Advanced Care Practitioner

Job description

Job responsibilities

Job Summary

The post holder will be an enthusiastic, motivated and experienced Registered General Nurse, Paramedic or Advanced Nurse Practitioner, who can act confidently and competently within their professional boundaries to provide clinical care for patients requiring home visits, in particular a focus on patients living with nursing and residential homes across Hereford City.

Clinical care will include telephone triage, initial history taking, face to face assessment, physical examination, diagnosis, treatment planning, care planning, education support to care home staff, case management, referral, evaluation of care and when necessary palliative care support. They will demonstrate safe, clinical decision-making and expert care, including physical assessment and diagnostic skills. They will utilise a range of advanced skills and expert knowledge for patients presenting with undifferentiated and undiagnosed conditions. The post holder will demonstrate critical thinking in the clinical decision-making process.

SCOPE & PURPOSE OF THE ROLE

• To enhance patient care including person centred care through seamless provision within care homes
• To reduce emergency calls and/or admissions to hospital
• Standardise an approach to care planning that are integrated with all teams including care homes
• Reduced unnecessary telephone calls to practices
• To enhance organisation of care to reduce unnecessary procedures for example care planning to prevent the need for post mortems
• Early identification of end of life needs, including care plans, carer support and DNAR status
• To support care home staff to have greater autonomy within their roles and gain an understanding of the role of primary care services

Key Duties & Responsibilities

Clinical:

The postholder will:

• Assess patients presenting with acute illness or for review of chronic disease conditions.
• Undertake home visits for acute illness or chronic disease management.
• 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
• Initiate treatment plans ensuring patients received timely treatment.
• Identify conditions not amenable to primary care based services, implement immediate and necessary care to stabilise patient and ensure prompt referral to more appropriate levels of care e.g. via call to 999.
• Prescribe and review medication for therapeutic effectiveness, appropriate to patient needs and in accordance with evidence-based practice and national and practice protocols and formularies
• Work with patients and their carers 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
• Assess, identify and refer patients presenting with mental health needs in accordance with the NSF for Mental Health
• Undertake palliative care planning including anticipatory care planning, carer support, and care home education

• To identify opportunities to work differently which could be shared across the locality, and care home to enhance patient care and reduce primary care demand.
• To link with the stakeholders i.e. CCG Care Home Liaison Nurse to identify training needs and any areas of improvement required within care home education or skill base.

Communication

The postholder will:

• Provide telephone triage.
• Utilise and demonstrate sensitive communication styles, to ensure patients are fully informed and consent to treatment
• Communicate with and support patients and carers 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
• Attend and contribute to primary care team meetings where appropriate

Delivering a Quality Service

• Recognise and work within own competence and professional code of conduct as regulated by the NMC/Health and Care Professions Council.
• 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 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 County and wider organisation
• Actively participate in the practice significant event procedures. Ensure learning and actions from significant event reviews are implemented and reviewed.
• 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
• Actively promote the workplace as a learning environment, encouraging everyone to learn from each other and from external good practice Support and contribute to the teaching of nursing staff/ medical students/ GP registrars and administration staff as appropriate
• 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 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 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
• Work with the management team to ensure sufficient staff of appropriate ability, quality and skill-mix are available to meet current and future service delivery, that selection and recruitment processes are effective and that equality of treatment of the team incorporates quality HR principles and processes
• 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 management team
• Agree plans and outcomes by which to measure success

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 regarding the Freedom of Information Act
• Collate, analyse and present clinical data and information to the team

Please see attached Job Description for further information

Person Specification

Behaviours

Essential

• Ability to relay clinical information and maintain accurate, comprehensive consultation records in line with NMC requirements
• A demonstrable commitment to professional development & the NMC Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates
• Evidence of working effectively within a team and respecting others' views noted as a 'team player'
• Able to demonstrate enthusiasm to developing nursing skills
• Able to work under pressure and prioritise workload
• Able to respond to urgent situations
• Able to work autonomously and determine own workload priorities
• Embrace change in working practices in a positive manner
• Able to deal with patients and colleagues in a professional and sympathetic manner
• Conscious of presentation and self-image to suit the practice

Desirable

• Evidence of leadership skills
• Evidence of leadership training

Experience

Essential

• Experience in working in an autonomous role relevant to primary care
• Experience of working in a multi-professional environment
• Experience of working under pressure
• Previous experience of primary/urgent care home visits
• Awareness of own accountability and other aspects of professional code of conduct
• An understanding, acceptance and adherence to the need for strict confidentiality
• Works autonomously and collaboratively recognising when referrals are required

Desirable

• Experience of telephone triage
• Interpretation of blood results
• X-ray interpretation
• Experience of developing advanced care plans
• Experience as a non-medical prescriber
• Experience of EMIS Web Clinical system and using templates
• Knowledge of Quality Outcomes Framework
• Experience of leadership
• Experience of managing others

Skills

Essential

• IT skills
• Interpersonal skills
• Time management
• Effective communication skills - verbal, non-verbal and written
• Problem-solving skills

Desirable

• Presentation skills
• Report-writing skills

Knowledge

Essential

• Experience of dealing with the public/patients
• Awareness of current professional nursing issues

Desirable

• Awareness of local and national primary care issues and changing environment

Other Requirements

Essential

• Confidentiality
• Must be flexible (cover for sickness and leave)
• Must be willing to undergo training
• Enhanced Disclosure clearance from the Disclosure & Barring Service
• Able to work at different locations if required in the future and to work flexibly including evenings and weekends (e.g., flu clinics and occasional extended hours)
• Able to develop self and others
• Hold a current driving licence

Desirable

• Able to make visits to patients in their own home

Qualifications

Essential

• RGN - current NMC registration with minimum 4 years post-registration experience or current registered paramedic (HCPC)
• Masters in Advanced Practice Care
• A demonstrable commitment to professional development
• Clinical skills qualification - at least Masters level
• Advanced health assessment
• Safeguarding Adults and Children
• In-date CPR training (within 18 months)

Desirable

• Level 6 or 7 Management of Illness
• Level 6 or 7 Advanced Clinical Assessment
• Level 6 or 7 qualification for managing long-term conditions
• Level 6 or 7 non-medical independent prescribing
• Completed relevant MSc
• Qualification in chronic disease

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).

Employer details

Employer name

Taurus Healthcare Limited

Address

Wargrave House Surgery

23 St. Owen Street

Hereford

HR1 2JB

Employer's website

https://www.herefordshiregeneralpractice.co.uk (Opens in a new tab)