Advanced Nurse Practitioner

Job responsibilities

JOB DESCRIPTION ADVANCED NURSE PRACTITIONER

POST: Advanced Nurse Practitioner LOCATION: The Heath Surgery GRADE: Dependant on experience ACCOUNTABLE TO: GP Partner for clinical matters and Practice Manager for operational matters

JOB PURPOSE:

To act as an autonomous practitioner working independently and in conjunction with other health care professionals to assess, diagnose and treat the conditions of patients attending within primary care initiating direct referrals as appropriate.

Provide expert professional advice to patients, carers and colleagues and ensure the maintenance of clinical excellence. To develop new and innovative concepts, models, methods and practices to deliver new and improved primary care services to meet the needs of the practice and ICB population. To provide education and training to other staff and students. To undertake research as part of the role.

PRIMARY DUTIES AND AREAS OF RESPONSIBILITIES CLINICAL NURSING PRACTICE

The Advanced Nurse Practitioner works autonomously and is accountable for own professional actions. Undertakes Clinical Nursing Practice at an advanced level using expert knowledge and clinical skills to deliver holistic care to people accessing primary health care services. Assesses diagnoses and treats patients attending primary health care services with a range of acute, non acute and chronic medical conditions. Assesses diagnoses and treats patients in surgery or own home who require acute medical attention and refer to appropriate agency. Directly admits patients to secondary care hospital in acute medical need. Refers patients to other medical specialities for assessment if deemed appropriate. Refers patients as appropriate to other members of the multidisciplinary team, secondary care and to other statutory and voluntary organisations including referral for x-ray.

Has undertaken x-ray training as required by hospitals trust. Interprets a range of diagnostic tests and routine clinical procedures. Makes critical judgements of the highest order to satisfy the expectations and demands of the job eg first contact with patients presenting acutely and manages care in the presence and absence of protocols. Makes decisions where precedents do not exist, where appropriate without recourse to others eg. direct referral of patients to Hospital Consultants without prior reference to other medical colleagues. Advises and supports others where standard protocols do not apply. Works within professional guidelines and codes of conduct. Works within all relevant practice policies and procedural guidelines eg. infection control, chaperoning, risk management. Extended and supplementary prescriber.

CARE AND PROGRAMME MANAGEMENT

Develops and manages highly specialised programmes of care and care packages and provides highly specialised advice concerning care normally beyond the scope of normal Nursing practice eg establishes differential diagnoses, management/treatment plans and makes referrals as appropriate. Makes fast track referrals. Communicates highly sensitive condition related information to patients, relatives and carers. Initiates the process of diagnosis with patients suspected to have a chronic disease eg. diabetes, COPD, asthma, IHD referring to other clinical staff as appropriate. Contribute to practice targets both local and national within the disease management agenda eg QOF, prescribing incentive scheme. Contributes to disease registers. Audits outcomes of care against standards and initiate changes as necessary. Undertakes annual review of patients understanding and ability to self manage and medication reviews. Refers to other members of the extended primary health care team as appropriate eg chiropodist, dietician, specialist Nurses. To actively implement safeguarding protocols for children and vulnerable adults and to know who to refer to and how to escalate concerns about radicalisation.

STRATEGIC DEVELOPMENT OF PRIMARY CARE SERVICES

Contributes to the strategic development of primary care and public health services to meet patient and population needs within the practice and across the wider organisation. Works/liaises across multi-professional and agency boundaries. Works at the forefront of practice innovation. Determines how to deal with ambiguous or unique problems to develop and advance primary care services for the benefit of patients, carers and communities. Develop links within the ICB and other local and national bodies relevant to primary care Nursing initiatives.

