To undertake a comprehensive holistic assessment of patients needs (HNA) at key stages during the illness experience from the point of referral in line with National directives To attend significant outpatient consultations, acting as the patients advocate, communicating complex information with patients and their families To review inpatients admitted with complications related to their disease/treatment, influencingmanagement options and liaising with professionals across primary and secondary care to ensure safe effective discharge from hospital To agree a plan of care in consultation with the patient/family, ensuring a written copy is available for the patient. To attend the weekly cancer multidisciplinary team meeting, contributing to the discussion, providing expert nursing opinion on the patients assessment and care and advocating for the patient and family To screen patients for psychological distress using a recognised tool To be skilled in providing Level 2 psychological support for patients and their carers, referring patient with complex needs to the Macmillan Clinical Psychologist. To routinely discuss diagnosis and prognosis with patient and their family To provide specialist support for patients and their families, ensuring their physical, psychological, social, emotional and spiritual needs are identified and met. To lead on complex communication issues and co-ordinate the patients pathway acting as the main point of contact or responsible for nominating a main point of contact for the patient depending on their individual needs. To identify and met patient/carers specialist informational needs utilising the local Macmillan Information Centre, referring patients to the dedicated Cancer You Tube Channel to support selfmanagement strategies. Supports the development of patient focussed education, including specialist information and advice to self-manage ongoing consequences of treatment. To be skilled in identifying and addressing the palliative care needs of patients and their families, referring patients with complex needs to the Specialist Palliative Care Team To be skilled in identifying AMBER patents working with the multidisciplinary team to agree ceiling ofintervention. To be skilled in identifying the patients Preferred Place of Care at the appropriate point in the illness experience, communicating very sensitive information to patients/carers ensuing they have the opportunity to discuss their choice of where they wish to die where possible. Support the generation of an End of Treatment Summary for patients following each modality of treatment, ensuring their ongoing needs are identified and addressed. To respond to EAU alerts for patients with secondary breast cancer providing specialist information and support, co-ordinating their pathway from the point of admission To lead the development of specialist Health & Wellbeing events for patients living with secondary breast cancer, ensuring they are tailored to meet their individual needs To use advance communication skills to support patients in the development of an Advance Care Plan, identifying their preferences and wishes To initiate proactive telephone support for patients in the palliative stage of their disease, identifying new or progression of symptoms providing specialist advice and support To promote a culture that supports and enables self-management strategies. Utilise patient/carer experience feedback to drive innovation and change. Promote self-management, risk stratifying patients into who can self-manage following education, those who will need guided support to self-mange and those who will require ongoing face-to-face support in order to support people to live with cancer. To adhere to the NMC Code of Professional Conduct and other national regulations To participate in the formal review process and plan future personal development and competencies to be achieved, actively engaging with the learning and development opportunities offered by Macmillan. To act as a specialist resource for healthcare professionals relating to secondary breast cancer, providing expert nursing advice and support To promote collaborative working relationships and effective communication between all members of the breast cancer multidisciplinary team and across different boundaries of care To act as a role model demonstrating high standards of holistic care, providing clinical leadership in secondary breast cancer. To support the development of the Band 6 Macmillan Secondary Breast Cancer Nurse/Support Worker, contributing to the appraisal process and objective setting To become acquainted with the local and regional pathways for patients with secondary breast cancer including knowledge of contact points for referral and advice. Ensure that people affected by cancer are aware that they are interacting with a Macmillan Professional and know the full range of resources and services available through Macmillan. To demonstrate advance practice in planning, implementing and evaluating nursing care, documenting the outcomes of consultations in the hospital notes and on the Somerset database In all aspects of work, challenge and demonstrate an ability to work across organisational and professional boundaries. To identity own personal development needs to work at specialist level and take appropriate action to ensure that these are met To maintain a personal professional profile, demonstrating clear evidence for nursing revalidation Actively engages with Macmillan Cancer Support to contribute expertise and experience and support the Macmillan priorities. Demonstrate specialist skills in conflict resolution and negotiation skills when dealing with difficult or challenging situations To ensure the Macmillan service is development in line with National directives related to cancer care. To collect activity data to demonstrate the effectiveness of the specialist nursing service. To participate in Macmillan Service reviews, completing a SWAT analysis to highlight the effectiveness/challenges of the Macmillan Secondary breast Cancer service To actively seek feedback from patients/carers to inform service developments To lead the development of policies and clinical guidelines to enhance the specialist nursing service in line with national directives To promote the Macmillan Secondary Breast Cancer specialist nursing service through conferences and written papers To influence decisions regarding service delivery through participation in local, regional and national meetings To evaluate the effectiveness of the Macmillan Secondary Breast Cancer CNS service, implementing change to enhance the patient/carer experience To identify areas of practice this may be expanded to promote optimal care and the best outcomes for patients Develop specialist nurse led clinics, undertaking a holistic review of the patients following oncology treatment to support self-management strategies and early identification of recurrence of disease. To act as an independent nurse prescriber To initiate and be actively involved in nursing research/audit To promote best practice ensuring care in evidence based To demonstrate knowledge of the clinical trials available for patients living with secondary breast