Job summary We are seeking a motivated, innovative and experienced ACP Nurse with proven leadership skills, in an autonomous position, to join our Primary Care Network. The aim of the EHCH team is to work collaboratively with our care homes, GPs and various multidisciplinary teams (MDT) in order to provide person centred, holistic, proactive healthcare and support to care home residents, their carers and care home staff (residential and nursing homes). The team work together with the wider MDT and the care homes to assess, diagnose and treat injuries and illness, alongside developing personalised care plans. Main duties of the job The post holder will be employed by Cleveland Surgery on behalf of the practices in the Trent Care Network. The role is to provide highly specialist, high quality person centred care which always considers peoples safety, privacy and dignity using advanced clinical knowledge that is evidence based. As part of a multi-professional team, the post holder will practice autonomously, whilst being accountable and self-directed in line with the relevant code of professional conduct. They will provide expert clinical advice, leadership and support ensuring the needs of the service are met by exercising and demonstrating high levels of clinical judgement, critical analysis and advanced decision-making skills. Lead as a driver for change, to monitor and improve standards through supervision, evidence-based practice, clinical audit, research and education. To promote and demonstrate best practice by integrating evidence into practice. To work strategically, contributing to the planning and development of integrated services. The post holder will be accountable for the direct delivery of autonomous care home resident care. The role will be based in multiple locations across the PCN area. About us Trent Care Network (TCN) consists of 5 GP surgeries in Saxilby, Gainsborough and Hibaldstow. We cover a population size of approximately 40,000 patients with a range of diversity. We pride ourselves on being an active PCN within our local system working with local system partners including NHS trusts, local council and voluntary sector. We can offer you a generous NHS Pension, up to 25 days' paid holiday during each holiday year or the pro rata equivalent if you work part time and in addition, the usual public holidays in England and Wales or a day in lieu where we require you to work on a public holiday. By working together our ambition is to strengthen and stabilise general practice. Our aim is to continue to provide high quality healthcare to our patients in the community, whilst taking up opportunities to improve and extend our services. PLEASE NOTE: We reserve the right to close this vacancy early should we receive a sufficient number of applications. Contact Details For further details or to arrange a visit please contact Grace Bowker, PCN Manager,grace.bowkernhs.net. Interviews to be held 20/03/2025. Date posted 24 February 2025 Pay scheme Other Salary Depending on experience Contract Permanent Working pattern Full-time Reference number A3638-25-0009 Job locations Cleveland Surgery Vanessa Drive Gainsborough Lincolnshire DN21 2UQ Job description Job responsibilities Clinical Develop and implement the highest quality innovative clinical practice. Be proactive in clinical decision making, underpinned by the highest level of theoretical and practical knowledge and be able to demonstrate improved patient care outcomes. To undertake comprehensive specialist holistic assessment of patients and carers where needs are highly complex. This will involve planning, implementing and evaluating the care delivery according to changing healthcare needs and varying degrees of clinical risk. Demonstrate a high level of knowledge in relation to pattern of disease / disorder, markers of condition progression and range of treatments available at each stage of disease or condition. Be able to assess critically and re-evaluate the clinical situation as the patients condition or needs change, including effective management of risk. Anticipate likely potential physical and psychological problems caused either by the condition or by treatment. Advise and communicate as appropriate with acute hospitals, primary and social care and community teams thus ensuring seamless continuity and transfer (if appropriate) of care for patients between other relevant health, social and third sector agencies, professionals and other care settings. To act at all times as an advocate for service users, carers and relatives. Take a lead in empowering and facilitating all other professions to meet the care needs of service users and their carers by the promotion of principles and philosophy such as Care Closer to Home, rehabilitation and optimal self-care. Establish, maintain and effectively manage barriers to advanced, highly skilled and effective communication with service users, carers and professionals across health and social care, in order to develop a therapeutic relationship within which highly sensitive, distressing health conditions and highly complex issues are often addressed. This includes imparting information regarding diagnosis, prognosis and treatment and referring to other teams as appropriate to promote integrated working and to improve patient outcomes. Provide appropriate support and advice to carers and refer for carers assessment if appropriate. Collect, collate, evaluate and report information, maintaining accurate confidential patient records to a very high standard reflective of Advanced Clinical Practice. Develop, implement and audit protocols, guidelines and policies for the service. These will be shared with the multi-professional teams in all care settings. Maintain a professional portfolio and demonstrate that practice is up to date and evidence based. Maintain competency and ensure own compliance with mandatory training and revalidation requirements. Identify own personal developmental and educational needs to work at an advanced level ensuring appropriate action is taken to maintain and further develop such skills. Receive clinical