Job summary
The Urgent Care Practitioner will provide autonomous clinical care across NEMS urgent care services. The role is open to suitably qualified UCPs, ECPs and Nurse Practitioners who are independent non-medical prescribers, and is designed to provide a mix of telephone and face-to-face consultations across Integrated Urgent Care Services, urgent treatment centres and other agreed service models.

Main duties of the job
The post holder will be an experienced registered clinician, able to assess, diagnose, treat, refer and discharge patients with undifferentiated urgent care presentations. They will work within their professional registration, agreed scope of practice, NEMS policies and local clinical pathways.

Telephone consultations will usually be undertaken within Integrated Urgent Care Services. Following induction, and where agreed by the service, some telephone consultation work may be undertaken remotely from home, provided that the post holder is meeting agreed KPIs, quality standards, governance requirements and information governance expectations.

Face-to-face work will include assessment and management of patients presenting to NEMS urgent treatment services. The post holder will be expected to recognise serious illness, clinical deterioration, safeguarding concerns, mental health risk and presentations requiring escalation or transfer to another service.

The role will ideally include a mix of telephone and face-to-face work. Multisite working may be agreed, although some NEMS locations provide both from the same base. The post holder will also contribute to learning, audit, incident review and service improvement, ensuring that care remains safe, effective, patient centred and financially sustainable.

About us
NEMS Community Benefit Services (NEMS) is a not-for-profit social enterprise and a Company Limited by Guarantee. It has been operating in Nottinghamshire for over 25 years, now providing a population of more than 1.2 million with urgent primary health care services. It operates out of 2 registered locations and four bases and deploys a team of more than 370 healthcare professionals, including 150+ sessional GPs, 90+ substantive staff, 30+ agency workers, and 140+ non-healthcare staff.

NEMS provides services to a population of circa 1.2 million under the following service portfolio headings;

• Care Co-ordination and non-clinical call handling
• Clinical Assessment and Care Navigation
• Support to Primary Care including General Practice Out-of-Hours and Urgent Treatment Centres
• Outbreak Management

The Board of Directors comprises non-executive Member directors and executive directors and is responsible for overall strategy and governance of the organisation. The Board of Directors is supported by two sub-committees Quality and People Committee and Finance and Performance Committee. An Operational Executive Team, comprising Executive Board Directors, together with other senior leaders, is being established to oversee the smooth running of the day-to-day activities of NEMS.

Job responsibilities
Clinical Practice and Service Delivery

• Work as an autonomous Urgent Care Practitioner across NEMS urgent care services, providing both telephone and face-to-face consultations.
• Assess, examine, diagnose, treat and safely discharge or refer patients with undifferentiated urgent care presentations.
• Make safe decisions around admission, transfer, referral, follow-up and safety-netting, working within professional competence and agreed local pathways.
• Recognise and act on serious illness, clinical deterioration, safeguarding concerns, mental health risk and presentations that require escalation to another service.
• Request and interpret appropriate investigations, including blood tests, urine tests, ECGs and imaging, in line with local policy, competence and relevant regulations.
• Prescribe, review and advise on medicines within the post holders independent non-medical prescribing qualification, professional competence and agreed scope of practice.
• Maintain clear, accurate and timely clinical records, including assessment findings, clinical reasoning, advice given, decisions made and onward plans.

Telephone Consultations

• Undertake telephone consultations within Integrated Urgent Care Services, using safe clinical assessment, decision-making and documentation.
• Recognise the limitations of remote assessment and arrange face-to-face review, ED attendance, ambulance response or other escalation where clinically required.
• Provide clear advice and safety-netting to patients and carers, ensuring that the plan is understood and documented.
• Undertake remote work from home where agreed after induction, provided that performance, KPIs, quality standards and information governance requirements are being met.

Face-to-Face Urgent Care

• Undertake face-to-face consultations across NEMS urgent care services, including assessment of minor illness, minor injury and other appropriate urgent care presentations.
• Carry out clinical procedures where trained, competent and required for patient care.
• Provide safe clinical handover to ED, specialties, GPs, community services or other colleagues where ongoing care is required.
• Support patient flow, streaming and redirection decisions where this forms part of the service model.

Team Working and Clinical Support

• Work as an experienced member of the clinical team, supporting colleagues and the safe running of the service.
• Provide advice and support to trainees, nurses, AHPs, UCAs and non-registered staff within own competence.
• Support induction, learning and competency development where appropriate.
• Escalate clinical or operational concerns early, particularly where patient safety, staffing, flow or professional practice may be affected.
• Address unsafe practice or poor behaviour in a professional and proportionate way, escalating concerns where required.

