Job responsibilities
The post holder is an experienced nurse who, acting within their professional boundaries, will provide care for the presenting patient from initial history taking, clinical assessment, diagnosis, treatment and evaluation of care.
They will demonstrate safe, clinical decision-making and expert care, including assessment and diagnostic skills, for patients within the general practice.
The post holder will demonstrate critical thinking in the clinical decision-making process.
They will work collaboratively with the general practice team to meet the needs of patients, supporting the delivery of policy and procedures, and providing nurse leadership as required.
In order to work at this level NMCrequirements for advanced practice must be met.
Key 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, diagnose, 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 in order 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
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 and provide information in an acceptable format to all patients, recognising any difficulties and referring where appropriate
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 NICE 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 root-cause 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
Leadership personal and people development
Take responsibility for own learning and performance including participating in clinical supervision and acting as a positive role mode
Support staff development in order to maximise potential
Critically evaluate and review innovations and developments that are relevant to the area of work
Enlist support and influence stakeholders and decision-makers in order to bring about new developments in the provision of services
Take a lead role in planning and implementing changes within the area of care and responsibility
Contribute to the development of local guidelines, protocols and standards
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
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
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
Understand and comply with whistleblowing procedures
Be fully conversant with safeguarding policies and procedures and ensure regular safeguarding training is undertaken in line with local and national guidance
Managing information
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 in order to ensure easy and accurate information retrieval for monitoring and audit processes
Manage information searches using the internet and local library databases
Understand responsibility of self and others to the practice and primary care trust regarding the Freedom and Information Act
Have an understanding of GDPR legislation and follow local and national policies and procedures
Learning and development
Undertake mentorship for more junior staff, assessing competence against set standards
Disseminate learning and information gained to other team members in order to share good practice and inform others about current and future developments
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
Equality and diversity
Identify patterns of discrimination and take action to overcome this and promote diversity and equality of opportunity
Enable others to promote equality and diversity in a non-discriminatory culture
Support people who need assistance in exercising their rights
Monitor and evaluate adherence to local chaperoning policies
Act as a role model in the observance of equality and diversity good practice
Accept the rights of individuals to choose their care providers, participate in care and refuse care
Assist patients from marginalised groups to access quality care
Undertake any training required in order to meet the needs of the practice