Job summary As a clinical expert and is required to have a high clinical profile ensuring the provision of effective and efficient care. They are expected to work as a highly skilled practitioner and to have expert knowledge. They will provide clinical expertise, leadership and guidance within the designated service. The primary focus of the role is to work as an advanced, autonomous practitioner providing patient centred clinical care, encompassing the skills of assessment, examination, diagnosis and treatment of patients. The post is intended to provide improved outcomes for patients by improving timeliness and consistency of care and driving innovation through new models of care and actively participating in research and development. You will be expected to exercise a high degree of personal professional autonomy and make critical judgements to satisfy the expectations and demands of the role, within a defined framework andwill be expected to work at an advanced level within their level of competence and to work flexibly across all areas of the team. Key responsibilities such as providing effective leadership by leading by example, empowering nurses/ AHPs to improve care and participating in strategic planning alongside wider MDT are paramount, as well as undertaking research within the specialist area. Consideration will be given to applicants that have not yet completed full ACP training if already on the pathway towards it. Main duties of the job Offer a high level of Emergency General Surgery (EGS) expertise, providing individualised patient centred care for EGS patients presenting to the Surgical Receiving Unit (SRU) in line with the Trust's values. Practically, this will involve performing patients assessments, arranging/performing investigations as required, formulating and instigating management plans and escalating to senior clinicians as appropriate. Though not exclusively, particular emphasis is placed on patients that are identified as potentially suitable for Same Day Emergency Care (SDEC). Appropriate patients are investigated/monitored/reviewed/treated in an ambulatory fashion on the same day or following days, avoiding unnecessary admissions. The post holder will work autonomously and will be experienced in identifying suitable patients and managing their ongoing care in line with SDEC/ambulatory care principles. Where caseload allows, the post holder will also engage with the assessment and management of non-ambulatory patients admitted to SRU, joining Consultant led ward rounds on SRU and demonstrating responsibility for ongoing patient care. Perform simple procedures under local anaesthetic on SRU, including straightforward abscess drainage, within a structured Abscess drainage under Local Anaesthetic pathway. If required, in-post training and senior support/supervision will be provided depending on post holder's experience and existing skillset. About us Why Work With Us The Surgical Receiving Unit (SRU) is a unit within Torbay Hospital that takes patients directly referred from GPs, patients from the Emergency Department and patients referred directly from clinics. SRU also has a number of patients planned to return to the unit for review following procedures to prevent admission. Specialities including General Surgery, Urology, Orthopaedics, Ophthalmology, Gynaecology, ENT and Max Fax. It is a fast-paced environment where each and every member of the MDT support each other and are valued. The team consists of an ADNPP, Consultants, Matron, Senior Sister, Unit Coordinators, Nurses and Health care support workers. Date posted 22 January 2025 Pay scheme Agenda for change Band Band 8a Salary £50,952 to £57,349 a year per annum Contract Permanent Working pattern Full-time Reference number 388-6910907-NMC Job locations Surgical Receiving Unit (SRU) Lawes Bridge Torquay TQ2 7AA Job description Job responsibilities Communication and working relationships Communication of highly complex information on managing urological conditions including risks and benefits and provide details of alternative options where appropriate. The ACP will communicate highly sensitive and contentious information supporting patients and their carers to make informed decisions about their care and treatment. This will require a high degree of empathy and advanced communication skills to support patients and their families Provide highly specialist advice to GPs and primary health care teams, especially in situations where there are conflicting views or opinions on the best course of action or care e.g. ethical dilemmas Provide support for patients, carers and family members to ensure that advice and information is accessible to them and to promote empowerment, informed choice and self-management Conducting family meetings with patients, families and carers to facilitate open communication and forward planning of care options, giving full regard to patient confidentiality The post holder will be expected to act as a clinical/ professional practice leader, managing their own workload and work across professional, organisational and system boundaries to improve services and develop practice. They will participate in networks, locally, regionally and nationally. The post holder will assess and manage risk and proactively challenge others about risk Participates in recruitment and selection process where appropriate Support patients and relatives through emotional and distressing circumstances, working with terminally ill patients and patients undergoing transplant assessment Co-ordinate care for patients and relatives by communicating closely with different care centres to ensure smooth transition of care between differing hospitals Planning and organisation Implement systems to identify the contribution and demonstration of the impact of advanced level nursing to the healthcare team and the wider health and social care sector Provide support services to other nurses and professional groups on therapeutic interventions, practice and service development Demonstrate leadership in clinical situations which are unfamiliar, complex and unpredictable Plans and organises complex activities, programmes and those requiring formulation adjustment Engage stakeholders both internal to the Trust and also key external