supervision in order to clinically improve knowledge and the quality of care to service users. Establish and maintain a regional and national network of contacts relevant to the service. Managerial/Leadership Undertake clinical supervision and systematic peer caseload review of colleagues on an individual or group basis. Act as a role model demonstrating effective clinical leadership on a daily basis. Assess and monitor risk in own and others practice, acting on results, thereby ensuring safe delivery of care. Participate in maintaining systems for risk assessment and minimisation including promoting a fair blame culture in order that near misses and incidents are reported and investigated. Contribute to investigation of incidents and complaints when required; participate in identifying lessons learnt and the sharing of learning across the organisation. Ensure dignity, privacy, and cultural and religious beliefs are respected at all times. Continually monitor standards of care through quality markers, achievement of PCN targets, and benchmarking. To be aware of local quality data and use it to identify practice development required. Work proactively in managing change in own speciality to improve practice and health outcomes. HR/Workforce Participate in the recruitment and selection of both trained and untrained staff which involves developing job descriptions, short listing candidates and interviewing. Provide mentorship and shadowing opportunities for other professional colleagues undertaking post registration courses or specialist placements, ensuring this learning experience is effectively managed, supporting the individual through highly complex and emotive clinical situations. Recognise and utilise the individuals skills and knowledge, coaching others in their development and acting as a mentor/preceptor across all professional boundaries. Plan, deliver and evaluate appropriate specialist learning programmes. Organise and arrange relevant study days and conferences to meet identified educational needs of multi-professional audience. Formally educate, supervise, mentor, coach and advise to enhance the principle of advancing practice for new staff/team members within the PCN. Provides training, clinical supervision and systematic peer caseload review of colleagues. Create and support an environment in which clinical practice development is fostered, evaluated and disseminated. Finance Influence decisions regarding the allocation of financial resources through consultation, service redesign, participation in meetings and audit. Research & Development Facilitate learning for patients and their carers in relation to their identified health needs. In collaboration with other senior staff, ensure that clinical practice is patient centred and research based in accordance with professional practice, guidelines, and national and local benchmarks. To actively engage in clinical supervision appropriate to advancing practice as well as other learning and development opportunities such as Special Interest Groups, Action Learning Groups and Communities of Practice Regularly undertake audit and service evaluation to inform service improvement using an evidence-based approach to draw on best practice. When necessary, support and facilitate colleagues in research and clinical audit to improve effectiveness and quality of patient care. Participate in surveys as required. Critically analyse research findings and their implications for practice. Disseminate evidence-based practice and audit findings through local, regional and/or national presentation to professional groups and through publication. Policy & Service Development To inform the management team of current changes and trends in national practice that could improve patient care and facilitate changes to practice. To ensure that good practice is rapidly shared within the service area and wider organisation where appropriate. Contribute to the strategic development of the service by the evaluation of service delivery, identify areas for improvement and change and implement the agreed changes to practice. Develop, influence and lead implementation of policy making, procedures, protocols and clinical guidelines, internally and externally, necessary to support the service. Information/Data Collects, collates and presents diverse statistical information in order to facilitate the formation of reports, business plans and succession planning. Maintains client records. Professional Responsibilities Ensure that personal performance meets job requirements, Professional Codes and standards and post competency standards at all times. Ensure the required level of IT competence required for the role to process, record, evaluate, analyse and report data. Challenge poor practice and take appropriate action making full use of current support systems. Provide a positive, compassionate role model to junior staff and colleagues to ensure the delivery of people centred care and the key components of compassionate care. Create effective teamwork across professional boundaries using team building skills, creating common goals, and through engagement. Respect and apply the requirements of equality and diversity, promoting and role modelling these across the multi-disciplinary team. Other Responsibilities To work collaboratively with the multidisciplinary hub team to support the assessment and management of people living both in care homes and in the community. Assist with the supervision and development of junior clinical staff. To provide line management of EHCH Care Coordinator and using systems available provide report mechanisms back to PCN management teams on caseload and strategic planning against national and localised objectives for the EHCH team. To be responsible for own caseload of patients working collaboratively with the Advanced Practitioner colleagues in the community team to cover the care homes and prioritise workload as needed. Assist with both reactive and proactive work. To provide clinical leadership to manage complex/ deteriorating patients at risk of inappropriate admission to acute