Advanced Nurse Practitioner/Advanced Clinical Practitioner

Job responsibilities

Clinical practice

• Assess, 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
• Prescribe and review medication for therapeutic effectiveness, appropriate to patient needs and in accordance with evidence-based practice and national and practice protocols, and within scope of practice
• Work with patients to support compliance with and adherence to prescribed treatments
• Provide information and advice on prescribed or over-the-counter medication on medication regimens, side-effects, and interactions
• Prioritise health problems and intervene appropriately to assist the patient in complex, urgent or emergency situations, including initiation of effective emergency care
• Support patients to adopt health promotion strategies that promote healthy lifestyles and apply principles of self-care. Provide smoking cessation advice and support.
• Support and manage health needs of women presenting for family planning, cervical cytology, or sexual health consultation to include provision of LARC and advice for HRT
• Assess, identify and refer patients presenting with mental health needs in accordance with the NSF for Mental Health, local guidelines and evidence-based practice.
• Provide triage assessment for home visit requests
• Participate in vaccination and immunisation programmes for both adults and children
• Advise, support, and administer vaccinations for patients travelling abroad, where appropriate
• Promote and deliver evidence-based care for patients presenting with aural conditions
• Meet the needs of patients presenting for opportunistic wound care
• Provide patient contact at surgery appointments, by telephone and home visits where appropriate, eg chronic disease evaluation or review

Communication

• Utilise and demonstrate sensitive communication styles, to ensure patients are fully informed and consent to treatment
• Communicate with and support patients who are receiving bad news
• Communicate effectively with patients and carers, recognising the need for alternative methods of communication to overcome different levels of understanding, cultural background, and preferred ways of communicating
• Anticipate barriers to communication and take action to improve communication
• Maintain effective communication within the practice environment and with external stakeholders
• Act as an advocate for patients and colleagues
• Ensure awareness of sources of support and guidance (eg PALS) and provide information in an acceptable format to all patients, recognising any difficulties and referring where appropriate
• Be aware and implement where necessary, the practice complaints procedure
• Participate in practice meetings (eg. palliative care, prescribing, practice team meetings, clinical meetings and multidisciplinary meetings)
• Liase with external agencies

Delivering a quality service

• Recognise and work within own competence and professional code of conduct as regulated by the NMC
• Produce accurate, contemporaneous, and complete records of patient consultation, consistent with legislation, policies and procedures
• Prioritise, organise and manage own workload in a manner that maintains and promotes quality
• Deliver care according to NSF, NICE guidelines local guidelines and evidence-based care
• Assess effectiveness of care delivery through self and peer review, benchmarking, and formal evaluation
• Initiate and participate in the maintenance of quality governance systems and processes across the organisation and its activities
• Utilise the audit cycle as a means of evaluating the quality of the work of self and the team, implementing improvements where required
• In partnership with other clinical teams, collaborate on improving the quality of health care responding to local and national policies and initiatives as appropriate
• Evaluate patients response to health care provision and the effectiveness of care
• Support and participate in shared learning across the practice and wider organisation
• Use a structured framework (eg significant event analysis) to manage, review and identify learning from patient complaints, clinical incidents and near-miss events
• Assess the impact of policy implementation on care delivery
• Understand and apply legal issues that support the identification of vulnerable and abused children and adults, and be aware of statutory child/vulnerable patients health procedures and local guidance
• Apply safeguarding policies and procedures where necessary
• Understand and apply the Mental Capacity Act
• Personal knowledge regarding domestic violence, vulnerable adults, substance abuse and addictive behaviour.
• Ensure patients rights, dignity and confidentiality are always preserved and upheld

Leadership personal and people development

• Take responsibility for own learning and performance including participating in clinical supervision and acting as a positive role model
• Support staff development to maximise potential
• Actively promote the workplace as a learning environment, encouraging everyone to learn from each other and from external good practice
• Encourage others to make realistic self-assessment of their application of knowledge and skills, challenging any complacency or actions that are not in the interest of the practice, public and/or users of services
• Critically evaluate and review innovations and developments that are relevant to the area of work
• Enlist support and influence stakeholders and decision-makers to bring about new developments in the provision of services
• Take a role in planning and implementing changes within the area of care and responsibility
• Contribute to the development of local guidelines, protocols, and standards
• Maintain active involvement in the processes of practice-based commissioning or similar initiatives
• Take responsibility for agreed areas of the GP Contract and commissioning

