Advanced Clinical Practitioner

Job responsibilities

Purpose

To deliver high-level, patient centred, evidence-based care, whilst integrating advanced clinical skills, leadership, education and research into practice.

KEY RESPONSIBILITIES

Direct provision of high-quality specialist palliative care

Assessment, diagnosis, and management of patients under the care of the Hospice. Majority of work is based in the adult in-patient unit, but if required as outpatients or domiciliary visits. Work includes:

Using effective joint working and prioritisation to support responsive admissions within available capacity each day.

Supporting safe transfer of care from acute or community settings to hospice settings by in-depth assessment and co-ordination between acute/community and the hospice.

Admission assessment and forming a management plan. This includes receiving patients with undifferentiated and undiagnosed problems and making an assessment of their health care needs, based on highly developed nursing knowledge and skills.

Providing explanation/ information according to individual patient preference, communication with patients/ family and other professional colleagues.

Arranging and reviewing appropriate investigations.

Be responsible for assessing and recognising emergencies in palliative care. Interpreting information and taking appropriate action, and to support other, less experienced, members of the team to do the same.

Supporting and enabling patients and carers to make informed decisions relating to their treatment and management.

Safe and effective prescribing in accordance with prescribing standards.

Supporting advance care planning.

Managing challenging symptoms.

With others, providing leadership in challenging situations.

Providing effective documentation and handover.

Managing expectations and working to provide holistic high quality responsive general medical and specialist palliative medical care in accordance with current evidence, accepted practice and guidance.

Use of a variety of clinical support systems to aid clinical decision making.

Working within the medical team to maintain continuity of care.

Assessment of appropriateness of discharge, contributing to discharge and aftercare planning.

Liaising promptly with professional colleagues involved in patient and family care during and after admission.

To be pivotal in encouraging and managing appropriate referrals within the specialty, attending complex case discussions, MDT and other meetings.

To use excellent prioritising and time management skills to meet the unpredictable and conflicting needs of the service.

Provision of specialist palliative care advice and Multi-disciplinary team working

With professionals, patients and carers during working hours and on call. This includes decision making over remote advice regarding symptom management, the appropriateness of admission or discharge to/from the Hospice.

Timely completion of medical correspondence and use of NHS mail to liaise with professional colleagues.

Working with the multidisciplinary team to provide holistic specialist palliative care to patients/carers and families.

Ensuring appropriate involvement of relevant professionals, interfacing and planning most effective joint working.

To work alongside the wider multidisciplinary team in promoting a rehabilitative palliative care approach enabling people to live fully until they die.

Leadership and strategy

Work autonomously across professional, organisational and system boundaries and proactively develop and sustain new partnerships and networks to influence and improve health, outcomes and healthcare delivery systems.

To provide a clinical leadership function as required.

To contribute to quality improvement activity including review of clinical guidelines and appropriate audit activity.

To participate in the investigation of incidents and/or complaints as required, ensuring that all complaints and incidences are reported and lead the development of action plans to address areas of concern, identifying learning and changes to practice.

Negotiate and facilitate management of change in practice to achieve best quality clinical services.

To develop and implement, with nursing, medical staff and AHP, new policies and clinical guidance for new procedures.

To work with nursing & medical leadership to support and facilitate the development of clinical skills for the nurses and clinical leadership as necessary.

Work alongside the nursing & medical leadership team in establishing and maintaining effective communication channels with multi-disciplinary team, patients and their carers, and external agencies.

Establish links with local and tertiary referral centres sharing good practice.

Engage in relevant departmental meetings, mortality reviews, clinical audit and quality improvement work.

Act as a clinical role model for developing and delivering care that is responsive to changing requirements.

Contribute to clinical governance processes, hospice strategy development and implementation.

Support the Registered Manager to be compliant with CQC reporting requirements by ensuring all delegated, required notifications are submitted in a timely and effective manner.

Education and Research

Support with the training and supervision of trainee advanced clinical practitioner, foundation doctors and GP registrars.

Lead on, and work in collaboration with others, to plan and deliver interventions to meet the learning and development needs of visiting medical students through timetabling their placements, identifying learning opportunities and ensuring feedback is received.

Work in collaboration with others to plan and deliver interventions to meet the learning and development needs of their own and other professions including trainee ACP, GP registrars and foundation doctors.

Engage in supervised professional development with medical and nursing colleagues to aid the development of progressive professional practice policies, identifying opportunities for succession planning.