trusts. Proactively manage patients according to needs identified from risk profiling/ frailty scoring. Assist with creation and updating of Advance Care Planning and Treatment Escalation Plans in collaboration with colleagues in the multidisciplinary team, including Primary Care. Support colleagues in the management of emergency situations e.g., deteriorating patients and be responsible for making decisions regarding patient care/ escalation. FULL JOB DESCRIPTION ATTACHED Job description Job responsibilities Clinical Develop and implement the highest quality innovative clinical practice. Be proactive in clinical decision making, underpinned by the highest level of theoretical and practical knowledge and be able to demonstrate improved patient care outcomes. To undertake comprehensive specialist holistic assessment of patients and carers where needs are highly complex. This will involve planning, implementing and evaluating the care delivery according to changing healthcare needs and varying degrees of clinical risk. Demonstrate a high level of knowledge in relation to pattern of disease / disorder, markers of condition progression and range of treatments available at each stage of disease or condition. Be able to assess critically and re-evaluate the clinical situation as the patients condition or needs change, including effective management of risk. Anticipate likely potential physical and psychological problems caused either by the condition or by treatment. Advise and communicate as appropriate with acute hospitals, primary and social care and community teams thus ensuring seamless continuity and transfer (if appropriate) of care for patients between other relevant health, social and third sector agencies, professionals and other care settings. To act at all times as an advocate for service users, carers and relatives. Take a lead in empowering and facilitating all other professions to meet the care needs of service users and their carers by the promotion of principles and philosophy such as Care Closer to Home, rehabilitation and optimal self-care. Establish, maintain and effectively manage barriers to advanced, highly skilled and effective communication with service users, carers and professionals across health and social care, in order to develop a therapeutic relationship within which highly sensitive, distressing health conditions and highly complex issues are often addressed. This includes imparting information regarding diagnosis, prognosis and treatment and referring to other teams as appropriate to promote integrated working and to improve patient outcomes. Provide appropriate support and advice to carers and refer for carers assessment if appropriate. Collect, collate, evaluate and report information, maintaining accurate confidential patient records to a very high standard reflective of Advanced Clinical Practice. Develop, implement and audit protocols, guidelines and policies for the service. These will be shared with the multi-professional teams in all care settings. Maintain a professional portfolio and demonstrate that practice is up to date and evidence based. Maintain competency and ensure own compliance with mandatory training and revalidation requirements. Identify own personal developmental and educational needs to work at an advanced level ensuring appropriate action is taken to maintain and further develop such skills. Receive clinical supervision in order to clinically improve knowledge and the quality of care to service users. Establish and maintain a regional and national network of contacts relevant to the service. Managerial/Leadership Undertake clinical supervision and systematic peer caseload review of colleagues on an individual or group basis. Act as a role model demonstrating effective clinical leadership on a daily basis. Assess and monitor risk in own and others practice, acting on results, thereby ensuring safe delivery of care. Participate in maintaining systems for risk assessment and minimisation including promoting a fair blame culture in order that near misses and incidents are reported and investigated. Contribute to investigation of incidents and complaints when required; participate in identifying lessons learnt and the sharing of learning across the organisation. Ensure dignity, privacy, and cultural and religious beliefs are respected at all times. Continually monitor standards of care through quality markers, achievement of PCN targets, and benchmarking. To be aware of local quality data and use it to identify practice development required. Work proactively in managing change in own speciality to improve practice and health outcomes. HR/Workforce Participate in the recruitment and selection of both trained and untrained staff which involves developing job descriptions, short listing candidates and interviewing. Provide mentorship and shadowing opportunities for other professional colleagues undertaking post registration courses or specialist placements, ensuring this learning experience is effectively managed, supporting the individual through highly complex and emotive clinical situations. Recognise and utilise the individuals skills and knowledge, coaching others in their development and acting as a mentor/preceptor across all professional boundaries. Plan, deliver and evaluate appropriate specialist learning programmes. Organise and arrange relevant study days and conferences to meet identified educational needs of multi-professional audience. Formally educate, supervise, mentor, coach and advise to enhance the principle of advancing practice for new staff/team members within the PCN. Provides training, clinical supervision and systematic peer caseload review of colleagues. Create and support an environment in which clinical practice development is fostered, evaluated and disseminated. Finance Influence decisions regarding the allocation of financial resources through consultation, service redesign, participation in meetings and audit. Research & Development Facilitate learning for patients and their carers in relation to their identified health needs. In collaboration with other senior