Job summary
We have a full time, B8a, Advanced Clinical Practitioner vacancy within our multidisciplinary team, which is led by a Consultant Geriatrician.

Our team consists of Frailty GP's, Nurse Consultants, Advanced Clinical Practitioners, Frailty Nurses, a Pharmacy team and support staff.

The Community Frailty Service supports patients to live well alongside their existing long-term conditions. Following a Comprehensive Geriatric Assessment patients spend up to 12 weeks on the service working through their individualised plan of care.

The Community Frailty Service also delivers the Frailty Virtual Ward and provides Advice & Guidance to Primary and Secondary care.

Main duties of the job

• Receiving patients with undifferentiated and undiagnosed problems.
• To assess health care needs based on highly developed knowledge and skills and use of advanced clinical assessment.
• Screen patients for disease factors and early signs of illness.
• Make differential diagnoses using decision-making and problem-solving skills
• Develop with the patient an on-going care plan for health and well-being, with an emphasis on health education and preventative measures,
• Order necessary investigations and provide treatment and care both individually, as part of a team, and through referral to other agencies
• Support patients to remain safely at home through proactive frailty management and virtual ward care
• Have a supportive role in helping people to manage and live with illness.
• Have the authority to admit or discharge patients from their caseload and refer patients to other health care providers as appropriate.
• Work collaboratively with other health care professionals and disciplines.
• Provide a leadership and consultancy function as required.

About us
Based at Moor Park Health & Leisure Centre and South Shore Primary Care Centre, on a rotational basis you will undertake a variety of duties including the provision of a daily telephone triage service, home acute visits, comprehensive geriatric assessment clinics and oversight of patients on the caseload including requesting and management of investigations.

Prescribing is undertaken using GP EMIS electronic record.

The service spans the whole Fylde Coast and welcomes referrals from all health and social care professionals.

Job responsibilities

• Analyses and interprets history, presenting symptoms, physical findings, and diagnostic information to develop the appropriate differential diagnoses.
• Diagnoses and manages acute and long-term conditions while attending to the patientsresponse to the illness experience.
• Employs appropriate diagnostic and therapeutic interventions and regimens with attention to safety, cost, invasiveness, simplicity, acceptability, adherence, and efficacy.
• Formulates an action-plan based on scientific rationale, evidence-based standards of care, and practice guidelines.
• Initiates appropriate and timely consultation and/or referral when the problem exceeds their scope of practice and/or expertise.
• Assesses and intervenes to assist the patient in complex, urgent or emergency situations.
• Diagnoses unstable and complex health care problems using collaboration and consultation with the multi-professional health care team as indicated by setting, specialty, and individual knowledge and experience.
• Plans and implements diagnostic strategies and therapeutic interventions to help patients with unstable and complex health care problems regain stability and restore health, in collaboration with the patient and multi-professional health care team.
• Demonstrates critical thinking and diagnostic reasoning skills in clinical decision-making.
• Obtains a comprehensive problem focused health history from the patient or carer.
• Performs a comprehensive problem focused age-appropriate physical examination.
• Analyses the data collected to determine health status of the patient.
• Formulates a problem list and prioritised management plan.
• Assesses, diagnoses, monitors, co-ordinates, and manages the health/illness status of patients during acute and enduring episodes.
• Demonstrates knowledge of the patho-physiology of conditions commonly seen in practice.
• Communicates the patients health status using appropriate terminology, format, and technology.
• Provides information and advice to patients and carers concerning drug regimens, side- effects and interaction, in an appropriate form.
• If legally authorised prescribes medications based on efficacy, safety, and cost from the formulary.
• Integrates appropriate non-drug-based treatment methods into a plan of management.
• Orders, may perform, and interprets common screening and diagnostic tests.
• Evaluates results of interventions using accepted outcome criteria, revises the plan accordingly and consults/refers when needed.
• Works collaboratively with other health professional and agencies as appropriate.
• Plans and conducts follow-up visits appropriately to monitor patients and evaluate health/illness care.

Person Specification
Qualifications & TrainingEssential

• Clinical based professional degree
• MSc Advanced Clinical Practice
• Current professional registration with the NMC or HCPC
• Minimum of five years post-registration experience, including at least three years at senior level in frailty, care of older people, community or primary setting
• Non-Medical Prescriber (V300) with evidence of safe prescribing practice, medicines optimisation and deprescribing awareness in frail older adults
• Evidence of continuing professional development relevant to frailty and care of older people

Desirable

• Post-graduate qualification in frailty, gerontology, long-term conditions or community care
• Experience across interfaces such as ED, acute medicine, primary care, intermediate care, care homes or virtual ward pathways.
• Independent prescriber experience within frailty, urgent community response, care homes or long-term conditions.
• Advanced communication skills, coaching, supervision, research or quality improvement training

Experience and SkillsEssential

• Expert clinical knowledge and autonomous decision-making skills in the assessment and management of frailty and its associated syndromes in a community setting, including risk stratification, admission avoidance and proactive care planning
• Able to undertake comprehensive geriatric assessment and formulate person-centred management plans alongside patients, carers and the multi-disciplinary team.
• Effective communicator: able to explain complex, sensitive and uncertain information, including escalation planning, advance care planning, safeguarding concerns and best-interest decision making.
• Evidence of involvement in clinical governance, audit, quality improvement, incident review, risk management and service development relevant to community frailty pathways.
• Evidence of effective leadership, supervision and mentorship

Desirable

• Senior clinical experience within a community frailty service, urgent community response team or integrated neighbourhood team
• Can demonstrate assertiveness, tact and diplomacy when working across organisational boundaries.
• Evidence of working in acute, community or primary care settings.
• Experience of pathway redesign, policy development, service evaluation or practice change.
• Evidence of proactive contribution to education and frailty capability development across the MDT

Skills & AbilitiesEssential

• Prioritise urgent and complex caseloads against tight deadlines and work safely under pressure.
• Work autonomously while recognising limits of competence and escalating appropriately.
• Complete holistic assessment, clinical reasoning, differential diagnosis and evidence-based management planning
• Identify deterioration, frailty-related trends and opportunities for early intervention or admission avoidance.
• Work collaboratively with patients, carers and other services, including primary care, acute services and voluntary and social care sector
• Maintain accurate records and handle confidential information in line with governance requirements.
• Influence, motivate and support colleagues through visible clinical leadership.
• Use IT systems, electronic patient records, data and digital communication tools effectively.

PersonalEssential

• Compassionate, person-centred approach to frail older people and their families.
• Assertive, resilience, professional curiosity and sound judgement.
• Motivational, negotiation and conflict-resolution skills.
• Problem solving, decision making and safe delegation.
• Enthusiasm for integrated care, service improvement and reducing avoidable hospital attendance/admission.
• Flexible approach to working across community bases, patient homes and care settings and acute settings if required
• Ability to persuade and influence at all levels.
• Full driving licence and access to a car on a daily basis,

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.

Certificate of Sponsorship Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab). From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).

UK Registration Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).