CLINICAL PRACTICE The postholder will: The post holder will practice in compliance with their respective code of professional conduct and within their scope of practice, being responsible and accountable for their decisions, actions and omissions at this level of practice. Demonstrate a critical understanding of their broadened level of responsibility and autonomy and the limits of own competence and professional scope of practice, including when working with complexity, risk, uncertainty, and incomplete information. Act on professional judgement about when to seek help, demonstrating critical reflection on own practice, self-awareness, emotional intelligence, and openness to change. Work in partnership with individuals, families, and carers, using a range of assessment methods as appropriate (e.g., of history-taking; holistic assessment; identifying risk factors; mental health assessments; requesting, undertaking and/or interpreting diagnostic tests; and conducting health needs assessments). Demonstrate effective communication skills, supporting people in making decisions, planning care or seeking to make positive changes, using Health Education Englands framework to promote person-centred approaches in health and care. Use expertise and decision-making skills to inform clinical reasoning approaches when dealing with differentiated and undifferentiated individual presentations and complex situations, synthesising information from multiple sources to make appropriate, evidence-based judgements and/or diagnoses. Initiate, evaluate and modify a range of interventions which may include prescribing medicines, therapies, lifestyle advice and care. Exercise professional judgement to manage risk appropriately, especially where there may be complex and unpredictable events and supporting teams to do likewise to ensure safety of individuals, families, and carers. Work collaboratively with an appropriate range of multi-agency and inter-professional resources, developing, maintaining, and evaluating links to manage risk and issues across organisations and settings. Evidence the underpinning subject-specific competencies i.e. knowledge, skills and behaviours relevant to the role setting and scope, and demonstrate application of the capabilities to these, in an approach that is appropriate to the individual role, setting and scope. LEADERSHIP AND MANAGEMENT The postholder will: Pro-actively initiate and develop effective relationships, fostering clarity of roles within teams, to encourage productive working. Role model the values of their organisation/place of work, demonstrating a person-centred approach to service delivery and development. Evaluate own practice, and participate in multi-disciplinary service and team evaluation, demonstrating the impact of advanced clinical practice on service function and effectiveness, and quality (i.e., outcomes of care, experience and safety). Actively engage in peer review to inform own and others practice, formulating and implementing strategies to act on learning and make improvements. Lead new practice and service redesign solutions in response to feedback, evaluation and need, working across boundaries and broadening sphere of influence. Actively seek feedback and involvement from individuals, families, carers, communities and colleagues in the co-production of service improvements. Critically apply advanced clinical expertise in appropriate faciliatory ways to provide consultancy across professional and service boundaries, influencing clinical practice to enhance quality, reduce unwarranted variation and promote the sharing and adoption of best practice. Demonstrate team leadership, resilience, and determination, managing situations that are unfamiliar, complex or unpredictable and seeking to build confidence in others. Continually develop practice in response to changing population health need, engaging in horizon scanning for future developments. Demonstrate receptiveness to challenge and preparedness to constructively challenge others, escalating concerns that affect individuals, families, carers, communities and colleagues safety and well-being when necessary Negotiate an individual scope of practice within legal, ethical, professional and organisational policies, governance and procedures, with a focus on managing risk and upholding safety. EDUCATION The postholder will: Critically assess and address own learning needs, negotiating a personal development plan that reflects the breadth of ongoing professional development across the four pillars of advanced clinical practice. Engage in self-directed learning, critically reflecting to maximise clinical skills and knowledge, as well as own potential to lead and develop both care and services. Engage with, appraise, and respond to individuals motivation, development stage and capacity, working collaboratively to support health literacy and empower individuals to participate in decisions about their care and to maximise their health and well-being. Advocate for and contribute to a culture of organisational learning to inspire future and existing PCN and practice staff members. Facilitate collaboration of the wider team and support peer review processes to identify individual and team learning. Supporting the wider team to build capacity and capability through work-based and interprofessional learning, and the application of learning to practice. Act as a role model, educator, supervisor, coach and mentor, seeking to instil and develop the confidence of others. RESEARCH The postholder will: Critically engage in research activity, adhering to good research practice guidance, so that evidence-based strategies are developed and applied to enhance quality, safety, productivity, and value for money. Evaluate and audit own and others clinical practice, selecting and applying valid, reliable methods, then acting on the findings. Critically appraise and synthesise the outcome of relevant research, evaluation and audit, using the results to underpin own practice and to inform that of others. Take a critical approach to identify gaps in the evidence base and its application to practice, alerting appropriate individuals and organisations to these and how they might be addressed in a safe and pragmatic way. Actively identify potential need for further research to strengthen evidence for best practice. This may involve acting as an educator, leader, innovator, and contributor to research activity and/or seeking out and applying for research funding. Develop and implement robust governance systems and systematic documentation processes, keeping the need for modifications under critical review. Disseminate best practice research findings and quality improvement projects through appropriate media and fora (e.g., presentations and peer review research publications). Facilitate collaborative links between clinical practice and research through proactive engagement, networking with academic, clinical and other active researchers. CLINICAL RESPONSIBILITIES Develops and manages highly specialised programmes of care and care packages and provides highly specialised advice concerning care normally beyond the scope of normal Nursing practice e.g., establishes differential diagnoses, management/treatment plans and makes referrals as appropriate. Assess patients presenting with acute illness or for review of chronic disease conditions. Diagnose, plan, implement and evaluate treatment/interventions and care for patients presenting with an undifferentiated diagnosis Clinically examine and assess patient needs from a physiological and psychological perspective, and plan clinical care accordingly. Assess, diagnosis, plan, implement and evaluate interventions/treatments for patients with complex needs. Proactively identify, diagnose and manage treatment plans for patients at risk of developing a long-term condition (as appropriate). Diagnose and manage both acute and chronic conditions, integrating both drug- and non-drug-based treatment methods into a management plan. Fully participate in the clinical administration within the practice/PCN, signing prescriptions, reviewing medication, reviewing patient letters/discharges, respond to queries as required Prescribe and review medication for therapeutic effectiveness, appropriate to patient needs and in accordance with evidence-based practice and national and practice protocols and formularies. Provide information and advice on prescribed or over-the-counter medication on medication regimens, side-effects and interactions. Communicates highly sensitive condition related information to patients, relatives and carers. Refers patients as appropriate to other members of the PCN multidisciplinary team, secondary care and to other statutory and voluntary organisations including referral for x-ray. Undertakes and interprets a range of diagnostic tests and routine clinical procedures e.g., cytology, venepuncture, blood pressure monitoring etc. Makes critical judgements of the highest order to satisfy the expectations and demands of the job e.g., first contact with patients presenting acutely and manages care in the presence and absence of protocols. FINANCIAL RESPONSIBILITIES Ensure your own care uses resources effectively with minimal waste.