Advanced Clinical Practitioner in Frailty

Job description

Job responsibilities

Clinical Care

To work closely with the Consultant Nurse for Older People, OPAL therapy team, Consultant Geriatricians, AMU and ED clinicians to provide effective, flexible and responsive SDEC services for patients with decompensated frailty to ensure rapid delivery of assessment, diagnosis, treatment, care planning, early transfer of care and hospital admission prevention where appropriate.

2. Develop, deliver and ensure high quality, safe clinical practice. Be proactive in clinical decision making, underpinned by an advanced level of theoretical and practical knowledge and be able to demonstrate improved patient care outcomes.

3. To work autonomously utilising advanced clinical practice skills including history taking, clinical examination, formulation of differential diagnoses, clinical testing, problem identification, diagnosis, and treatment planning.

4. To be responsible and accountable for their own decisions, actions, and omissions at this level of practice. Demonstrating a critical understanding of own level of responsibility and autonomy and the limits of own competence, capabilities, and professional scope of practice, including when working with complexity, risk, acuity and uncertainty.

5. To act as the Lead Clinician undertaking Comprehensive Geriatric Assessments for older people presenting with frailty. This will involve working as part of a multi-disciplinary team, planning, implementing, and evaluating the care delivery according to changing healthcare needs.

6. To prescribe, de-prescribe and review medication (as an independent non-medical prescriber) for therapeutic effectiveness appropriate to patient need and choice and in accordance with best/evidence-based practice and national and local protocols and within the post holders professional scope and the roles scope of practice and legal framework.

7. Demonstrate a high level of knowledge in relation to the common comorbidities of older age, markers of condition progression and ranges of treatment available at each stage of disorder or condition. Seek advice from and involve specialist teams wherever appropriate.

8. Demonstrate an ability to safely and effectively prioritise need within fluctuating clinical workloads to achieve the best possible outcomes for patients, showing an ability to delegate where appropriate and to manage and escalate any concerns where workload exceeds capacity.

9. To be responsible for the delivery of a detailed, accurate and, where required, complex clinical handover and to document detailed and accurate written information within the medical notes regarding all clinical assessments, investigations completed and requested, and treatments administered.

10. To advise, communicate and work in conjunction with a wide range of clinical colleagues and systems partners; including primary care and community teams and Adult Social Care professionals, leading and facilitating a patient-focused, co-ordinated case management approach for people requiring complex discharge planning and who are at high risk of re-admission to hospital.

11. Effectively manage and balance risk in decision making and communicate and negotiate risk with patients, their families or carers and holders of power of attorney where available. Always considering what matters most to the patient, ensure shared decision-making is at the core of the service provided.

12. To proactively participate in and influence efforts across the health and social care system to shape multi-disciplinary pathways designed to support patient choice, improve quality of life, promote self-management, and assure early intervention through the proactive provision of care in or as close to the patients own home as possible.

13. Participate in the development, implementation and review of protocols, guidelines, and policies for an integrated Frailty service. This will include working with wider system partners including from HCRG, Primary Care, Adult social care, BSW ICB.

14. As an SDEC service responding to clinical demands the postholder will need to work across a variety of clinical areas and shift patterns.

Responsibilities for Leadership:

1. Act always with Compassion, and be committed to delivering high quality care, using effective communication, clinical competence and courage when needed.

2. Act as a role model, mentor, educator, and clinical support for the existing service and as it expands. Ensure sustainability through succession planning within the team, identifying talent and skills within the team and fostering its development.

Participate in the recruitment, selection and retention of both trained and untrained staff which will include the development of job descriptions, short-listing of candidates and interviewing.

Review the effectiveness of clinical care provided ensuring that patient safety is maintained, and care delivery meets the standards required by the Trust and the Care Quality Commission.

Manage change through strategic thinking, use of negotiating skills, self-awareness, and effective communication. Be an active participant in the Trusts Improving Together strategy.

Although this is not a budget-holder post, the post holder is expected to maintain responsibility for delivering cost effective care and services, including appropriate ordering of investigations, equipment, and other resources.

Education, Development and other Professional Responsibilities.

Act as a constant source of clinical and theoretical knowledge for all grades and disciplines of staff as well as patients and their significant others, providing support and clinical advice in specialist areas, based on evidenced based research and accepted best practice.

