Advanced Nurse Practitioner

Job responsibilities

JOB SUMMARY

The post holder is an experienced nurse, 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, clinical decision-making and expert care for patients within the general practice and their own homes. They will work collaboratively with the multi-disciplinary general practice team 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, NMC requirements for advanced practice must be met.

1. SCOPE AND PURPOSE OF THE ROLE

• To deliver a high standard of patient care as Advanced Nurse Practitioner (ANP) in general practice, using advanced autonomous clinical skills, and a broad and in-depth theoretical knowledge base
• To manage a clinical caseload, dealing with presenting patient’s needs in a primary care setting
• To develop the nursing services offered by the practice
• To provide clinical leadership within the practice within specialist fields.

2. JOB DIMENSIONS

• To manage own clinical workload in general practice responding effectively to patient need and ensuring patient choice and ease of access to services.
• The development and use of referral pathways for NPs to the local acute NHS Trust services and to Diagnostic and Treatment Centres .
• To mentor and support other nurses in developing and maintaining clinical skills

3. KNOWLEDGE, SKILLS AND EXPERIENCE REQUIRED

See person specification

4. PRIMARY DUTIES & AREAS OF RESPONSIBILITY

A. CLINICAL ROLE:

The post-holder will :

• Provide the choice of direct access to a ANP, both in the Practice and over the telephone, for the general practice population
• Make professionally autonomous decisions for which he/she is accountable
• Provide a first point of contact within the Practice 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
• Instigate necessary invasive and non-invasive diagnostic tests or investigations and interpret findings/reports
• Where the post holder is an independent prescriber : to prescribe safe, effective and appropriate medication as defined by current legislative framework
• 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
• Undertake home visits as requested
• 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
• Assist the Practice in developing and delivering specialist primary care services, such as long term disease management (diabetes, asthma, chronic obstructive pulmonary disease, coronary heart disease and hypertension)
• Work with nursing, medical and health care assistant colleagues to ensure that NICE Guidelines (eg Coronary Heart Disease/Older People/ Diabetes /Mental Health) are being delivered
• Work with mutli-disciplinary team within the Practice, and across the wider CCG, to promote integrated and seamless pathways of care
• Contribute to the practice 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

B. TEACHING AND MENTORING ROLE:

The post-holder will :

• Promote a learning environment for patients, nurses and other health professionals.
• Contribute to the planning and implementation of the teaching for existing staff, such as medical students, GP registrars, Health Care Assistants, within the Practice.

C. 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
• 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 NMC Code of Professional Conduct
• Record accurate consultation data in patients records in accordance with the latest NMC 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

D. MANAGERIAL ROLE :

The post-holder will :

· Act as mentor for if required for nurses and through this, support colleagues personal development.

· Participate in clinical supervision with the nursing team

· Encourage and develop teamwork within the practice.

· Participate in multi-disciplinary protocol and Patient Group Directions development

· Identify appropriate opportunities to delegate both clinical and administrative tasks to more junior staff.

· Help the practice operate in a cost-effective manner.

· Identify and manage nursing care risks on a continuing basis.

· Participate in practice meetings as appropriate.

· Participate in audits and inspections as appropriate.

· Work closely with the doctors and administrative managers in the setting up and/or improving of practice systems for monitoring/measuring performance against Clinical Governance and Quality Indicator targets.

· Ensure that all Practice Policy’s are fully implemented

E. AREAS OF PRACTICE EXCLUDED FROM THE POST-HOLDERS REMIT:

The post-holder will not undertake the following :

• All aspects of antenatal/obstetric care

5. HEALTH AND SAFETY/RISK MANAGEMENT

· The post-holder must comply at all times with the Practice’s Health and Safety policies, in particular by following agreed safe working procedures and reporting incidents using the organisations Incident Reporting System.

· The post-holder will comply with the Data Protection Act (1984) and the Access to Health Records Act (1990).

6. EQUALITY AND DIVERSITY

· The post-holder must co-operate with all policies and procedures designed to ensure equality of employment. Co-workers, patients and visitors must be treated equally irrespective of gender, ethnic origin, age, disability, sexual orientation, religion etc.

7. RESPECT FOR PATIENT CONFIDENTIALITY

· The post-holder should respect patient confidentiality at all times and not divulge patient information unless sanctioned by the requirements of the role.

8. COMMUNICATION & WORKING RELATIONSHIPS

• The post-holder will establish and maintain effective communication pathways with the multidisciplinary team internally and externally.

9. REHABILITATION OF OFFENDERS ACT 1994 (optional)

Because of the nature of the work, this post is exempt from the provisions of Section 4(2) of the Rehabilitation of Offenders Act 1994 (Exceptions) Order 1995. Applicants for posts are not entitled to withhold information about convictions which for other purposes are “spent” under the provisions of the Act and in the event of employment any failure to disclose such convictions could result in disciplinary action or dismissal by the Practice. Any information given will be completely confidential and will be considered only in relation to an applicant of a position to which the order applies.

Experience

Essential

• Minimum of 5 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 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
• 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

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

Knowledge

Essential

• Understanding and knowledge of policy developments related to the delivery of primary care services including General Practice, the GMS/PMS contract, Clinical Governance.
• 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, NICE guidelines etc)
• Understanding of accountability arising from the NMC Code of Professional Conduct (2004) and medico-legal aspects of the Nurse Practitioner role
• Understanding of equal opportunity and diversity issues

Qualifications

Essential

• Registered General Nurse (Currently registered with the Nursing & Midwifery Council)
• Recognised ANP qualification at minimum of degree level or equivalent or Masters

Desirable

• Independent Nurse Prescriber
• Teaching / Mentoring experience and /or qualification

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).