Job SummaryTo work autonomously and collaboratively to deliver high-quality patient-centred care. Provide advanced clinical assessment, diagnosis, treatment and ongoing management for patients with acute, chronic and complex needs primarily for patients who are housebound or reside in the local nursing home, but there will also be a requirement to provide care to acutely presenting patients in an urgent care clinic.
Main DutiesClinical Care- Consult with patients, taking full history, assessing, diagnosing and managing acute and long-term conditions using evidence-based practice and NICE guidelines.
- Prescribe and review medication within scope of practice and current guidelines.
- Initiate action if required ordering investigations or organising referrals.
- Maintain clinical competence in a wide range of skills required to meet patient needs.
- Proactively identify, monitor and manage patients with complex needs, frailty or long-term conditions.
- Lead on care for patients in residential/nursing home and those who are housebound.
- Develop personalised care plans, including advance care plans and promote self-management.
- Recognise early signs of deterioration and intervene to prevent hospital admission.
- Provide clinical support for the nursing team.
- Lead nurse for long term conditions
- Provide timely clinical interventions and coordinate multi-disciplinary and multi-agency support.
- Support delivery of clinical targets including QoF and enhanced services.
Professional Practice- Work autonomously within professional boundaries, national protocols and local policies.
- Demonstrate advanced clinical decision-making and critical thinking
- Ensure accurate, contemporaneous clinical documentation on SystmOne.
- Adhere to the NMC/HCPC Professional Code of Conduct.
- Maintain patient confidentiality and uphold safeguarding responsibilities.
Communication- Maintain effective communication with patients, carers, colleagues and external agencies.
- Provide clear signposting to appropriate services
- Ensure accurate collection of activity data for audit and service evaluation.
- Seek support and advice from GPs and senior clinicians when required.
Education, Training and Development- Participate in the education and training of students and new staff.
- Support induction of new clinical and non-clinical team members.
- Maintain professional accreditation and engage in continuous professional development.
- Participate in annual appraisal and maintain a portfolio of professional development.
- Attend clinical supervision and mandatory training.
Clinical Governance and Quality- Contribute to clinical governance, risk management and quality improvement.
- Reflect on own and team performance, identifying opportunities for improvement.
- Alert colleagues to issues of quality, safety or risk.
- Work effectively with external agencies to meet patient needs.
- Manage own workload, time and resources efficiently.
Health and SafetyThe post holder will assist in promoting and maintaining their own and others health, safety and security as defined in the practice Health and Safety Policy.
Working in a busy, rural General Practice involves teamwork. It is essential that we communicate with openness and honesty for the benefit of our patients and colleagues.
Equality and DiversityThe post-holder will support the equality, diversity and rights of patients, carers and colleagues, to include:
- Acting in a way that recognizes the importance of peoples rights, interpreting them in a way that is consistent with practice procedures and policies, and current legislation.
- Respecting the privacy, dignity, needs and beliefs of patients, carers and colleagues
- Behaving in a manner which is welcoming to and of the individual, is non-judgmental and respects their circumstances, feelings, priorities and rights.
Contribution to the Implementation of ServicesThe post-holder will:
- Apply practice policies, standards and guidance
- Discuss with other members of the team how the policies, standards and guidelines will affect own work
- Participate in audit where appropriate.
Other DutiesTo undertake duties as agreed with the Partners or the Practice Manager
Person SpecificationExperienceEssential- Significant post registration clinical experience in primary care, community or acute settings.
- Experience managing complex, chronic and long term conditions.
- Experience working autonomously and making advanced clinical decisions.
- Experience in care home or housebound patient management.
Desirable- Experience in palliative and end of life care.
- Experience delivering QOF, QIS or Enhanced Services.
- Experience leading or contributing to service development.
QualificationsEssential- Registered Nurse (NMC) or Allied Health Professional (HCPC).
- Masters level qualification in Advanced Clinical Practice (or working towards).
- Independent Prescribing Qualification.
- Evidence of ongoing CPD and professional development.
- Additional specialist clinical qualifications (palliative care, frailty, LTCs).
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. 
