PCN Care Homes Advanced Clinical Practitioner

Job responsibilities

JOB DESCRIPTION

Post

Primary Care Network Advanced Clinical Practitioner - Care Homes

Salary Grade

£27.75 - £30,50 / hour

£54,261 - £59,638 / annum pro rota

Reporting to: Care Home Clinical Lead

Accountable to

PCN Care Home Clinical Lead

GP Clinical Lead for Care Homes

PURPOSE OF THE ROLE

The post holder, as a qualified Advanced Clinical Practitioner with a digital badge, will support the development and provision of the Enhanced Health in Care Homes service across the Rushcliffe Primary Care Network (PCN) by working closely within a Multi-Disciplinary team and working as an autonomous practitioner:

This role will utilise your advanced clinical skills as autonomous practitioners. You will lead the delivery of weekly care home rounds in Rushcliffe. Providing medical management of care home residents with chronic health conditions, non-acute medical needs and undifferentiated acute presentations through clinical assessment, examination, investigation, diagnosis, care planning, treatment and evaluation of care.

You will also provide structured medication reviews, develop ReSPECT plans in conjunction with residents and significant others and support the overall delivery of the Enhanced Healthcare in Care Homes framework.

Medications management and structured medication reviews are a critical part of being an ACP in the care home team.

Deliver a high standard of patient care with in-depth theoretical knowledge and evidence-based practice, working autonomously and with the support and supervision of a GP

Manage a clinical caseload and deal with presenting patient needs within a care home setting

You will work within their clinical competencies as agreed with the PCN GP Lead for Care Homes

Use the Comprehensive Geriatric Assessment framework to complete new resident assessments when they are admitted to a new care home.

Provide clinical leadership and expert professional advice to patients, relatives, carers, and colleagues to support the delivery of high-quality clinical care

Support the teaching, training, and education of PCN and Care Home Staff

Work across organisational boundaries, developing new ways of working to promote relationships between providers and statutory bodies and improve care for people living in long term residential care.

The successful applicant will have an MSc in Advanced Clinical Practice, be a non-medical prescriber and come from a Nursing, Pharmacy, Physiotherapy or Paramedic Background with a digital badge in advanced clinical practice.

MAIN DUTIES AND RESPONSIBILITIES

Working autonomously with accountability for their professional actions, the post holder is responsible for undertaking care home ward rounds to proactively manage the health needs of care home residents within Rushcliffe to make decisions regarding the appropriateness of onward referrals and hold others to account for their delivery of actions.

The post holder will undertake clinical assessments for care home residents presenting with undifferentiated, long term conditions and undiagnosed problems utilising history taking, physical examinations, problem solving and clinical decision making skills to establish a working diagnosis and management plan in partnership with the patient (and their carers where applicable). The management plan will take into account medications management, prescribing, monitoring and structured medication reviews.

Request invasive and non-invasive diagnostic tests or investigations and interpret findings/reports within your scope of competence. Discuss the result and implications of laboratory investigations with patients, GP and where necessary the community geriatrician.

Utilise available diagnostics, plus interpretation, to support diagnosis, treatment, and develop management plans.

Where required and within skill competence and relevant training, offer specialised support in areas including, but not limited to COPD, asthma, diabetes heart failure and anti-coagulation. Additional training will be provided as part of ongoing CPD, and to upskill where needed.

Undertake a Comprehensive Geriatric Assessment on residents new to a care home and following hospital discharge including the prescribing of treatment for patients in care homes with complex illnesses: consulting the wider medical team of GPs and Geriatricians as required.

You will support the delivery of COVID and flu programme, by vaccinating residents and providing a level of medication oversight as part of the Rushcliffe and National programme

Provide health/disease promotion and prevention advice to care home residents and their carers/family:

• To confidently consult with patients/families/carers to determine the needs of individuals and develop and review care plans to support care including end of life planning, and discussions. This will include developing a ReSPECT plan, in conjunction with the resident, relatives and others as appropriate.

Utilise and work within the boundaries of local and national clinical guidelines and promote evidence-based practice.

Deliver integrated patient centred care through appropriate working with the wider primary care network multi-disciplinary team and social care networks

• Working autonomously with accountability for their professional actions, make onward referral to medical specialities for further assessment
• Work within Professional guidelines and code of conduct

Utilise clinical guidelines and promote evidence-based practice, participate in clinical audits, significant event reviews and other research and analysis tasks.

• Utilising the non-medical prescribing qualification, develop their area of expertise in frailty to meet the needs of the care home population and with accountability for their professional actions prescribe and deprescribe medication in line with local and national guidelines
• The post holder is responsible for ensuring that the residents and care home managers within Rushcliffe receive assistance in accessing health care interventions by signposting to the most appropriate person to provide care
• The post holder is responsible for consulting and collaborating with other healthcare professionals and specialists across both primary, secondary, social care and the voluntary care sectors

As a registered Advanced Clinical Practitioner, you will be supported with a GP clinical lead and Partners Health to continually develop ACP skills, in conjunction with the University and Nottingham Training Alliance (NATH)

ADMINISTRATION

Ensure consultations are documented accurately, clearly, and contemporaneously.

