Working as a senior clinical pharmacist at the ROH has immensely improved my knowledge,
experience and skills. This job role has allowed me to clinically review intensively critical patients,
requiring highly specialised medications or doses, where limited information is available, hence
requiring me to research using studies, trials, guidance and provide evidence-based knowledge to
MDTs and consultants. As part of the Women’s & Children’s division committee, through attending
monthly meetings with clinical directors, chairs of the D&T committee, financial leads, antimicrobial
leads, lead nurses and speciality consultants, I have been involved with not only creating SOPs/
guidelines and policies, but also approving these for use in the four hospitals as part of the trust. I
am also involved in consultant meetings on the neonatal unit, feeding meetings and directorate
meetings on the ward, allowing me to input into prescribing, financial decisions and medicines
management issues and incidents.
Directorate work is a role I have been fully involved with as part of this band 8 role. I am regularly
updating the trusts neonatal doses policy for prescribers and other healthcare professionals to use,
this requires constructing monographs on drugs for preterm and term neonates, providing advice on
dosing, preparations, side-effects and more specialist information i.e., rates and concentrations of
infusions, sodium content, prescribing examples and further ensuring these medications are
available to use alongside the monograph. Through my time on the neonatal unit, I have undertaken
multiple reviews and added new drugs to the formulary for use on the neonatal unit. This has been
carried out through submitting applications and presenting the benefits of these agents (using
various studies/ trial data and current usage and guidance (where present)), costs-effectiveness,
where this drug will be used in current practice and further creating monographs and updating the
doses or other related policies. These have been presented and approved by initially the ward
consultants and then the medicines optimisation group and D+T committee for the trust. In addition
to this, I have also ensured any new drugs added to the formulary have been added on to the
infusion pump devices, through liaising with Baxter pumps and ensuring new guardrails are in place
for the nurses to use, ultimately ensuring patient safety.
I have been able to work effectively under pressure, due to dealing with various medicines
discontinuations and stock issues, whilst ensuring to provide suitable alternatives appropriate for
use in preterm neonates, ensuring to involve the ward management team, nurses and consultants
when making these decisions. This has also included liaising with the procurement team and other
specialist teams such as infections control to resolve urgent matters, whilst also carrying out clinical
duties on the ward. This is a vital skill which will be beneficial as a Specialist clinical pharmacist –
community services, due to the evermore increasing workload, hence my ability to work well under
pressure, whilst paying attention to detail will be very beneficial to this role.
Outpatient clinics for neonates during the RSV season have also been managed by myself and an
advanced neonatal nursing practitioner. I have ensured to identify high risk babies requiring
Palivizumab during this season and ensuring blueteq approval (high cost drug) have been obtained. I
have further ensured the babies are booked on to the correct weeks clinic and have carried out the
process of stock procurement through to stock reconciliation myself. This has improved my
organisational skills and the ability to work well as part of a team in a new setting and department.