partners, using high-level negotiating and influencing skills to develop and improve practice Generate and implement new solutions that will best suit the needs of patients and carers, through thinking laterally about practice Act as a positive role model and provide highly specialist advice and consultancy for multidisciplinary colleagues including colleagues working in the Acute Trust, Primary Care, Social Care, charitable sector and other external agencies Review and monitor standards for best practice contributing towards preparation for performance evaluations Provide clinical supervision to clinicians within the trust Overcoming barriers to understanding using negotiation and persuasion skills Provide expert advice and information to other professionals and agencies to ensure appropriate referral to the service Analytical and judgement Make critical judgements to inform clinical decision-making, recommendations and prescription of treatment, including making referrals to others Use highly complex reasoning skills to provide diagnosis, treatment options and health promotion advice in the area of expertise to patients Manages conflicting views and reconciles professional differences of opinion To recognise and work within the limits of their own competency. To consult and seek advice from the Consultant when appropriate. To take part in the medical review of patients as required Challenge practice standards and influence constructive change Responsibility and accountability Practice autonomously and self-direct their workload, defining their own boundaries of practice within the scope of this job description Have advanced leadership skills to enhance the development of patient pathways to meet national standards and guidelines Represent the Trust and ISU at local, regional, national level, presenting at meetings and conferences as required Responsibility for patients and client care Carry out thorough holistic assessment of patients with specialist care needs, referred to the service, via the ordering/undertaking and interpretation of diagnostic tests Assess patients as an expert clinician and facilitate stepped up care provision where required Provide direct care to patients including using practical nursing skills & procedures, whilst maintaining privacy & dignity and acting as a role model for other members of staff Develop highly specialised programmes of care and provide highly specialised advice regarding care To be familiar with and use a variety of diagnostic, symptom management and patient outcome tools The post holder will have competence in the clinical skills required for the role e.g. prescribing, interpretation of blood results To facilitate discharge planning including effective communication with primary care teams and out of hours services The post holder will be competent at undertaking clinical procedures relevant to the role and be responsible for developing competency frameworks and training to ensure safe and effective care Highly developed physical skills with great degree of accuracy and precision i.e. cannulation, venepuncture, biopsies, ultrasound Policy and service responsibility Proactively lead strategic developments and other activities that monitor and improve the quality of healthcare and the effectiveness of practice Improve clinical practice within the general Surgery services areas Propose policy or service changes, including those that impact beyond own area The post holder will make themselves aware of developments in practice at a national and international level and implement changes that reflect benchmarked best practice Engage in appropriate audit programmes within the service at both individual and systems level. Select and apply valid and reliable approaches and methods which are appropriate to the service user group and act on the findings Continually assess and monitor risk in their own and others practice and challenge others about wider risk factors within the service Use evidence-based practice to underpin clinical guidelines and integrate research into clinical practice Develop, implement and evaluate strategies to advance knowledge and practice Identify national issues, strategies and policies that have an impact on service provision and initiate and implement practice and service improvement Participate in the development of the organisations mission, vision and values and promote a culture of excellence Identify and develop systems to motivate, support and recognise the contributions of others Advocating and contributing to the development of an organisational culture that supports continuous learning and development, is evidence-based and promotes succession planning Support the senior leadership team in delivery of long-term plan forward view priorities for responsive care Support the senior leadership team in delivery of services that meet the needs of the whole person paying particular attention to those with protected characteristics or are vulnerable Responsibility for finance, equipment and other resources Ensure there are systems in place for teams to maximise use of clinical capacity Authorised signatory/ designated budget holder for urology unit and specialist nurses services Assist in the formulation of business cases to ensure adequate, appropriate equipment and staffing Collaborate in the redesign of services to ensure they are organized to meet service user need Personal duty of care in relation to equipment, resources and safe use of equipment used within clinical areas Responsible for the effective and appropriate use of resources and the cost implications As a non-medical prescriber, be aware of cost implications and NICE guidance when prescribing Responsibility for supervision, leadership and management Participate in academic and clinical supervision Continue their own academic development Promote the development of a culture that is conducive to lifelong learning Contributing to the development and implementation of evidence-based protocols, documentation processes, standards, policies and clinical guidelines The post holder will be expected to work alongside the Planned Care nursing education lead to develop and deliver teaching packages that enable expert skills development. Provide specialist input for the education and training