HEALTH IMPROVEMENT

Initiates and carries out programmes of health screening and ensures other team members are aware of health agendas and screening programmes. Introduces innovation in practice to meet on going health need demands of the practice. Works to introduce new developments that will improve health outcomes for patients and is able to demonstrate through written and presentation these developments. Shares innovation and new learning with others. Supports practitioners in profiling the practice population in order to initiate contribute and promote improved health and prevent disease in individuals and groups. Represents individuals and families interests when they are not able to do so themselves. Makes referrals to statutory and voluntary agencies as appropriate.

COMMUNICATION

Provides and receives highly complex, sensitive or contentious information and frequently deals with situations which are hostile or emotive.

Uses developed communication, negotiation, conflict management skills which require empathy, reassurance and persuasive skills where there can be significant barriers to acceptance which need to be overcome.

Regularly communicates service related information to Partners, Practice Manager, Salaried GPs, Nursing and Administrative staff, patients, relatives and carers. Makes operational judgements, manages conflicting views and reconciles inter and intra professional differences of opinion. Builds and communicates therapeutic working relationships with a wide array of statutory and voluntary organisations for the benefit of patient care and facilitates good working relationships.

MANAGE/LEAD SELF/OTHERS

Encourage and motivate others to be forward thinking in ideas that address the health needs of the practice that will be innovative whilst managing and developing new ways of working. Develops and leads on evidence based practice. Promotes effective communication and relationships within the team. Partakes in monthly clinical supervision for own development. Actively participates in clinical and practice meetings. Develops own knowledge and practice to meet objectives/changes in service, through attendance on study days, self-directed learning and reflection on practice. Integrates theory into practice and establishes formal links with educational institutions. Leads on setting standards and promotes best practice. Operates high standards of probity.

MANAGE AND USE INFORMATION

Makes effective use of the clinical system by ensuring the consistent and accurate entering of data and use of Read Codes. Facilitates the use of up to date information technology in order to collate accurate and timely information as and when required by the practice. Ensures a satisfactory call and recall system of patients. Assist in the development of practice protocols for the surgery and clinical protocols for the clinical team. Identifies, monitors and reviews deficiencies in procedures and implements remedial action.

RESEARCH AND DEVELOPMENT

Continuous involvement in research/evaluation and/or development work which may be as part of one or more formal research programmes or activities. Actively contributes to Practice/Service/Team audit/Research activity as required. Instigates audit activity as required e.g. new services. Identifies, applies and disseminates research findings relating to clinical practice.

WORKING CONDITIONS

Frequent exposure to body fluids, blood, wounds, fleas and lice. Occasional exposure to aggressive behaviour Frequent use of VDU equipment. Requirement to travel between different locations e.g. home visits and care homes. Requirement to provide extended access in line with practice initiatives

Qualifications

Essential

• Registered General Nurse (Currently registered with the Nursing & Midwifery Council)
• Recognised ANP qualification at minimum of post graduate degree level or equivalent (MSc in Clinical Nursing or Nurse Practitioner Degree Level)
• Independent and Supplementary Nurse Prescriber

Desirable

• Teaching / Mentoring experience and /or qualification

Knowledge

Essential

• Extensive Clinical Skills
• 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
• 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 (eg National Service Frameworks, NICE guidelines etc)
• Understanding of their accountability arising from the NMC Code of Professional Conduct and medico-legal aspects of the Advanced Nurse Practitioner role
• Understanding of equal opportunity and diversity issues

Desirable

• Interpreting and implementing local and National policy agendas for health

Experience

Essential

• Minimum of 2 years post registration experience
• Evidence of appropriate continuing professional development activity to maintain up-to-date knowledge and on-going competence in all aspects of the ANP role
• Experience in essential skills to assess health including history taking, examination, interpreting investigations, diagnosis and prescribing.
• Experience in management long term conditions e.g. asthma, COPD, diabetes, CHD
• Evidence of 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

Skills

Essential

• 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 safely
• 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 PCT and with key external stakeholders

Desirable

• Proven record of effective use of networking and influencing skills
• Ability to think strategically
• Experience of presenting information to wider audience

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).