Assist GP's to help deliver effective implementation of management of pts with chronic diseases as detailed by the Quality and Outcomes framework. Contribute to the development of policies / protocols / guidelines within the practice. Aid the practice team with implementation of new initiatives in the delivery of chronic disease management services. Formulate reports as required for the practice management Support the implementation of evidence-based guidelines in conjunction with the practice nursing team. Encourage the development of integrated services within Primary Care to include integrated practice based teams and multidisciplinary working. Promote the continuing professional development of yourself and other nurses & HCAs within the practice. Recognise the opportunities for working in partnership with the Primary Health care team. Clinical Work alongside Health Care Assistants and Phlebotomist to help develop their skills. Support the practice in achieving quality indicators and targets of the GMS contract and any relevant National Service Frameworks. Undertake wound care/ management/dressing techniques. Carry out ear examination and syringing, following appropriate training and assessment. Undertake family planning assessments, give advice and refer patients appropriately - following appropriate training. Perform cervical screening and promote breast awareness - following appropriate training. Administer adult and paediatric injections under an individualised prescription or Patient Group Direction, ensuring safe storage, rotation and disposal of vaccines and drugs. To undertake such duties in specific chronic disease management. e.g. diabetes, respiratory, epilepsy, CHD etc. Contribute to the maintenance of the practice diseases registers. Provide advice on lifestyle issues, assist and support patients in changing their unhealthy behaviours and refer appropriately. Provide an adult and childhood immunisation service working to Patient Group Directions - following appropriate training if required. Delivers travel health care, including vaccinations and advice for patients - following appropriate training if required. Recognise the signs of child abuse, family violence, vulnerable adults, substance abuse, addictive behaviours, suicidal tendencies and is aware of local, referral procedures. Ensure that current evidence based approaches to patient are standard practice Apply infection control measures when collecting and handling of laboratory specimens, disposing of waste materials, dealing with blood and body fluids spillages and report and treat sharps injuries. Undertake first aid and management of emergencies, eg burns, haemorrhage, hypo/hyperglycaemic emergencies/asthma attacks. Undertake annual training and demonstrates competency in anaphylaxis and resuscitation techniques