Promote a learning environment within the clinical area of responsibility, and the wider hospital environment, in which individuals take ownership for their professional development. Take an active role in undertaking staff training needs analysis as appropriate.

Critically assess and address own learning needs, negotiating a personal development plan that reflects the breadth of on-going professional development across the four pillars of advanced clinical practice, ensuring own appropriate and on-going clinical support.

Disseminate best practice research findings whilst developing and contributing to local guidelines, interpreting and adapting national protocols and standards to enhance patient care and safety.

Ensure own compliance with mandatory training, revalidation requirements and CPD, including what is required as a non-medical prescriber, following relevant Trust policy. Through supervision and mentorship identify personal learning needs; participating in personal continuing education to broaden educational and professional knowledge and skills. Ensure compliance with NMC / HCPC revalidation requirements.

Other Factors

The nature of this role, working autonomously in unscheduled and emergency care environments, includes potentially stressful situations with fluctuating workload and occasional unmet need, which will require the post-holder to have resilience, excellent communication skills, and self-care capabilities. The job will include dealing with emotionally charged situations, distressed patients and relatives, and the postholder will need to be able to deal with these situations effectively and professionally whilst recognising their own limits and being able to seek help and relief when required.

We are a friendly team with a broad range of experience in the care of older people and Frailty, including Nursing and Physiotherapy. We are passionate about the care of older people and applying advanced practice to improve the outcomes for our patients. We are very well supported by our Consultant colleagues both in the Emergency department and in Older persons medicine. We have great links to the wider MDT including front door therapy and Community services including Hospital@home. Salisbury is a great place to live and work with a genuine family atmosphere.

Person Specification

Qualifications

Essential

• Previous NHS experience.
• Registered General Nurse or Registered Allied Health Professional with current NMC or HCPC professional registration.
• Master's Degree in Advanced Clinical Practice or Master's level award that covers all 4 pillars of the Advanced Clinical Practice (ACP) capabilities (essential to include: advanced clinical assessment skills and diagnostic reasoning qualifications) (Will consider applicant with all other Master's (ACP) level modules completed but pending completion of Dissertation module)
• Registered Non-Medical Prescriber, (if professionally appropriate) with evidence of updating knowledge appropriate to patient groups for role.
• Post registration qualification or equivalent experience gained by undertaking on-going personal development and training focused on older adults / frailty / advanced practice skills.
• Recent experience in managing patients with Acute Frailty presentations in an acute hospital setting.
• Significant post registration experience at band 7 working with Older Adults.
• Clear and demonstrable evidence of advanced, autonomous practice working with the older adult population.
• Experience of multi-disciplinary working, demonstrating the ability to work across professional boundaries, acknowledging their unique skills and knowledge.
• Evidence of proactive involvement in the supervision and development of members of the multi-disciplinary team and able to demonstrate change management skills.
• Ability to demonstrate specialist expertise and knowledge underpinned by theory acquired through CPD in relation to history taking, clinical assessment, planning, implementation and evaluation of care.
• Ability to demonstrate specialist clinical reasoning skills to assimilate information in order to make a clinical judgement regarding diagnosis and intervention.
• Confident in the use of computer systems, spread sheets, databases, data collection, word processing and report writing.
• An understanding and insight into relevant, current issues and developments within the NHS, especially in relation to Frailty and Older People.
• Ability to communicate effectively at different levels of the organisation and with staff, patients, visitors or external organisations both verbally and in writing in the exchange of highly complex, sensitive or contentious information.
• Ability to demonstrate resilience under situational pressure, professional challenges, and change.
• Ability to work independently within scope of role and competence.
• Ability to evaluate care leading to improvement in quality standards and service improvement.

Desirable

• Teaching and assessing qualification / clinical supervision / mentorship qualification.
• Management /Leadership Qualification or development programme
• IRMER trained
• Evidence of research involvement
• Able to demonstrate clinical skills beyond traditional professional boundaries, such as prescription of mobility aids in nursing. Generic interdisciplinary experience and skills.

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.

Certificate of Sponsorship

Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).

From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).

Employer details

Employer name

Salisbury NHS Foundation Trust

Address

Salisbury Hospital NHS Foundation Trust

Odstock Road

Salisbury

SP2 8BJ

Employer's website

https://www.salisbury.nhs.uk/ (Opens in a new tab)