve patient safety. Right Medicine, Right Patient, Right Time

Our Clinical Pharmacy Service operates on the majority of wards across the Trust. Our specialist and dedicated clinical pharmacy ward teams consist of trained clinical pharmacists, many of whom are prescribers, and pharmacy technicians. We provide services that include:

Medicines Reconciliation

Ensuring medicines are right when a patient transfers from one care setting to another, most commonly this is from home to hospital.

  • To support this process we ask patients to bring their own medicines into hospital with them. In addition, the teams have access to the patient's Summary Care Record to obtain further information from Primary Care of the patient's current medication. This enables us to get a more accurate picture of what medicines are being taken.

Medicines Optimisation

A holistic review of a patients' medication. This includes:

  • Supporting patients' understanding of their medicines through counselling and use of patient information resources
  • Ensuring the medication and / or the device a patient uses to administer medication is appropriate to their individual needs
  • Assessing and addressing barriers to medicines adherence (compliance)
  • Making a specialist contribution to the multi-disciplinary team by providing essential medicines expertise to optimise patient care (this includes being an integral part of consultant-led ward rounds)
  • Specialist pharmacists are involved in treatment decision-making and, as independent prescribers, can prescribe appropriate medication.

Transfer of Care

Towards the end of a patients stay we will help plan and prepare for transfer home or to another care setting. This will involve effective communication with the multi-disciplinary ward team, the patients GP and community pharmacy.

The teams also offer education, training, advice, and promotes the safe and effective use of medicines for the medical and nursing staff on the ward.