of other health care professionals within the Trust Evaluate the impact of training on practice and service provision Develop Specialist Nurses within the department in the utilization of advanced clinical reasoning skills and evidence-based knowledge in the management of patients with highly complex disease and presentations Assessment and mentorship of Specialist nurses who are doing advanced practice modules such as prescribing Support other Specialist nurses in their prescribing confidence and developing skills in conducting skilled nursing interventions and addressing ethical dilemmas Support /lead staff within the trust to provide care appropriate to patient need and support staff to develop required skills and knowledge Information technology and administrative duties To maintain clinical records in line with Trust policy and NMC standards. Implement work and communication systems that ensure clinical teams have access to specialist advice and information using IM&T Introduce systems to provide timely and accurate information to teams. Coach teams to use the information effectively and monitor compliance Job description Job responsibilities Communication and working relationships Communication of highly complex information on managing urological conditions including risks and benefits and provide details of alternative options where appropriate. The ACP will communicate highly sensitive and contentious information supporting patients and their carers to make informed decisions about their care and treatment. This will require a high degree of empathy and advanced communication skills to support patients and their families Provide highly specialist advice to GPs and primary health care teams, especially in situations where there are conflicting views or opinions on the best course of action or care e.g. ethical dilemmas Provide support for patients, carers and family members to ensure that advice and information is accessible to them and to promote empowerment, informed choice and self-management Conducting family meetings with patients, families and carers to facilitate open communication and forward planning of care options, giving full regard to patient confidentiality The post holder will be expected to act as a clinical/ professional practice leader, managing their own workload and work across professional, organisational and system boundaries to improve services and develop practice. They will participate in networks, locally, regionally and nationally. The post holder will assess and manage risk and proactively challenge others about risk Participates in recruitment and selection process where appropriate Support patients and relatives through emotional and distressing circumstances, working with terminally ill patients and patients undergoing transplant assessment Co-ordinate care for patients and relatives by communicating closely with different care centres to ensure smooth transition of care between differing hospitals Planning and organisation Implement systems to identify the contribution and demonstration of the impact of advanced level nursing to the healthcare team and the wider health and social care sector Provide support services to other nurses and professional groups on therapeutic interventions, practice and service development Demonstrate leadership in clinical situations which are unfamiliar, complex and unpredictable Plans and organises complex activities, programmes and those requiring formulation adjustment Engage stakeholders both internal to the Trust and also key external partners, using high-level negotiating and influencing skills to develop and improve practice Generate and implement new solutions that will best suit the needs of patients and carers, through thinking laterally about practice Act as a positive role model and provide highly specialist advice and consultancy for multidisciplinary colleagues including colleagues working in the Acute Trust, Primary Care, Social Care, charitable sector and other external agencies Review and monitor standards for best practice contributing towards preparation for performance evaluations Provide clinical supervision to clinicians within the trust Overcoming barriers to understanding using negotiation and persuasion skills Provide expert advice and information to other professionals and agencies to ensure appropriate referral to the service Analytical and judgement Make critical judgements to inform clinical decision-making, recommendations and prescription of treatment, including making referrals to others Use highly complex reasoning skills to provide diagnosis, treatment options and health promotion advice in the area of expertise to patients Manages conflicting views and reconciles professional differences of opinion To recognise and work within the limits of their own competency. To consult and seek advice from the Consultant when appropriate. To take part in the medical review of patients as required Challenge practice standards and influence constructive change Responsibility and accountability Practice autonomously and self-direct their workload, defining their own boundaries of practice within the scope of this job description Have advanced leadership skills to enhance the development of patient pathways to meet national standards and guidelines Represent the Trust and ISU at local, regional, national level, presenting at meetings and conferences as required Responsibility for patients and client care Carry out thorough holistic assessment of patients with specialist care needs, referred to the service, via the ordering/undertaking and interpretation of diagnostic tests Assess patients as an expert clinician and facilitate stepped up care provision where required Provide direct care to patients including using practical nursing skills & procedures, whilst maintaining privacy & dignity and acting as a role model for other members of staff Develop highly specialised programmes of care and provide highly specialised advice regarding care To be familiar with and use a variety of diagnostic, symptom management and patient outcome tools The post holder will have competence in the clinical skills required for the role e.g. prescribing, interpretation of blood results To facilitate discharge planning including