Advanced Clinical Practitioner (Urgent Care)
This role provides post holders the opportunity to work across our hospital at home services including our virtual ward, urgent care wrap around service as well as assessing undifferentiated patients. The role will provide post holders with opportunities to develop their experience of urgent and primary care as part of a multidisciplinary team whilst supported by our clinical leads. GPN is an innovative patient-focused organisation seeking to support patients to be cared for at home whenever possible.
Main duties of the job
The post holder will be practising in a highly autonomous manner as an advanced clinical practitioner (ACP). This will encompass the skills of history taking, extended assessment, examination, diagnosis and treatment within an agreed extended scope of practice. Providing definitive care without requirement for supervision. Where patients require further input undertake appropriate referrals. The post holder will be a highly experienced independent senior clinician with excellent interpersonal and communication skills and clinical attributes, enabling them to provide expert clinical and professional support to other clinicians and staff.
Provide support, advice and supervision of more junior registered and unregistered staff within the service.
About us
Our vision: To provide the patients of Greater Peterborough with high quality, sustainable healthcare that supports them to stay well and at home for as long as possible.
We are an ambitious at scale primary care organisation with a passion for integration and innovation.
We provide:
* Enhanced evening and weekend access to General Practice.
* Deliver at scale services to improve the health and wellbeing of the populations we serve.
* Home visiting and community services.
* Virtual ward services.
* Advice to ambulance crews to help patients remain at home or to see the most appropriate secondary care team.
* Recruitment, induction and support of workforce through a team dedicated to supporting Primary Care Networks and hosting of the Cambridgeshire & Peterborough Training Hub.
* To attract innovation and investment into primary care.
* To be dynamic always seeking out new opportunities.
* To be the primary care provider at scale - supporting delivery of services at place level that benefits our patients and members.
* To engage our clinical community identifying local clinical leaders to drive service redesign and delivery across our place.
* To face challenges head on, working collaboratively to deliver solutions.
Job responsibilities
1. Clinical/patient care
To deliver and participate in the clinical care of patients working as a highly autonomous practitioner.
To ensure that every patient receives specialised advice and appropriate management to facilitate a safe discharge, transfer or admission as required.
Provide a level of advanced and comprehensive assessment based on a specialist body of knowledge, with a focus on assessing and managing risk.
Direct responsibility for the management of patients within own case load and supervision /development of junior members of the multidisciplinary team.
To appropriately assess, examine, investigate, diagnose and treat patients, resulting in the safe management, appropriate referral or discharge of patients.
To gain collateral history for patients to ensure appropriate management decisions are taken, this includes accessing summary care records.
To manage patient expectations using highly developed communication skills, recognising that many patients will have chronic conditions that should be managed within primary care. This communication will often involve conflict due to unrealistic expectations and that managing these expectations will require delivery of a contentious message. To work in an environment that is high pressured, with multiple competing priorities, caring for patients from a range of backgrounds and conditions.
To contribute to the development and improvement of systems, policies and processes that facilitate patient care.
Maintain own clinical development by keeping abreast of new treatments and technologies within primary, acute and emergency care.
To improve the quality of the patient experience by identifying and meeting the individual clinical needs of patients.
Where appropriate to their presenting circumstances, to rigorously review all aspects of the patients plan of care and identify and address issues that cannot wait for the patient to be reviewed by their own GP.
Contribute to the review and development of integrated care pathways and clinical guidelines to ensure a standardised approach.
Practice with confidence and competence within professional bodies guidelines (e.g. NMC, HCPC).
To ensure that accurate documentation and records of patient care are kept.
To provide expert advice on patient care to the healthcare team taking into account all aspects of clinical governance, and act as a specialist resource within the team.
Ability to adapt expert clinical knowledge and skills to different clinical settings and influence service delivery and patient care.
To prescribe safely and effectively as a non-medical prescriber in accordance with relevant guidelines and within the individual's scope of professional competence, to ensure all prescribing practice offers best value for money to the health system.
Actively implement effective systems and processes for infection control management and relevant audit within their clinical area.
To be a conscientious, confident and competent practitioner who works within their own scope of professional practice.
2. Management and Leadership
Support the delivery of the service KPIs and play an active part in clinical governance, developing and leading on action plans.
Lead and develop an area of responsibility related to advanced clinical practice or service development.
To co-ordinate and provide leadership for the non-medical teams.
Deliver the highest level of interpersonal and communication skills and be actively involved in the development of effective communication strategies with other members of the multidisciplinary team. This will include discussions with patients around sensitive information and difficult conversations with patients and relatives.
Participate in the development of a specialist service and act as a change agent, where necessary leading staff and facilitating the change process whilst encouraging others to be innovative and adaptable in the approach to change including development of new services.
To act as a champion for the team, proactively liaising with external and internal stakeholders advocating advanced practice provision that is effective and responsive and that patients and clinicians experience a high standard of communication care and continuity.
To be an effective, competent and confident role-model / clinician and to champion the ACP role to other members of the team.
