PCN Advanced Care Nurse Practictioner - Care of Older, Frail Adults

Job responsibilities

Our PCN Advanced Care Nurse Practitioner has the following key responsibilities in delivering health services to our older frail adults:

- Practice both independently within scope of practice and in partnership with the multidisciplinary team (MDT) under the clinical supervision of a General Practitioner or a community consultant where applicable, ensuring interventions and treatments are undertaken in line with best practice.

- Work as part of the practice and wider multidisciplinary teams to support the delivery of a frailty service, reviewing complex patients and sharing expertise to improve patient care.

- Be an independent prescriber, using prescribing and deprescribing skills to optimise the use of medicines to improve patient outcomes.

- Undertaking home visits for the practice or PCN.

- Perform at an advanced level under the core capabilities across the four pillars of Advanced Practice (Health Education England Multi-Professional Framework 2017):

- Clinical Practice

- Leadership and Management

- Education

- Research.

Clinical Practice

Undertake clinical assessment of the patient, analysing complex clinical signs, patient history, and investigation to establish a clear care plan, including the generation of anticipatory, escalation, or admission avoidance plans, arranging rescue medicines and ensure the completion of out of hours special messages.

Interpret clinical results and act on findings accordingly.

Liaise closely with medical, therapy, nursing, pharmacy, social prescribing professionals and PCN care co-ordinators on care plans.

Admit and discharge patients from the caseload appropriately, providing accurate and effective clinical handovers across professional boundaries and receiving/making referrals as appropriate.

Provide advice and clinical decision making where information is lacking.

Provide specialist advice and support to staff, relatives or carers of older adults with the aims of enabling shared decision making, obtaining consent and enhancing the quality of patient care.

Communicate effectively with patients, and where appropriate family members and their carers, where applicable, complex and sensitive information regarding their physical health needs, results, findings, and treatment choices.

Agree, set and ensure systems are in place to continuously monitor, review and reset clinical standards of care. That wherever possible clinical practice is research based and in line with nationally recognised best practice, commenting on and creating clinical guidelines and procedures to support this.

Maintain accurate and contemporaneous health records appropriate to the consultation or advice given in any practice setting, ensuring accurate completion of all necessary documentation associated with patients healthcare and registration with the practice.

Recognises own limitations and effectively seeks appropriate help from a range of multiagency and interprofessional resources in their practices.

Leadership and Management

Lead, develop and evaluate the delivery of a responsive, proactive, patient-focused frailty service across the PCN.

Communicate at all levels across organisations ensuring that an effective, person-centred frailty service is delivered and understood.

Work collaboratively and in partnership with other health care professionals, providing appropriate leadership, guidance, and supervision to colleagues and assisting in recruitment where required.

Be involved in planning and implementing standards of care in the practices or PCN, practice guidelines and to continually evaluate the quality of patient care.

Develop processes, protocols, standards, policies and guidelines for others to use in practice through interpreting and synthesising complex information from a variety of sources.

Contribute appropriately to clinical governance activities that relate to own area of practice and patient/client group.

Contribute to the management of the service, in collaboration with multidisciplinary team and the PCN board.

Develop and sustain appropriate collaborative relationships, partnerships, and networks to influence and improve health outcomes and healthcare delivery systems.

Education

Provide supervision, advice, support and training for the clinical and non-clinical members of the frailty team.

Where requested, take an active role in educating and developing members of the wider practice multidisciplinary teams, including students through formal and informal teaching sessions.

Identify own continuing professional development needs in line with service needs and maintenance of ongoing capability and competence in practice.

Actively seek and participate in peer review of their own practice and participate in annual appraisal, 360 feedback for self, demonstrate ongoing professional development by keeping up to date with national and local developments in specialist area of practice.

Maintain a professional portfolio to demonstrate ongoing professional development and capabilities under the four pillars of advanced practice.

Complete the relevant training in order to provide multi-professional clinical practice and CPD supervision to other roles within the frailty team and personalised care roles.

Research

Maintain an up-to-date knowledge in the specialist field, using information to affect change in practice and ensuring the effective dissemination of new knowledge.

