Job summary
East Durham Medical Group is situated in the beautiful coastal area of County Durham. The Practice works from 6 sites across the region. We are a very successful, high achieving, PMS training practice with a patient list of over 18 500 patients. We are an extremely forward thinking Practice and our core values include Caring, Commitment, Consistency and Celebrating success. We work to make a difference by providing the highest quality patient-centred care in a supportive environment that values patients and staff. We offer competitive rates of pay and access to the NHS pension scheme.

Main duties of the job
This is an exciting new opportunity to become a vital and proactive member of the clinical team within the practice, which includes GPs, Physician Associates, ANPs, Pharmacists, and Practice Nurses. This role will include core General Practice hours and a regular rotation at Peterlee Health Centre to support the PCN Enhanced Access service and the primary care service, which forms part of the NHS 111 referral pathway. The service supports local practices between 1:00 pm and 8:00 pm, Monday to Friday, and from 8:00 am to 5:00 pm on Saturdays. Successful candidates will be required to assess and treat patients of all ages, from birth onwards, with no exceptions. Weekend working is an essential requirement of this role, and successful candidates will be expected to participate in the Saturday rota as part of their contracted duties.

About us
Travel between sites will be a requirement of the role therefore you will be expected to hold a current driving licence, however you will have 2 x sites as your usual sites of work. Experience in using SystmOne would be an advantage although not essential. Competitive rates of pay based on clinical competencies , clinical and management commitments and previous experience.

Job responsibilities
The post holder will be employed to undertake duties both for the Practice, Enhanced Access Service and for the Primary Care Extended Access service. They will be an experienced nurse practitioner who will provide care for the presenting patient from initial history taking, clinical assessment, diagnosis, treatment and evaluation of their care. They will demonstrate safe, clinical decision-making and expert care for patients within the general practice. They will work collaboratively with the multi-disciplinary 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, NMC requirements for advanced practice must be met.

JOB PURPOSE
The practice operates across 6 sites to cover 18500 patients. You will be usually assigned across 2 sites covering the Practice. The Primary Care Service is a nurse practitioner led service commissioned by Durham ICB. General Practitioners will be contracted to the service to provide advice throughout the hours of operation but will not routinely be present within the premises for the Extended Primary Care Services. The service is open to the population of County Durham ICB who request an appointment via 111 at any site and regardless of age. The Enhanced Access Service provision is to cover Durham Coast PCN and Easington Central PCNs.
The role of ACP requires an experienced nurse practitioner who, acting within her / his own professional boundary, will provide care for patients who access the services.
Acting as an autonomous practitioner working independently, and in conjunction with other health care professionals, to assess, investigate, diagnose, treat and evaluate all patients seen, including referring into other services wherever or whenever required. The post holder will demonstrate safe, clinical decision-making and will provide expert professional advice to patients, carers and colleagues ensuring maintenance of clinical excellence.

KEY RESPONSIBILTIES
CLINICAL ROLE
The post-holder will

• Provide the choice of direct access to a Nurse Practitioner, both in the Practice and over the telephone, for the general practice population
• Make professionally autonomous decisions for which he/she is accountable
• Provide a first point of contact within the Practice for patients presenting with undifferentiated, undiagnosed problems, making use of skills in history taking, physical examination, problem-solving and clinical decision-making, to establish a diagnosis and management plan
• To maintain accurate and contemporaneous records, utilising computer systems where appropriate and consider the Caldicott Principles in relation to all data handling.
• Instigate necessary invasive and non-invasive diagnostic tests or investigations and interpret findings/reports
• Prescribe safe, effective and appropriate medication as defined by current legislative framework
• Provide safe, evidence-based, cost-effective, individualised patient care
• Promote health and well-being through the use of health promotion, health education, screening and therapeutic communication skills
• Refer patients directly to other services/agencies as appropriate
• Support the other clinicians within the Practice in developing and delivering specialist primary care services, such as long term disease management (diabetes, asthma, chronic obstructive pulmonary disease, coronary heart disease and hypertension) To work within the practice guidelines, policies and protocols.
• To provide ongoing care to our vulnerable population group in the Unplanned Admissions register or equivalent,and liaise with appropriate multi disciplinary team and create appropriate care plans and review them as required of the practice.

Assess patients presenting with acute illness or for review of chronic disease conditions.
Clinically examine and assess patient needs from a physiological, psychological and sociological perspective, and plan clinical care accordingly
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
Provide education for patients for whom another service would be more appropriate
Prioritise health problems and intervene appropriately to assist the patient in complex, urgent or emergency situations, including initiation of effective emergency care
Refer patients to other medical specialities for assessment if deemed appropriate
Undertake and interpret a range of diagnostic tests and routine clinical procedures
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
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
Support the practice and PCN Home Visiting Scheme.

TEAM ROLE

• As a clinician be available to support other healthcare team members and to accept referrals from other team members.
• To liaise with all members of the Primary Health Care Team and other agencies local authority, social services, secondary care and voluntary sector in order to assure appropriate care is provided for the practice population.
• To participate as a key member of the multi-professional team through the development of collaborative and innovative practice.
• To value all team members.
• To delegate appropriate tasks to the primary care team whilst still maintaining responsibility for this area.
• To support the delivery of health and safety guidance as agreed within the practice.
• To support the writing of, maintenance and delivery of CQC guidance within the practice

Person Specification
Experience working with 111 service is desirable but not essential

• Good interpersonal and communication skills. The ability to be a team player and work within a busy team.

Desirable

• Knowledge of system one

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.
Applicants must have current UK professional registration. For further information please see NHS Careers website.