Governance, Quality and Service Improvement

• Contribute to a culture where incidents, complaints, audit, feedback and day-to-day operational learning are used to improve care.
• Take part in incident reviews, significant event analysis, complaint responses and shared learning activity where required.
• Support audit, quality improvement and service evaluation work across NEMS urgent care services.
• Contribute to the development and review of clinical guidelines, SOPs, pathways and local standards, ensuring they are practical, evidence-based and relevant to the way services are delivered.
• Use available data, feedback and clinical experience to support improvements in patient flow, clinical quality, productivity and patient experience.

Education and Professional Development

• Maintain professional registration, mandatory training, clinical supervision, CPD and revalidation requirements.
• Maintain an up-to-date portfolio showing competence, scope of practice, reflective learning and prescribing practice where applicable.
• Share learning with colleagues through teaching, case discussion, supervision, peer review and practical shift-based support.
• Support students, trainees and developing practitioners in a safe and constructive way, recognising their competence and learning needs.

Professional Responsibilities

• Work within relevant NMC, HCPC or equivalent code of conduct NEMS policies and agreed scope of practice.
• Communicate clearly with patients, carers and colleagues, particularly where information is complex, sensitive or distressing.
• Involve patients in decisions about their care and ensure that consent, capacity and best-interest issues are considered and documented appropriately.
• Maintain confidentiality and information governance standards at all times.
• Work flexibly across NEMS sites and services where reasonably required, in line with service need, competence and contractual arrangements.
• Undertake any other reasonable duties requested by a manager, where these are appropriate to the role, grade and competence of the post holder.
• Act in a manner that reflects and promotes the values of NEMS.

Person Specification
Qualifications
Essential

• NMC, HCPC or equivalent professional standards
• Medico-legal aspects of autonomous urgent care practice and independent non-medical prescribing
• Assessment and management of urgent care presentations, including recognition of red flags and clinical deterioration
• Safeguarding adults and children
• Mental capacity, consent and mental health risk
• Confidentiality and information governance
• Clinical governance, audit, incident learning and quality improvement

Desirable

• Knowledge of NEMS services, local urgent care pathways and system partners
• National standards relevant to urgent care, out-of-hours and clinical assessment services

Skills and Abilities
Essential

• Able to make safe, autonomous clinical decisions and recognise when to seek advice or escalate
• Able to undertake safe telephone and face-to-face clinical assessment
• Explains complex situations in ways that are accessible to patients, carers and colleagues
• Maintains clear, accurate and timely clinical records
• Able to work under pressure and manage competing clinical priorities
• Able to work collaboratively with teams across professional and organisational boundaries
• Flexible and adaptable to changing service needs
• Commitment to patient centred care and safe service delivery

Desirable

• Competent in the use of Adastra, SystmOne, EMIS, Nervecentre or other relevant clinical systems
• Able to contribute to audit, service improvement and pathway development

Experience
Essential

• Experience of working clinically in a primary, community, urgent care, emergency care or out-of-hospital setting
• Experience of autonomous assessment and management of patients with undifferentiated urgent care presentations
• Experience of telephone or remote clinical assessment
• Experience of face-to-face urgent care consultations
• Experience of independent non-medical prescribing within professional competence and scope of practice

Desirable

• Experience working in Urgent Treatment Centres, GP Out-of-Hours, Clinical Assessment Services or Emergency Departments
• Experience of supervising, supporting or teaching other clinical staff or students

Knowledge
Essential

• NMC, HCPC or equivalent professional standards
• Medico-legal aspects of autonomous urgent care practice and independent non-medical prescribing
• Assessment and management of urgent care presentations, including recognition of red flags and clinical deterioration
• Safeguarding adults and children
• Mental capacity, consent and mental health risk
• Confidentiality and information governance
• Clinical governance, audit, incident learning and quality improvement

Desirable

• Knowledge of NEMS services, local urgent care pathways and system partners
• National standards relevant to urgent care, out-of-hours and clinical assessment services

Other
Essential

• The ability to work flexibly when required in line with the demands of the role
• Ability to undertake both telephone and face-to-face clinical work across NEMS services
• Willingness and ability to work across more than one NEMS site where this forms part of the agreed working pattern
• Ability to work remotely for telephone consultations where agreed following induction, and where KPIs and quality standards are being met

Desirable

• Full driving licence and the ability to travel between locations where multisite working is agreed

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.

NEMS Community Benefit Services Ltd is a not-for-profit social enterprise and a Company Limited by Guarantee. It has been operating in Nottinghamshire for over 25 years, now providing a population of more than 1.2 million with urgent primary health care services.