CLINICAL & PROFESSIONAL RESPONSIBILITIES Provide first contact assessment, confirm diagnosis and reason for surgery and comprehensively assess patient with complex/advanced conditions and co-morbidities where more specialist assessment is required. Order/undertake, interpret and act upon diagnostic tests and investigations. Clinically assess patients to determine need for preoperative anaesthetic assessment. Liaise with Anaesthetic Leads based on agreed protocols for patients graded high risk for anaesthetic. Liaise with other clinical teams regarding abnormal findings within agreed protocols, to offer a differential diagnosis and ensure patient clinical safety. Act as advanced practitioner exercising judgement, discretion, and decision making in clinical care. Ensure compliance with specific regulations with regard to drugs/omission of drugs prior to surgery, and record keeping within area of work. Document patients clinical conditions and action plans in preoperative assessment notes, communicating with relevant medical/nursing staff and ensure all documentation is directed to the appropriate department for electronic scanning, or direct to ward in event of imminent patient admission. Take active role in nurse led clinics, developing and advancing service. Refer complex cases to Anaesthetist for further discussion, assessment and action as appropriate. Liaise with primary and secondary care Clinicians as required. Prescribe medication in accordance with current legislation and trust policy. GOVERNANCE RESPONSIBILITIES Active participation in collection and collation of research and audit data as appropriate, presenting the outcomes to clinical audit. Active participation in the reporting of clinical incidents/concerns and take appropriate action to address any safety and quality issues raised. Adhere to policies, procedures and protocols relevant to area of work. Monitor standards of care and participate in the improvement of care through ad hoc benchmarking/audit/research. Maintain clear, concise, legible and contemporaneous records at all times, in line with Trust Policy and the Standard for Record keeping (NMC Act 1993). Demonstrate understanding of evidence based care, including where to obtain evidence. Provide verbal and written advice to patients/carers about discharge planning, equipment needs, etc. Ensure decisions regarding consent and mental capacity are taken in accordance with Trust protocols. TEACHING & TRAINING RESPONSIBILITIES Impart high level knowledge, advice and support to colleagues, patients, carers and relatives; in relation to planned surgery and recovery. Raise awareness of specialist conditions and their specific requirements for surgery/anaesthetics, by development of protocols for practice. Assist in the provision of an appropriate learning/practice environment for nursing students allocated to the department. COMMUNICATION RESPONSIBILITIES Establish effective communication with patients, carers and relatives attending the department. Provide sensitive, complex information to patients, carers, relatives and professionals across multidisciplinary and multi-agency boundaries, as appropriate to the patients specific needs. Support patients, carers and relatives in their understanding and acceptance of their diagnosis and surgical treatments, and provide education and support in their postoperative needs. Liaise with consultant surgical/anaesthetic team as appropriate to ensure preoperative needs are met and to ensure effective planning for postoperative care package. SERVICE IMPROVEMENT AND CHANGE MANAGEMENT Provide leadership support to Department Manager and Pre Op Lead Nurse in the continued development of preoperative assessment department. Take lead of development projects as appropriate. Continually promote equality and diversity, undertaking equality impact assessments when appropriate. Ensure effective uses of physical and financial resources within the service. Promote patient and public involvement activities in specialist area to promote service improvement. PROFESSIONAL DEVELOPMENT Develop and maintain specialist clinical skills in assessment, diagnosis and investigation request/interpretation within the preoperative service. Attend annual appraisal to identify and agree training and development needs as part of a Personal Development Plan Participate in clinical supervision sessions and provide leadership to colleagues, arranged by the team Leader/Clinical Supervisor. Deputise, if required, for Pre-Op Manager maintaining smooth running of the clinic TEAM WORK AND DEVELOPMENT Be responsible for own development, including attendance at mandatory training and continually keep up to date with changes to legislation and current best practice. Support nursing colleagues in their continuous professional development including peer supervision.