Teaching and training have been a fundamental part of my role as a senior clinical pharmacist, this
includes providing teaching to junior pharmacists, medical students, new speciality doctors on the
ward and neonatal nurses and advanced practitioners. I have created and presented teaching
sessions to the new doctors who have started on the ward, including one on one sessions on
medicines management, and prescribing. I have also provided teaching to University of Salford
students carrying out the prescribing course in April, prior to their exams. I have also carried out
training for band 7 specialist pharmacists on the ward, training them up to cover the ward where
necessary and have prepared a training pack and ensured all competencies have been met before
signing them off.
As there is no band 8 senior pharmacist present on the maternity wards, I regularly oversee any
issues the band 6/7 pharmacists may have, provide guidance on policies, prescribing, training, and
teaching to the pharmacists and doctors. I also ensure the Women’s & Children’s pharmacists work
as a team to provide the most optimal care, as the mother may still be on postnatal ward and baby
on the neonatal unit, hence proper and effective communication between these teams ensures
effective medicines management and ensuring medicines prescribed for the mother are safe and
appropriate to use, especially if the mother is breast-feeding. As well as this, a new electronic system
(Badgernet) is currently being rolled out for maternity and neonatal wards, I have been involved
with creating and approving SOPs for this, as well as ensuring staff are provided training through
liaising with the Badgernet team. I also ensure any discharges carried out are clear and sent to the
GP as soon as the baby is discharged, to avoid any delay in medication reconciliation in primary care
and allowing the GP time to prescribe the medications and the community pharmacy to order the
medications, due to these medications commonly being unlicensed/ specials.
Any incidents taking place on the unit, in particular related to medications are always received by
myself and further root cause analysis/ investigations are carried out and action plans are prepared
by myself. My actions plans are combined with those from other health care professionals, i.e.
doctors/ nurses and changes are therefore made, i.e. changes in the policy to allow safer and more
effective prescribing to prevent reoccurrence of errors, training of nursing staff, providing teaching
to doctors in a specific area/ on a specific medication.
I have also managed the wider pharmacy team through admin roles, by completing the weekly
pharmacist rota for all pharmacists and ensuring ward cover in the hospital. Ensuring that I am
punctual to work to deal with any sickness or emergencies that may occur first thing in the morning
and providing cover or changing the rota according to this and relaying the message to the line
managers. I also provide senior leadership on late night working at the hospital, one day a week,
weekend working and ensure to aid and assist junior pharmacists if they require more support, as I
have experience in all specialities in the hospital and have built good relationships and rapport with
ward staff and consultants through my time at the hospital.
Working as a band 7 specialist clinical pharmacist at the ROH allowed me to further improve
immensely upon the skills and knowledge obtained as a band 6 clinical pharmacist. This is through
working on specialised wards such as ICU, NICU, haematology, maternity wards and AMU. I was able
to use the primary knowledge obtained from my band 6 rotations and advance upon this through
working in these specialist areas, whilst also studying and advancing through my clinical pharmacy
diploma. I have been able to ensure high quality care in the provision of treatment with medicines,
through maximising efficiency in use of resources, more so advanced and specialist resources such
as chemotherapy protocols, ICU national groups, UKCPA and more specialist trust policies, NPPG and
bedside guidelines for paediatrics and neonates and guidelines for patients who require imminent
management i.e withdrawal symptoms, meningitis, COVID-19, PE and providing advice in a timely
manner on medications to use as per trust policy and dosing advice based on various patient factors.
Hence, through these experiences I have improved upon my time management and prioritisation
skills and the ability to provide evidence-based advice to promote patient care as part of an MDT. As
part of this role, I have become more involved in ward rounds and MDT meetings and attend weekly
meetings and daily ward rounds when working on these specialist wards. This has allowed me to
obtain more knowledge on patients conditions and provide input in to prescribing decisions. I have
continued to provide prescribers evidence-based medication advice, as well as advice on unlicensed
medications or highly specialised and costly medications, especially for ICU and NICU patients.
Effective medicines management and promoting economic use of medicines is also carried out
through ensuring high-cost medications have blueteq approval if necessary, these are also
highlighted to the homecare and high cost drugs team. I also promote economic use of medicines
through conducting regular ward stock list reviews and promoting the use of patients own drugs
where appropriate. I ensure to implement current guidelines when dealing with both patient care
and professional working standards. Therapeutic drug monitoring is an area I have obtained a lot of
knowledge in and have further relayed this knowledge when training other pharmacists and
providing teaching sessions to junior doctors. Through this role I have been very much involved in
training other pharmacists, preregistration pharmacists and providing monthly teaching sessions to
medical students and junior doctors. I have undertaken the responsibility of updating policies and
guidelines and providing advice on the addition of new drugs into policies, hence researching and
providing a pharmacist review on suitability in current guidance, cost-effectiveness and further
presenting this information to senior pharmacists and specialist consultants. I have also been able to
carry out more leadership roles such as leading medical teams and initiating pharmacist cover and
ward dispensing on the maternity wards, as well as dealing with sickness and providing cover,
amending rotas and creating rotas for various religious holidays as well as bank holidays and
weekends.

No

Reputable and recommended by other pharmacists.

Manufacturer discontinued chlorhexidine solution used to sterilise skin on preterm neonates prior to insertion of invasive lines. Used NPPG group and studies to identify appropriate alternative, other sites were not aware of the discontinuation so made them aware as well. Was able to find an unlicensed product and order in with contingency plan and obtain rapid approval from consultants and chief pharmacist, due to good working relationship. Prevented any delay and harm to neonates. Too high of strength of chlorhexidine or inappropriate excipients can cause burns on neonatal skin due to thin skin.

Sets out the ruling and guidance on the manufacture and supply of medications. Splits them into three categories, POM, P and GSL. Also deals with licensing i.e. wholesale licensing.
Governs control of medicines for human and veterinary use and who can prescribe certain medications, restrictions on prescribing based upon healthcare professional.

Check what the medication is, indication. What is need for the prescription, how urgently is it required. Check the patients background, history and who is asking to prescribe it.
Check if it meets all clinical and legal requirements and whether it is appropriate for the patient clinically.
If patient was on this medication before, check using other sources the dose, compliance and still check appropriateness of prescription.
Do not prescribe until certain that this medication is required for this patient and there is a plan for reviewing and monitoring and is clinically appropriate and you have the information required to provide. May need to check lab results, recent weights, other medications patient is on, other conditions patient has etc.

Review the incident or complaint, speak to other people involved. Reflect upon this and how this could have been avoided, carry out RCA and future learning to prevent this from occurring again. May need escalation to line manager as well.

It is how services are reviewed and continuously improve the services provided and ensure they meet the right standards and are of high quality. Involved quality improvement, quality assurance and risk and incident management. Also ensuring KPIs are being met, overall making sure and creating a safe and high quality environment where clinical excellence will flourish.

Parents for a baby wanted a specific brand of baby feed, advised them that this was not part of the formulary so would not be available. They were very distressed and wanted that specific one. I sat down with them and explained the differences between formualry feed and the one they required and that for their preterm neonate the formulary preterm formula would be more appropriate as it would give the baby more nutrients, required for the growth. I showed them figures and information and used experience and knowledge and calmly and professionally explained this, they were happy with this and I documented this consultation.