Able to critically appraise and synthesise the outcomes of relevant research, evaluations and audits and act on this information in collaboration with colleagues to continually develop the service.

Able to review and critically appraise new evidence to ensure that practice is evidence based and in line with current local and national guidance.

Identify gaps in evidence or areas of practice requiring development, undertaking audit, implementing change of practice where appropriate and evaluating outcomes.

Liaise with PCN research lead(s) to initiate or participate in appropriate local and national clinical trials related to the care of an older, frail adult.

Share good practice through creating positive opportunities to network locally, regionally, and nationally, and contribute to the wider development of area of practice through publication and dissemination.

Communicate proactively and effectively with all colleagues across the multidisciplinary team, attending and contributing to meetings as required;

Support in the delivery of enhanced services and other service requirements on behalf of the PCN.

Ensuring cost-effective use of resources, adherence to personnel policies and the achievement of service targets.

Participate in the management of patient complaints when requested to do so and participate in the identification of any necessary learning brought about through incidents and near-miss events.

Undertake all mandatory training and induction programmes.

Always maintain a clean, tidy, effective working area.

Experience

Essential

• Experience of practice within the four pillars with portfolio/evidence or role that demonstrates ability to work as an advanced clinical practitioner.
• Clinical experience and knowledge that is relevant to the care of older, frail adults
• Ability to effectively assess, plan, treat and refer patients appropriately and evaluate patient care confidently
• In-depth therapeutic and clinical knowledge and understanding of the principles of evidence-based healthcare
• An appreciation of the nature of general practice
• An appreciation of the NHS landscape including the relationships between individual practices, PCNs and the commissioners

Desirable

• Experience of prescribing, medication reviews and optimising treatments

Qualifications

Essential

• Holds a MSc advanced practice programme qualification accredited by the Centre for Advancing Practice or has completed the Centres ePortfolio (supported) Route
• Holds an Advanced digital badge
• Is registered with the Nursing and Midwifery Council
• Is able to practice as an advanced practitioner in the speciality of elderly care and frailty
• If not a qualified non-medical prescriber, must be prepared to obtain the non-medical prescribing qualification

Desirable

• Is an independent non-medical prescriber
• Teaching qualification
• Is an ALS/APLS provider

Wider responsibilities

Essential

• Evidence of working autonomously or as part of a team
• Understanding and knowledge of healthcare provision in GP surgeries, QOF and enhanced services
• Knowledge of national standards that inform general practice (e.g. NICE guidelines)
• Enhanced Disclosure Barring Service (DBS) check
• Occupational Health Clearance
• Evidence of continuing professional development commensurate with the role of an Advanced Care Practitioner
• Access to own transport and ability to travel across the locality on a regular basis, including to visit people in their own home

Personal qualities

Essential

• Ability to use own initiative, discretion and sensitivity
• High level of integrity and loyalty
• Able to get along with people from all backgrounds and communities, respecting lifestyles and diversity
• Ability to identify risk and assess/manage risk when working with individuals
• Knowledge of and ability to work to policies and procedures, including confidentiality, safeguarding, lone working, information governance and health and safety
• Undertake a range of administrative tasks such as ensuring stock levels are maintained and securely stored and equipment is kept in good working order

Skills

Essential

• Ability to follow clinical, legal, ethical, professional and organisational policies/procedures and codes of conduct
• Able to work within the parameters within skills and knowledge, to recognise the limitations of practice and to work within the boundaries of training and capability to make clear decisions with confidence
• Advanced communication skills to impart complex, highly sensitive, and potentially distressing information effectively with people at all levels by telephone, email and face to face
• Excellent interpersonal, influencing, negotiation and organisation skills with the ability to constructively challenge the view and practices of patients, managers and clinicians
• Problem solver with the ability to process information accurately and effectively, interpreting data as required
• Ability to record accurate clinical notes
• Knowledge of IT systems including the ability to use word processing skills, emails and the internet to create simple plans and reports
• Effective time management (planning and organising)
• Demonstrate personal accountability, emotional resilience and work well under pressure

Desirable

• Clear, polite telephone manner
• Good clinical system IT knowledge of EMIS/SystmOne/Vision

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).