Advanced Clinical Practitioner/Nurse Interface Consult

Job responsibilities

Job Purpose:

To provide expert clinical leadership to lead on the development and implementation of the acute component of the Worcestershire System Single Point of Access. Enhance patient care in crossing professional and organisational boundaries.

To provide consultative clinical nursing, education, management expertise and advice in all aspects of the speciality of emergency care, with particular emphasis on admission and attendance avoidance and the development of integrated pathways.

To work in partnership with the UEC Consultants to improve care and clinical management and the way the emergency services unite and operate.

Undertake and participate in relevant research and audit projects and trials specific to the care of emergency care and alternatives to hospital admission.

The post holder can offer nurse led Outpatient services,manage a caseload of inpatients on the acute site and review, treat and discharge patients from ED, acute medicine wards and through the medical SDEC.

The post holder will attend Divisional and Trust meetings and other meetings outside the organisation as required and as clinical duties allow. They will act as an advocate for patients within the service, seek and portray the views of the patients wherever possible.

General Duties:

As part of the UEC multi-disciplinary team (MDT), utilise advanced assessment skills to improve access to Frailty care, aid assessment and enhance the management of patients across Frailty care pathways.

To work as an expert, independent and highly visible autonomous clinical practitioner through hands on clinical practice, facilitation and clinical consultation supporting the development of the SPOA.

Take a key role in the strategic development of the SPOA and integrated pathways in local NHS Trusts, WMAS and the wider community and system, drawing on and utilising multiple research and development methodologies.

Working as a core member of the MDT and UEC Team to ensure the service wide delivery of quality, performance and financial frameworks.

To provide an expert educational and advisory resource for patients, carers and all levels of staff, as well as other agencies involved in UEC services.

To play a key operational and clinical lead role in order to maintain a pro-active approach to managing patient pathways and flow.

To identify, initiate, perform and evaluate appropriate research and audit to improve the quality of patient care at both local and national level.

Key Duties:

Clinical:

Plans and manages own workload and the workload of the service, in a flexible manner, ensuring that service provision meets the needs of the patients.

Provides a visible clinical profile as a Consultant practitioner, having leadership, advisory and clinical input into quality and harm-free patient care.

Carries out highly complex patient assessment, using expert clinical acumen that includes (a), (b) and (c) :-

(a) Obtaining comprehensive history from patient/carer including complex and sensitive information.

(b) Performing specific physical examination, using advanced clinical skills developed through advanced level education, specialist training and experience.

(c) Obtaining a detailed medicines history from patient/carer, applying expert knowledge gained through high level education / experience.

Independently prescribes medication within legal, national and local frameworks considering efficacy, safety and cost from the formulary.

Identification of new therapeutic interventions including drugs.

Autonomously develops, implements and evaluates patient management plans for new and reviewed patients, using advanced clinical reasoning and decision-making skills, often without guidelines, in line with best practice guidance and evidence-based standards of care.

Initiates and accepts appropriate and timely consultation and/or referral of patients.

Provide on-going follow-up in conjuction with other senior clinicians through ambulatory care settings.

Carries out a defined range of diagnostic tests and specialist treatments, which are identified as advanced clinical skills, using highly developed neurological and physical assessment skills.

Assesses and intervenes to assist the patient in urgent and emergency situations, in collaboration with the multi-disciplinary team.

Rapidly and continuously evaluates the patients changing condition and response to therapeutic interventions and modifies the plan of care or optimal patient outcomes.

Plans and manages complete episodes of care, working in partnership with others, delegating and referring as appropriate to optimise health outcomes and resource use.

Makes appropriate onward referrals for specialist input.

Acts as a role model, to promote consistently high standards of professional practice. To produce and promote evidence-based practice to enhance patient care.

Acts as clinical expert and lead in emergency care, practising at an advanced level, demonstrating the ability to make critical judgements regarding patient care pathways, drawing on highly developed specialist theoretical, research and advanced practical knowledge within emergency medicine.

Analyses and interprets patient history and examination, presenting symptoms, physical findings and diagnostic information, often of a highly complex nature.

Orders and interprets specialist screening and diagnostic tests, based on expert knowledge and experience to aide diagnosis if appropriate.

Refers to appropriate senior clinicians when the diagnosis of conditions are questionable.

Uses sound judgement and analytical skills in directing and delivering care, assessing conflicting priorities and needs, demonstrating a highly advanced level of critical thinking and diagnostic reasoning skills in clinical decision-making.

Exercises independent clinical judgement by analysing and interpreting clinical signs and considers the range of options available.

Agrees on consensus plan when expert opinion differs or when the research evidence is not available.

Provides expert advice to healthcare professionals, both within the Trust and wider community, on clinical management of their patients.

Participates in internal and external working groups, services and initiatives to provide advice and expertise and to share best practice.

Works in partnership with other senior clinicians, staff and patients to co-design and develop person centred services to improve the patient experience.

Uses their professional judgement in managing complex and unpredictable care events and captures the learning from these experiences to improve patient care and service delivery.

Incorporates current technology appropriately in care delivery and uses information systems to support decision-making and to improve care.

Experience

Essential

• Demonstrate leadership and nursing experience at senior level in Emergency Care
• Working in a multi-disciplinary team.
• Teaching and mentoring experience.
• Strategic specialty service and strategy development and project manangement.
• Research, evaluation and audit.
• Managing and influencing change in a multi-professional environment.

Desirable

• Participation in relevant professional interest groups.
• Working across organisational boundaries.
• Publications.
• Conference presentations.

Personal Qualities

Essential

• Highly motivated.
• Flexible to the needs of the service
• Supportive of staff / team members
• Professional approach.
• Self-awareness
• Recognises stress in self and others.
• Adaptive to unpredictable workloads.
• Situational awareness and manangement of self and others.
• Problem solving and decision making skills.
• Ability to provide and receive complex information, often in difficult and emotive situations.
• Acts as a effective role model.

Skills/Knowledge

Essential

• Advanced assessment skills, relevant to the diagnosis of patients presenting to emergency services.
• Ability to analyse, interpret and disseminate complex information / reports / statistics.
• Interpretation of reports / procedures e.g. CT / MRI scans, ECGs, Xrays.
• Trust consent competencies.
• Computer literate and ability to use software to develop documents and reports.
• Ability to present to groups of differing abilities and disciplines.
• Able to lead a multi-disciplinary team of ACPs.
• Competent to provide education and training to patients, carers and all levels of staff.
• Able to work autonomously and without guidelines.
• Able to accept and make referrals unsupervised.
• Research and Audit skills
• Able to carry out specialist examinations, procedures, investigations, diagnostic tests.
• Use of a wide range of specialist equipment to assess, diagnose to medical advice or intervention.
• Comprehesive understanding and knowledge of advanced level healthcare practice.
• Expert nursing knowledge within Frailty.
• Current national developments affecting Frail patients.
• Up to date evidence base in Frailty

Qualifications

Essential

• NMC registered Nurse
• Relevant post graduate qualification demonstrates theoretical and practical knowledge in Emergency Care
• Masters Level Degree
• Non-medical independent and supplementary prescriber.
• Recognised post-graduate teaching qualification.
• IRMER regulation course

Desirable

• Project / business management course.
• Commitment to studying for a relevant doctorate.
• Advanced communication / counselling 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.

UK Registration

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