effective communication with primary care teams and out of hours services The post holder will be competent at undertaking clinical procedures relevant to the role and be responsible for developing competency frameworks and training to ensure safe and effective care Highly developed physical skills with great degree of accuracy and precision i.e. cannulation, venepuncture, biopsies, ultrasound Policy and service responsibility Proactively lead strategic developments and other activities that monitor and improve the quality of healthcare and the effectiveness of practice Improve clinical practice within the general Surgery services areas Propose policy or service changes, including those that impact beyond own area The post holder will make themselves aware of developments in practice at a national and international level and implement changes that reflect benchmarked best practice Engage in appropriate audit programmes within the service at both individual and systems level. Select and apply valid and reliable approaches and methods which are appropriate to the service user group and act on the findings Continually assess and monitor risk in their own and others practice and challenge others about wider risk factors within the service Use evidence-based practice to underpin clinical guidelines and integrate research into clinical practice Develop, implement and evaluate strategies to advance knowledge and practice Identify national issues, strategies and policies that have an impact on service provision and initiate and implement practice and service improvement Participate in the development of the organisations mission, vision and values and promote a culture of excellence Identify and develop systems to motivate, support and recognise the contributions of others Advocating and contributing to the development of an organisational culture that supports continuous learning and development, is evidence-based and promotes succession planning Support the senior leadership team in delivery of long-term plan forward view priorities for responsive care Support the senior leadership team in delivery of services that meet the needs of the whole person paying particular attention to those with protected characteristics or are vulnerable Responsibility for finance, equipment and other resources Ensure there are systems in place for teams to maximise use of clinical capacity Authorised signatory/ designated budget holder for urology unit and specialist nurses services Assist in the formulation of business cases to ensure adequate, appropriate equipment and staffing Collaborate in the redesign of services to ensure they are organized to meet service user need Personal duty of care in relation to equipment, resources and safe use of equipment used within clinical areas Responsible for the effective and appropriate use of resources and the cost implications As a non-medical prescriber, be aware of cost implications and NICE guidance when prescribing Responsibility for supervision, leadership and management Participate in academic and clinical supervision Continue their own academic development Promote the development of a culture that is conducive to lifelong learning Contributing to the development and implementation of evidence-based protocols, documentation processes, standards, policies and clinical guidelines The post holder will be expected to work alongside the Planned Care nursing education lead to develop and deliver teaching packages that enable expert skills development. Provide specialist input for the education and training of other health care professionals within the Trust Evaluate the impact of training on practice and service provision Develop Specialist Nurses within the department in the utilization of advanced clinical reasoning skills and evidence-based knowledge in the management of patients with highly complex disease and presentations Assessment and mentorship of Specialist nurses who are doing advanced practice modules such as prescribing Support other Specialist nurses in their prescribing confidence and developing skills in conducting skilled nursing interventions and addressing ethical dilemmas Support /lead staff within the trust to provide care appropriate to patient need and support staff to develop required skills and knowledge Information technology and administrative duties To maintain clinical records in line with Trust policy and NMC standards. Implement work and communication systems that ensure clinical teams have access to specialist advice and information using IM&T Introduce systems to provide timely and accurate information to teams. Coach teams to use the information effectively and monitor compliance Person Specification criteria Essential First level Registered Nurse Education at Masters Level (Advanced Practice or equivalent) Non-medical independent prescriber Desirable Leadership course/ Qualification Working towards Master's Degree Evidence of working autonomously as an Advanced Nurse Practitioner within the speciality Advanced assessment skills Person Specification criteria Essential First level Registered Nurse Education at Masters Level (Advanced Practice or equivalent) Non-medical independent prescriber Desirable Leadership course/ Qualification Working towards Master's Degree Evidence of working autonomously as an Advanced Nurse Practitioner within the speciality Advanced assessment skills Disclosure and Barring Service Check This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions. Certificate of Sponsorship Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab). From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab). UK Registration Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window). Additional information Disclosure and Barring Service Check This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions. Certificate of Sponsorship Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab). From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab). UK Registration Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window). Employer details Employer name Torbay and South Devon NHS Foundation Trust Address Surgical Receiving Unit (SRU) Lawes Bridge Torquay TQ2 7AA Employer's website https://www.torbayandsouthdevon.nhs.uk (Opens in a new tab)