Update patient records in accordance with PCN policies and procedures meeting the requirements of professional bodies NMC/HCPCYou will be responsible for management of a clinical ledger, to ensure the metrics required within the Enhanced Healthcare in Care Homes are met.

Ensure continuing education, training and development is undertaken to meet clinical governance guidelines for Continuing Professional Development and a Personal Development Plan.

Actively participate in clinical notes and prescribing audits, along with clinical supervision as part of the ongoing CPD and governance compliance requirements.

Maintain professional registration with the NMC/HCPC as required to maintain the healthcare professional registration.

Provide evidence of a digital badge in Advanced Clinical Practice.

Undertake a fair share of the overall administration associated with clinical practice within primary care.

Involvement in clinical audit as part of new service implementation, quality improvement, patient reviews, QOF and any other audit work undertaken by the PCN Care Home Team and/or PartnersHealth

Show a caring attitude towards patients, care home staff and colleagues. Have well-developed communication skills to provide treatment plans and work to a professional code of ethics

Keep up to date with relevant medical research, technology, and evidence-based medical practice by attending continuing education courses and professional meetings, reading journals etc.

As an employee of PartnersHealth, working with patients registered with GP practices across the PCN, you will take due diligence and care regarding any information collected, recorded, processed or handled by you during the course of your work and that such information is collected, recorded, processed and handled in compliance with PCN requirements and instructions.

The post holder will be required to travel as part of their duties to other sites in the PCN, and travel expenses will be reimbursed by the employer.

To undertake research and service development where possible to maintain the ACP pillars of practice.

Support the teaching, training and education of PCN and Care Home Staff

To ensure observance and adherence to the Health and Safety at Work Act 1974.

To participate in staff meetings, 1-2-1 meetings and the appraisal scheme and undertake training appropriate to the development of the job role and in line with the PCNs statutory obligations.

To work to the agreed standards, policies and procedures and protocols of the PCN and be fully conversant with emergency procedures.

To reflect on own practice individually and/or through regular clinical supervision.

Work with The GP lead and Care Home Team Lead in developing the strategic and operational management of the Enhanced Health in Care Homes Service

The duties of this post are a guide to the range of responsibilities that may be required. These may change from time to time to meet the needs of the service and/or the development needs of the post holder. This job description will be revised regularly to take account of changes within the organisational structure and the practice business plan.

Commitment to PartnersHealth Values & Behaviours

Essential

• Must be able to demonstrate behaviours consistent with PartnersHealth values and behavioural standards

Circumstances

Essential

• Car owner/driver, with exclusive access to a vehicle
• Ability to work alone in the primary care setting

Knowledge, Skills & Experience

Essential

• Hold an advanced clinical skills qualification, with a digital badge.
• Hold a Non-Medical Prescriber qualification.
• Experience of working as an Advanced Clinical Practitioner within a multi-disciplinary team and across organisational boundaries
• Ability to provide a holistic clinical consultation for a frail, older patient cohort, including assessments, history taking, examination, diagnosis, plan, monitoring and follow up.
• Dealing with acutely unwell patients and distressed relatives / carers, including unwelcoming news, as to future prognosis of patients condition
• Ability to apply clinical judgements involving complex facts or situations, requiring analysis, interpretation, comparison of a range of options.
• Experience managing acute, sub acute, long term conditions, minor and major health conditions, and consider differential diagnosis.
• Ability to present patient cases to allow comprehensive and thorough debrief of the patient with the GP as required.
• Experience of requesting investigations and interpret their findings in view of other clinical information as per guidelines within the acute setting.
• Demonstrate own professional judgement and in discussion with the medical and nursing team decide when patients require referral to another speciality.
• Ability to work flexibly across different locations as required and multi-task when necessary, including as required out of hours work.
• Able to work independently as well as part of a multi-disciplinary team utilising good interpersonal skills.
• Evidence of excellent organisational and planning skills
• Ability to manage clinical ledgers and prioritise workload.
• Excellent communication skills written and verbal
• Ability to influence and challenge colleagues appropriately.
• Demonstrate working with wider system partners such as social care, acute and community services.
• Adaptable to changing working environment and service needs.
• Planning, organising and prioritising tasks, activities, or programmes some of which may be urgent or ongoing.
• Physically and mental capable of undertaking full duties of post. There may be occasional requirements to exert moderate physical effort to meet the flexible needs of the service.
• Good IT skills in word processing, excel and e-mail.
• Understanding of Confidentiality and the Data Protection Act
• Understanding of clinical governance and its significance and impact upon practice.
• Dealing with situations where family situations or circumstances can be a difficult emotional experience, including the delivery of difficult messages in relation to a deterioration in patients condition
• Awareness of equality and valuing diversity principles
• Experience of clinical supervision
• Evidence of experience / competency in the form of a professional portfolio.
• Able to work on own initiative, but knows limitations of own competencies

Desirable

• Experience of working with frail older people.
• Experience of working with SystmOne clinical system, and Ardens.
• Experience of working with care home staff, and older people living in residential care homes.

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).