Advanced Clinical Practitioner

Job responsibilities

JOB SUMMARY

The post holder is an experienced clinician, who acting within their professional boundaries, will provide care for the presenting patient from initial history taking, clinical assessment, diagnosis, treatment and evaluation of their care. They will demonstrate safe, critical thinking in clinical decision-making and expert care for patients within the general practice.

They will work collaboratively with the multi-disciplinary General Practice teams 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, professional requirements for advanced practice must be met.

• To deliver a high standard of patient care as an Advanced Clinical Practitioner (ACP) in general practice, using advanced autonomous clinical skills, and a broad and in-depth theoretical knowledge base. Have a good understanding and appreciation of clinical governance and to work within ones sphere of competence.
• To clinically manage patients presenting with acute conditions on the same day
• To manage a clinical caseload, dealing with presenting patients needs in a primary care setting, responding effectively and holistically to patient needs and ensuring patient choice and ease of access to services
• To triage patients into the most appropriate appointment based on their triage request and presenting symptoms
• To provide clinical leadership within the practice, ensuring development and use of referral pathways for ACPs to the local services
• To mentor and support other nurses in developing and maintaining clinical skills.

KEY RESPONSIBILITIES

CLINICAL ROLE:

The post-holder will:

• Provide the choice of direct access to an ACP, both in Practice and over the telephone, for the general practice population
• Make professionally autonomous decisions for which they are accountable
• Provide a first point of contact within the Practices 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. This could be in the practice as well as seeing patients in their own homes.
• Instigate necessary invasive and non-invasive diagnostic tests or investigations and interpret findings/reports
• To prescribe safe, effective and appropriate medication as defined by current legislative framework and considering agreed prescribing formula guidelines
• To maintain comprehensive, accurate and contemporaneous computerised records of all consultations and contacts with patients and, when appropriate, written or printed records
• To maintain confidentiality and privacy while communicating data, plans and results, in a manner that preserves the dignity and privacy of the patient and provides a legal record of care
• Provide safe, evidence-based, cost-effective, individualised patient care
• Offer a holistic service to patients and their families, developing where appropriate an on-going plan of care/support, with an emphasis on prevention and self-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 and as agreed by the PCN, practice and partners
• To liaise with a doctor about patients with complex problems who need the expertise of a general practitioner
• To liaise with all members of the practices, community teams and other agencies local authority, social services, secondary care and voluntary agencies to assure appropriate care is provided for the practice population.
• Work with nursing, medical and health care assistant colleagues to ensure that National Service Frameworks (e.g. Coronary Heart Disease/Older People/Diabetes/Mental Health) are being delivered
• Work with multi-disciplinary team within the Practices, and across the wider local trust, to promote integrated and seamless pathways of care
• Contribute to the practices achieving its quality targets to sustain the high standards of patient care and service delivery
• Participate in identification of community health needs and develop patient/family-centred strategies to address them.
• Help develop and set up new patient services and participate in initiatives to improve existing patient services
• Be aware of and contribute to planning and delivery of practice-based commissioning.

PROFESSIONAL ROLE:

The post-holder will:

• Promote evidence-based practice through the use of the latest research-based guidelines and the development of practice-based research
• Monitor the effectiveness of their own clinical practice through the quality assurance strategies such as the use of audit and peer review
• Maintain their professional registration
• To promote personal and clinical excellence
• Participate in continuing professional development opportunities to ensure that up-to-date evidence-based knowledge and competence in all aspects of the role is maintained
• Work within the latest Code of Professional Conduct and to be conversant with The Scope of Professional Practice
• Record accurate consultation data in patients records in accordance with the latest guidance and other pertinent standards
• Keep up to date with pertinent health-related policy and work with the practice team to consider the impact and strategies for implementation
• Work collaboratively with colleagues within and external to the practice
• Demonstrate leadership
• Pro-actively promote the role of the ACP within the Practices, and externally to key stakeholders and agencies.

ADMINISTRATIVE ROLE:

The post-holder will assist;

• to encourage and develop teamwork within the practices
• Working within the different practice teams in developing new roles, responding to changing healthcare needs
• Identify appropriate opportunities to delegate both clinical and administrative tasks
• Help the practices operate in a cost-effective manner
• Interpret variations in outcomes and use of data from information systems to improve practice
• Participate in PCN and practice meetings where required
• Participate in audits and inspections as appropriate, using such data to make improvement to service
• Work closely with the Primary Care Network, Clinical Director, GPs and management in the setting up and/or improving of practice systems for monitoring/measuring performance against Clinical Governance and Quality Indicator targets
• To actively participate in the delivery for such QOF and other targets
• Ensure that all Practice Policies are fully implemented
• To keep PCN management and GP Partners informed about pressures and difficulties or problem areas when aware
• To understand and participate the role of risk management within the practices, contributing to risk assessment, significant event audits and infection control.

Qualifications

Essential

• Registered General Nurse/Pharmacist/Paramedic (with current registration)
• Independent Prescriber
• Recognised Advance practice qualification

Desirable

• Teaching/Mentoring experience and/or qualification

Knowledge and Skills

Essential

• Knowledge
• Understanding and knowledge of policy developments related to the delivery of primary care services including General Practice, the GMS/PMS contract, Clinical Governance, Quality & Outcomes Framework and Primary Care Network DES
• Understanding of systems to gain an understanding of the health needs of the Practice population as they relate to primary care
• Understanding of evidence based practice
• Knowledge of national standards that inform practice (e.g. National Service Frameworks, NICE guidelines etc.)
• Understanding of equal opportunity and diversity issues
• Skills
• Ability to assess and manage patient risk effectively and safely
• Well-developed word processing/data collection/IT skills
• Excellent interpersonal, verbal and written communication skills
• Reflective practitioner
• Time management and ability to prioritise workload
• Able to analyse data and information, drawing out implications for the individual patient/impact on care plan
• Able to establish and maintain effective communication pathways within the organisation, the local ICB and with key external stakeholders

Desirable

• Have an understanding of Commissioning issues
• Experience of use of a medical software package, EMIS, Docman
• Proven record of effective use of networking and influencing skills
• Ability to think strategically
• Experience of presenting information to wider audience

Experience

Essential

• At least 12 months post advance practice qualification and working as an ACP in a GP Practice or similar environment
• Evidence of appropriate continuing professional development activity to maintain up-to-date knowledge and on-going competence in all aspects of the ACP role
• Experience in management long term conditions e.g. asthma, COPD, diabetes, CHD
• Working autonomously and as part of a team
• Proven ability to evaluate the safety and effectiveness of their own clinical practice

Desirable

• Interpreting and implementing local and National policy agendas for health

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).