Team working

• Understand own role and scope and identify how this may develop over time
• Work as an effective and responsible team member, supporting others and exploring the mechanisms to develop new ways of working
• Delegate clearly and appropriately, adopting the principles of safe practice and assessment of competence
• Create clear referral mechanisms to meet patient need
• Prioritise own workload and ensure effective time-management strategies are embedded within the culture of the team
• Work effectively with others to clearly define values, direction and policies impacting upon care delivery
• Discuss, highlight, and work with the team to create opportunities to improve patient care
• Manage and lead on the delivery of specifically identified services or projects as agreed with the practice management team
• Agree plans and outcomes by which to measure success

Management of risk

• Adhere to practice policies for Health & Safety and Infection Control
• Manage and assess risk within the areas of responsibility, ensuring adequate measures are in place to protect staff and patients
• Monitor work areas and practices to ensure they are safe and free from hazards and conform to health, safety and security legislation, policies, procedures, and guidelines
• Comply with practice policy for safe storage, rotation and disposal of vaccines and drugs
• Apply infection-control measures within the practice according to local and national guidelines
• Advocate for policies that reduce environmental health risks, are culturally sensitive and increase access to health care for all
• Interpret national strategies and policies into local implementation strategies that are aligned to the values and culture of general practice

Managing information

• Adhere to Confidentiality and GDPR/IG policy
• Adhere to Data Protection Policy
• Use technology and appropriate software as an aid to management in planning, implementation and monitoring of care, presenting and communicating information
• Review and process data using accurate Read codes to ensure easy and accurate information retrieval for monitoring and audit processes
• Process and evaluate lab links and patient notes in a timely manner
• Process hospital letters ensuring recommendations and changes in medication are updated
• Manage information searches using the internet and local library databases
• Understand responsibility of self and others to the practice and CCG regarding the Freedom and Information Act
• Monitor and confirm that the nursing team are receiving and processing data and information in an agreed format
• Collate, analyse and present clinical data and information to the team
• Communicate essential financial restraints with the team and discuss with them ideas for effective and efficient working within these constraints

Learning and development

• Ensure mandatory training is updated on time, eg safeguarding, fire lecture, clinical governance, CPR, anaphylaxis, and cervical screening
• Disseminate learning and information gained to other team members to share good practice and inform others about current and future developments (eg courses and conferences)
• Assess own learning needs and undertake learning as appropriate
• Provide an educational role to patients, carers, families and colleagues in an environment that facilitates learning
• Participate in annual appraisal process

Qualifications

Essential

• Essential Criteria:
• Advanced clinical practice skills.
• Management of patients with long-term conditions .
• Management of patients with complex needs.
• Clinical examination skills.
• Accountability of own role and other roles in a nurse-led service.
• Local and national health policy.
• Wider health economy.
• Clinical governance issues in primary care.
• Patient group directions and associated policy.
• Safeguarding policy.
• Mental Capacity Act.
• Prescribing Qualification V300.
• Skills:
• Clinical leadership skills.
• Communication skills, both written and verbal.
• Communication of difficult messages to patients and families .
• Negotiation and conflict management skills.
• Change management.
• Teaching and mentorship clinical setting.
• Resource management.
• Experience:
• Minimum 5 years post registration experience.
• At least 2 years recent primary and community nursing experience.
• Nurse-led management of minor illness, minor ailments, and injuries.
• Nurse-led triage.
• Compiling protocols and clinical guidelines.
• Leadership in quality initiatives such as clinical benchmarking.
• Audit.
• Research.
• Nurse prescribing.
• Qualifications;
• Registered first level nurse MSc or equivalent.
• Relevant nursing/health degree.
• Clinical supervision training and experience.
• Extended/independent nurse.
• Other:
• Self-directed practitioner.
• Highly motivated.
• Flexibility.
• DBS clearance.
• Enthusiasm.
• Team player.
• Ability to work across boundaries.

Desirable

• Desirable:
• Knowledge of public health issues.
• Able to identify determinants on health in the area.
• Knowledge of GP contract, and clinical indicators within the Quality and Outcomes framework, enhanced services and for clinical commissioning.
• Good IT skills and knowledge of GP computer system.
• Smoking cessation intermediate advisor.
• Sexual Health.
• Cervical cytology update training.
• Project management.
• Working with community development initiatives.
• Health-needs assessment.
• Teaching and mentorship clinical setting.

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).