Provide a quarterly report of the statistics related to the support and experience offered to medical student whilst at EVH, key performance indicators, service and practice developments.

The post holder will develop new areas of practice and will actively lead on wider research engagement, alongside nursing and medical staff ensuring quality standards are met.

Lead on, and participate in, local and national research studies that have been identified and agreed by the Eden Valley Hospice MDT. Work with the lead research team (National or Local) and support the EVH & Jigsaw medical and nursing team to ensure all research requirements are achieved.

Utilise research findings in the delivery of specialist patient care, developing new ways of working and disseminating relevant information to staff.

Lead and contribute to audit and research within the specialty in collaboration with colleagues, developing action plans and disseminating information.

To be familiar with current clinical research protocol issues and relevant treatment and procedures employed in the diagnosis and treatment within their speciality.

Develop and lead on requested teaching sessions for both small and larger groups of students, EVH colleagues and wider generalist colleagues in the acute and community setting.

Follow professional code of practice and hospice professional expectations, policies and procedures. Maintain compliance with the EVH mandatory training requirements.

The post holder will develop new areas of practice, with nursing and medical staff ensuring quality standards are met. The post holder will work closely with the interdisciplinary team and collaborate with colleagues to ensure that high quality patient care is maintained.

Advocate and contribute to the development of an organisational culture that supports continuous learning and development, evidence-based practice and succession planning.

Qualifications

Essential

• Working at MSc Advanced Practice or willingness to work towards this
• V300 independent prescriber qualification
• Advanced Clinical/Physical Assessment skills / qualification
• Masters level qualification/in progress or equivalent clinical experience
• Advanced communication skills
• Professional/ Statutory Registration
• Registered Health Care Professional
• Evidence of compliance with requirements for professional revalidation

Desirable

• Certificated speciality courses
• Teaching / Mentorship qualifications

Skills, Knowledge, Ability

Essential

• Advanced assessment and history taking skills
• Advanced theoretical and practical knowledge of palliative care with a wide range of approaches to the management of patients, demonstrated by advanced clinical reasoning, critical thinking and be able to comprehensively assess patients for risk factors and early signs of illness
• Ability to draw on a diverse range of knowledge in their decision-making to determine evidence-based therapeutic interventions (which will usually include prescribing medication and actively monitoring the effectiveness of therapeutic interventions)
• Excellent written and advanced verbal communication skills demonstrating the use of a variety of media/IT skills
• Advanced communication skills, ability to handle challenging situations and conflict resolution with use of negotiation skills
• Demonstrate strong leadership skills in contexts that are unfamiliar, complex, and unpredictable and advise their own and other professions on therapeutic interventions, practice and service development

Desirable

• Ability to lead within multi-professional working; within an organisation and across organisation boundaries being able to identify and implement systems to promote their contribution and demonstrate the impact of advanced level nursing to the healthcare team and the wider health and social care sector
• Evidence of managing clinical services, service innovation and up-to-date knowledge of nursing policy and strategy, together with successful change management experience and a proven track record in launching new initiatives.
• Ability to develop working relationships locally, regionally and nationally

Additional requirements

Essential

• High level of work organisation, self-motivation, drive for performance and improvement, and flexibility in approach and attitude
• Strong sense of commitment to openness, honesty, and integrity in undertaking the role

Experience

Essential

• Clinical experience of managing patients with complex specialist palliative care needs
• Experience of teaching patients and staff and others
• Demonstrates advanced skills in clinical assessment, diagnosis and decision making for patients with a variety of general medical and palliative diagnoses
• Evidence of evaluation of clinical practice and continuing professional development
• Significant experience of working within a multidisciplinary team
• Significant experience of undertaking a holistic approach to patient care
• Developed understanding and experience of the fundamental importance in the emotional, psychological, social and spiritual support of patients and families
• Experience of applying research evidence to clinical practice
• Ability to use information technology appropriately
• Ability to lead on and participate in collaborative educational programmes
• Knowledge and experience of mentorship within clinical practice
• Participation in the development, maintenance and monitoring of service standards
• Able to identify and address personal development needs
• Able to work without supervision and use own initiative whilst also understanding limitations and when to ask for help.

Desirable

• Demonstrate evidence of engaging stakeholders and influencing the development and improvement of practice, patient care and service delivery
• Understanding and experience of quality improvement practices

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).