staff, ensure that clinical practice is patient centred and research based in accordance with professional practice, guidelines, and national and local benchmarks. To actively engage in clinical supervision appropriate to advancing practice as well as other learning and development opportunities such as Special Interest Groups, Action Learning Groups and Communities of Practice Regularly undertake audit and service evaluation to inform service improvement using an evidence-based approach to draw on best practice. When necessary, support and facilitate colleagues in research and clinical audit to improve effectiveness and quality of patient care. Participate in surveys as required. Critically analyse research findings and their implications for practice. Disseminate evidence-based practice and audit findings through local, regional and/or national presentation to professional groups and through publication. Policy & Service Development To inform the management team of current changes and trends in national practice that could improve patient care and facilitate changes to practice. To ensure that good practice is rapidly shared within the service area and wider organisation where appropriate. Contribute to the strategic development of the service by the evaluation of service delivery, identify areas for improvement and change and implement the agreed changes to practice. Develop, influence and lead implementation of policy making, procedures, protocols and clinical guidelines, internally and externally, necessary to support the service. Information/Data Collects, collates and presents diverse statistical information in order to facilitate the formation of reports, business plans and succession planning. Maintains client records. Professional Responsibilities Ensure that personal performance meets job requirements, Professional Codes and standards and post competency standards at all times. Ensure the required level of IT competence required for the role to process, record, evaluate, analyse and report data. Challenge poor practice and take appropriate action making full use of current support systems. Provide a positive, compassionate role model to junior staff and colleagues to ensure the delivery of people centred care and the key components of compassionate care. Create effective teamwork across professional boundaries using team building skills, creating common goals, and through engagement. Respect and apply the requirements of equality and diversity, promoting and role modelling these across the multi-disciplinary team. Other Responsibilities To work collaboratively with the multidisciplinary hub team to support the assessment and management of people living both in care homes and in the community. Assist with the supervision and development of junior clinical staff. To provide line management of EHCH Care Coordinator and using systems available provide report mechanisms back to PCN management teams on caseload and strategic planning against national and localised objectives for the EHCH team. To be responsible for own caseload of patients working collaboratively with the Advanced Practitioner colleagues in the community team to cover the care homes and prioritise workload as needed. Assist with both reactive and proactive work. To provide clinical leadership to manage complex/ deteriorating patients at risk of inappropriate admission to acute trusts. Proactively manage patients according to needs identified from risk profiling/ frailty scoring. Assist with creation and updating of Advance Care Planning and Treatment Escalation Plans in collaboration with colleagues in the multidisciplinary team, including Primary Care. Support colleagues in the management of emergency situations e.g., deteriorating patients and be responsible for making decisions regarding patient care/ escalation. FULL JOB DESCRIPTION ATTACHED Person Specification Qualifications Essential Current Registered Advanced Clinical Practitioner (NMC) Independent Non-Medical Prescriber (V300) Masters Degree in relevant area of expertise community/frailty/palliative Experience Essential Experience and /or qualification in Mentoring Evidence of continuing professional development Previous experience of Non- Medical prescribing Working / worked as an Advanced Clinical Practitioner Able to demonstrate advanced skills for assessing and interpreting complex client conditions, comparing a range of options and taking appropriate action Experience of co-ordinating complex activities / programmes of care with other professionals and agencies Able to undertake clinical supervision and systematic peer caseload review of colleagues on an individual or group basis and support aspiring and trainee Advanced Clinical Practitioners through supervisory roles Evidence of effective leadership and risk management skills Person Specification Qualifications Essential Current Registered Advanced Clinical Practitioner (NMC) Independent Non-Medical Prescriber (V300) Masters Degree in relevant area of expertise community/frailty/palliative Experience Essential Experience and /or qualification in Mentoring Evidence of continuing professional development Previous experience of Non- Medical prescribing Working / worked as an Advanced Clinical Practitioner Able to demonstrate advanced skills for assessing and interpreting complex client conditions, comparing a range of options and taking appropriate action Experience of co-ordinating complex activities / programmes of care with other professionals and agencies Able to undertake clinical supervision and systematic peer caseload review of colleagues on an individual or group basis and support aspiring and trainee Advanced Clinical Practitioners through supervisory roles Evidence of effective leadership and risk management 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. 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. 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 The Welby Group Address Cleveland Surgery Vanessa Drive Gainsborough Lincolnshire DN21 2UQ Employer's website https://www.thewelbypractice.co.uk/ (Opens in a new tab)