Some of the services provided by clinical pharmacists within the Trust:

Prescription Monitoring

Clinical pharmacists spend a significant amount of their time on the wards and inpatient units reviewing prescription charts to help identify and resolve potential problems. For example:

• Medication errors
• Drug interactions
• Side-effects and adverse drug reactions

Prescribing advice to medical staff, including :

• Choice of medicine and dose
• Method/route of administration
• Possible side-effects
• Interactions with other medication
• Pharmacokinetic monitoring
• Acute pain management (as part of the acute pain team)
• Palliative care
• Parenteral nutrition

Drug History Taking

The clinical pharmacist collates information on all the medication a patient is taking, including non-prescription medicines, and assesses patient compliance with prescribed treatment.

Patient Counselling on Medicines

The clinical pharmacist helps the patient to understand how their medicines should be taken and answer any questions that they may have. The pharmacist can also supply aids to help patients take their medicines correctly.

Answering Medicines Information Queries

The hospital has a dedicated drug information centre where clinical pharmacists can answer more complicated queries and provide references for prescribers. It also runs a telephone helpline for patients who would like further information on medicines supplied by the hospital

Treatment Guidelines

Clinical pharmacists collaborate with other health care professionals to produce guidelines on the most appropriate use of medicines.

Medicines Management

Clinical pharmacists work closely with budget holders and senior clinicians to ensure that scarce NHS resources for medicines are used efficiently.

Anticoagulant Clinics

In collaboration with the Haematology Department, three of the Trust's clinical pharmacists contribute to the provision of anticoagulant clinics by helping to review and dose patients with oral anticoagulants.

Clinical Audit

Clinical pharmacists contribute to the Trust's annual audit program by undertaking medicines use evaluations and by collaborating on a wide variety of multidisciplinary audits.

Education and Training of Staff

Clinical pharmacists contribute to the education and training of undergraduate and pre-registration students and postgraduate staff within pharmacy and from other health care disciplines.

Collaboration with General Practitioners

More recently clinical pharmacists based at the hospital have been working in local primary care health centres helping GPs to ensure that their patients receive the most appropriate treatment with medicines