Advanced Clinical Practitioner

**POST: Advanced Nurse Practitioner**

**LOCATION: Alastair Ross Medical Practice**

**GRADE: Dependant on experience - Band 8a**

**ACCOUNTABLE TO: GP Partners for clinical matters and Practice Manager for operational matters**

**JOB PURPOSE**:

- To act as an autonomous practitioner working independently and in conjunction with other health care professionals to assess, diagnose and treat the conditions of patients attending within primary care and initiating direct referrals as appropriate.
- Provide expert professional advice to patients, carers and colleagues and ensure the maintenance of clinical excellence.
- To develop new and innovative concepts, models, methods and practices to deliver new and improved primary care services to meet the needs of the practice and GM ICB (Bolton) population.
- To provide education and training to other staff and students.
- Clinically examine and assess patient needs from a physiological and psychological perspective, and plan.
- Prescribe and review medication for therapeutic effectiveness, appropriate to patient needs and in accordance with evidence-based practice and national and practice protocols, and within scope of practice
- Prioritise health problems and intervene appropriately to assist the patient in complex, urgent or emergency situations, including initiation of effective emergency care
- Support and participate in shared learning across the practice and wider organisation

**PRIMARY DUTIES AND AREAS OF RESPONSIBILITIES**:
The Advanced Nurse Practitioner works autonomously and is accountable for own professional actions, as regulated by the NMC.
- Undertakes Clinical Nursing Practice at an advanced level using expert knowledge and clinical skills to deliver holistic care to people accessing primary health care services.
- Assesses diagnoses and treats patients attending primary health care services with a range of acute, non-acute and chronic medical conditions.
- Directly admits patients to secondary care hospital in acute medical need.
- Refers patients to other medical specialities for assessment if deemed appropriate.
- Refers patients as appropriate to other members of the multidisciplinary team, secondary care and to other statutory and voluntary organisations including referral for x-ray.
- Interprets a range of diagnostic tests and routine clinical procedures.
- Makes critical judgements of the highest order to satisfy the expectations and demands of the job e.g. first contact with patients presenting acutely and manages care in the presence and absence of protocols.
- Makes decisions where precedents do not exist, where appropriate without recourse to others e.g. direct referral of patients to Hospital Consultants without prior reference to other medical colleagues.
- Advises and supports others where standard protocols do not apply.
- Works within professional guidelines and codes of conduct.
- Works within all relevant practice policies and procedural guidelines e.g. infection control, chaperoning, risk management.
- Take responsibility for own learning and performance including participating in clinical supervision and acting as a positive role model

**CARE AND PROGRAMME MANAGEMENT**:

- Develops and manages highly specialised programmes of care and care packages and provides highly specialised advice concerning care normally beyond the scope of normal Nursing practice e.g. establishes differential diagnoses, management/treatment plans and makes referrals as appropriate. Makes fast track referrals.
- Communicates highly sensitive condition related information to patients, relatives and carers.
- Initiates the process of diagnosis with patients suspected to have a chronic disease e.g. diabetes, COPD, asthma, IHD referring to other clinical staff as appropriate.
- Contribute to practice targets both local and national within the disease management agenda e.g. QOF, BQC.
- Contributes to disease registers.
- Audits outcomes of care against standards and initiate changes as necessary.
- Refers to other members of the extended primary health care team as appropriate e.g. chiropodist, dietician, specialist Nurses.
- To actively implement safeguarding protocols for children and vulnerable adults and to know who to refer to and how to escalate concerns about radicalisation.

**STRATEGIC DEVELOPMENT OF PRIMARY CARE SERVICES**:

- Contributes to the strategic development of primary care and public health services to meet patient and population needs within the practice and across the wider organisation. Works/liaises across multi-professional and agency boundaries.

**COMMUNICATION**:

- Provides and receives highly complex, sensitive or contentious information and frequently deals with situations which are hostile or emotive.
- Uses developed communication, negotiation, conflict management skills which require empathy, reassurance and persuasive skills where there can be significant barriers to acceptance which need to be overcome.
- Regularly commun