To act as a role model for infection control practice, nutritional standards, medicines management and falls prevention, ensuring best practice in these areas is intrinsic to care delivery.
To develop evidence-based policies and procedures specifically required by the team.
To develop clinical competencies for staff working within the team.
To develop and maintain effective communication with the multidisciplinary team to ensure high standards of care.
To work collaboratively and strategically with representatives of other clinical areas, disciplines and services to provide a seamless pathway of care.
Participate in the recruitment, selection and retention of staff.
To be conversant with all policies and procedures and ensure they are correctly implemented.
Participate in business planning and the development of financial bids for service development.
3. Education and Training
To help identify, plan and implement goals for clinical development of staff working within the service, monitor the development of advanced skills within the team.
To develop and maintain a positive learning environment for the team by providing support, ensuring developmental requirements are addressed.
To support the provision of clinical supervision and provide the opportunity to reflect and discuss areas of practice.
To plan, implement and participate in teaching programmes for nursing, medical and allied health professional staff of all grades.
To maintain close links with local Universities and to participate in the development and delivery of new and established specialist practice programmes.
4. Audit and Research
Contribute and at times lead the development of multidisciplinary research and clinical audit in the service and adjacent assessment areas, implementing effective and evidence-based practice.
Exhibit advanced research and audit skills and provide support and appropriate implementation strategies for changes in clinical practice.
Ensure the results of audit and research conducted by the team are disseminated.
To share best practice; through publications and attendance/presentation opportunities at conference level.
5. Resource Management
To apply sound financial evaluation to proposed service developments.
Support junior nursing, AHP and medical staff to manage their workload.
Work as a member of the multidisciplinary team, sharing in the responsibility for the provision of 7 day care.
Promote and adhere to the principles and practice of clinical governance.
Responsible on a shift by shift basis for the advanced clinical practitioner management of all patients within the service.
Demonstrate effective multidisciplinary team working and acknowledge the role of individual team members, ensuring that expertise is seen as a resource within the team.
Utilise a developed knowledge of vulnerable adult safeguarding procedures.
Support trainee, new and experienced ACPs to manage their workload.
To ensure all prescribing practice offers best value for money to the health system, that medications classed as general sale and pharmacy items are not provided to patients.
To ensure appropriate use and care of high value clinical equipment such as portable ultrasound equipment.
To ensure that systems are in place to manage, reduce and prevent clinical risk to self and others within acute services.
To assist in the assessment and management of risk in line with the trust standard and alongside the operational management team by ensuring adverse incidents are reported, investigated and utilised to develop and open culture of learning from risk.
Share lessons learned from significant events.
To monitor incidents highlighted by members of the team and communicate to appropriate areas to address risk issues.
Promote best practice in health & safety, utilising organisational policies.
All employees are subject to the requirements of the data protection act and must maintain strict confidentiality in respect of patients and staff records.
All employees have a responsibility under the organisations health and safety policy, to be aware of and conform to the policy, ensuring all health and safety rules are adhered to and ensuring that all accidents, incidents, near misses, damages and irregularities are documented and reported to a manager in accordance with policy.
This job description is not intended to be an exhaustive list of duties and it may be reviewed and altered in the light of changed service needs and developments after discussion with the post holder.
Person Specification
Qualifications
* Relevant registered professional qualification (eg NMC/HCPC)
* MSc in relevant field which includes
* Assessment, diagnosis, referral and discharge
* Assessing and managing risk
* Critical thinking and analytical skills
* Decision making/clinical judgement and problem solving
* Higher levels of autonomy
* Developing therapeutic interventions to improve service user outcomes
* Advanced psychomotor skills
* Higher level communication skills
* Managing complexity
* Non-medical prescribing (or willingness to gain)
* Driving licence
* Recognised teaching qualification
* Recognised leadership qualification
* Professional doctorate
* Royal College Credentialled ACP (or working towards)
* ALS
* ePLS
Experience
* Significant urgent/acute/primary care experience with experience working as a competent proficient fully autonomous practitioner within a relevant environment such as emergency care setting.
* Established Autonomous Nurse Practitioner/Specialist Paramedic in Primary Care/Unscheduled Care.
* Proven experience of utilising expert diagnostic and clinical skills to provide autonomous unscheduled medical care and management of patients presenting with undifferentiated and undiagnosed conditions.
* Specialist knowledge in clinical reasoning, history taking, physical examination, diagnostic skills and treatment.
* Evidence of ability and knowledge on how to undertake audit and feedback.
* Clear understanding of urgent and emergency care performance targets and ability to identify opportunities to improve service delivery.
* Experience of working as an autonomous practitioner in out of hours primary care.
* Relevant experience of service transformation.
* Evidence of involvement in primary research.
* Evidence of presenting at local/national levels.
Skills
* Excellent communication skills: interpersonal, written and verbal.
* Confidence to adapt to an evolving and changing service.
* Proven leadership skills, with a vision to work with others.
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.
£56 an hour uplift of 15% Saturdays, 20% Sundays/Bank Holidays.
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