CLINICAL PRACTICE The Advanced Clinical Practitioner works autonomously and is accountable for their own professional actions. Their responsibilities include: Undertakes Clinical Practice at an advanced level using expert knowledge and clinical skills to deliver holistic care to people accessing the iHeart service. Assesses diagnoses and treat patients attending the iHeart service with a range of acute, non-acute and chronic medical conditions. Assesses diagnoses and treats patients in surgery, hubs or own home who require acute medical attention and refer to appropriate agency. Directly admits patients to secondary care hospital in acute medical need. As well as referring patients to other medical specialities for assessment if deemed appropriate. Refers patients as appropriate to other members of the multidisciplinary team, secondary care and to other statutory and voluntary organisations including referral for x-ray. Has undertaken x-ray training as required by hospitals trust. Can interpret a range of diagnostic tests and perform 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. Works within professional guidelines and codes of conduct. However, will makes decisions where precedents do not exist, where appropriate without recourse to others. Works within all relevant practice policies and procedural guidelines e.g. infection control, chaperoning, risk management. Extended and supplementary prescriber. CARE AND PROGRAMME MANAGEMENT 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. Makes fast track referrals. Communicates highly sensitive condition related information to patients, relatives and carers. Initiates the process of diagnosis with patients suspected to have a chronic disease e.g. Diabetes, COPD, asthma, IHD referring to other clinical staff as appropriate. Undertakes annual review of patients understanding and ability to self-manage. Refers to other members of the extended primary health care team as appropriate e.g. chiropodist, dietician, specialist Nurses. STRATEGIC DEVELOPMENT OF PRIMARY CARE SERVICES Contributes to the strategic development of iHeart and additional public health services to meet patient and population needs within the practice and across the wider organisation. Works/liaises across multi-professional and agency boundaries. Determines how to deal with ambiguous or unique problems to develop and advance iHeart services for the benefit of patients, carers and communities. Recognition and involvement in the Federation as a teaching unit and help drive the Nursing element of training. Develop links within the Federation and other local and national bodies relevant to iHeart Nursing initiatives. HEALTH IMPROVEMENT Initiates and carries out programmes of health screening and ensures other team members are aware of health agendas and screening programmes. Introduces innovation in iHeart to meet on going health need demands of the practice. Works to introduce new developments that will improve health outcomes for patients and is able to demonstrate through written and presentation these developments i.e. Sexual Health agenda. Supports practitioners in profiling the practice population in order to initiate contribute and promote improved health and prevent disease in individuals and groups. Represents individuals and families interests when they are not able to do so themselves. Makes referrals to statutory and voluntary agencies as appropriate. COMMUNICATION Provides and receives highly complex, sensitive or contentious information and frequently deals with situations which are hostile or emotive. Uses developed communication, negotiation, conflict management skills which require empathy, reassurance and persuasive skills where there can be significant barriers to acceptance which need to be overcome. Regularly communicates service related information to Partners, Business Manager, Salaried GPs, Nursing and Administrative staff, patients, relatives and carers. Makes operational judgements, manages conflicting views and reconciles inter and intra professional differences of opinion. Builds and communicates therapeutic working relationships with a wide array of statutory and voluntary organisations for the benefit of patient care and facilitates good working relationships. Develops and delivers presentations to large groups e.g. local and national conferences, clinical meetings, empowers staff to develop presentation skills in order to promote good practice. MANAGE/LEAD SELF/OTHERS Develops a leadership role within the iHeart service. Encourage and motivate others to be forward thinking in ideas that address the health needs of the practice that will be innovative whilst managing and developing new ways of working, e.g. Implanon clinic, teenage health clinic. Develops and leads on evidence-based practice. Partakes in clinical supervision for own development. As well as actively participating in clinical and practice meetings. Develops own knowledge and practice to meet objectives/changes in service. Also integrates theory into practice and establishes formal links with educational institutions. Assists in the mentorship and assessment of trainee Nurse Practitioners. Acts as mentor for pre-registration students and other staff within the iHeart service. Leads on setting standards and promotes best practice. Operates high standards of probity. INFLUENCE AND DEVELOP POLICY Responsible for establishing how policies should be interpreted and translated within the practice. Implements local/national, PCT and practice policies, proposes developments and improvements to service delivery. MANAGE AND USE INFORMATION Makes effective use of the clinical system by ensuring the consistent and accurate entering of data and use of Read Codes. Facilitates the use of up-to-date information technology in order to collate accurate and timely information as and when required by the iHeart service. Ensures a satisfactory call and recall system of patients. Assist in the development of practice protocols for the surgery and clinical protocols for the clinical team. Review deficiencies in procedures and implements remedial action. RESEARCH AND DEVELOPMENT Continuous involvement in research/evaluation and/or development work which may be as part of one or more formal research programmes or activities. Actively contributes to Practice/Service/Team audit/Research activity as required. Instigates and takes part in audit activity as required e.g. new services. Identifies, applies and disseminates research findings relating to clinical practice.