Senior Clinical Nurse Specialist

Job summary

The Christie NHS Foundation Trust launched the Senior Adult Oncology service (SAOS) in 2022 as a pilot service for 18 months in line with the Trust's strategic aims to support an ageing population with frailty and complex needs coming through our cancer services. Patients aged 70+ represented over 80% of the patients in need of this specialized support. This pilot was successful in assessing its feasibility and it confirmed improvements in the outcomes of these patients. This led to the recentapproval of long-term funding for a new SAOS to be implemented to support patients with frailty, primarily older patients, from multiple disease groups undergoing treatments at The Christie.

The successful candidate will be highly motivated and driven to improve patient care and experienceand although oncology experience advantageous it is not essential as you will be supported with asupernumerary period to develop the required skills as experience in geriatric or frailty is successful candidate will have completed formal ACP training of have significant Clinical Nursespecialist experience in frailty and have achieved a master's level study, enabling them to work autonomously in the planning and delivery of care for this complex group of post will comprise of 80% clinical, 20% non-clinical hours to allow for service development, audit and research and professional development opportunities within the four pillars of advanced clinicalpractice

Main duties of the job

The SAOS is an outpatient service, and the post holder will work alongside a multidisciplinary team to provide Comprehensive Geriatric Assessments for older adults with frailty and complex needs undergoing cancer treatments. The post holder will be expected to manage a case load of patients, supported by the wider multidisciplinary team. The SAOS has two aims: to support complex olderpatients with frailty during cancer treatments; and to enable complex treatment decision makingalongside parent oncology teams in this population. The postholder will deliver specialist assessments and interventions focused on frailty and older patients as part of an outpatient clinic, supporting patients with a variety of cancer types. This is a key clinical and leadership role within the SAOS. As an experienced healthcare professional, the postholder will be expected to provide advanced clinical care, contribute to the development of the service through quality improvement, support education within andbeyond the SAOS team, and enable clinical research activity

About us

The Christie is one of Europe's leading cancer centres, treating over 60,000 patients a year. We are based in Manchester and serve a population of million across Greater Manchester & Cheshire, but as a national specialist around 15% patients are referred to us from other parts of the country. We provide radiotherapy through one of the largest radiotherapy departments in the world; chemotherapy on site and through 14 other hospitals; highly specialist surgery for complex and rare cancer; and a wide range of support and diagnostic services. We are also an international leader in research, with world first breakthroughs for over 100 years. We run one of the largest early clinical trial units in Europe with over 300 trials every year. Cancer research in Manchester, most of which is undertaken on the Christie site, has been officially ranked the best in the UK.

Job description

Job responsibilities

Clinical

Leading the day-to-day clinical management of patients under SAOS, whilst working with the multidisciplinary team to plan, manage, and coordinate the person-centred care provided by the SAOS.

Receive and triage referrals to the SAOS, supported by the multidisciplinary team.

Within the SAOS multidisciplinary team, provide a Comprehensive Geriatric Assessment (CGA) to identify and manage frailty, with the purpose of creating an individualised management plan focused on the issues and conditions identified (both related and unrelated with their cancer diagnosis)

Practice autonomously within the multidisciplinary team, whilst being accountable and self-directed in line with the relevant code of professional practice.

Use high levels of clinical judgement, critical analysis, and advanced decision-making skills to provide advanced level care for patients attending face to face or virtual clinics, including history taking, physical assessment, prescribing, and reviewing investigations.

Prescribe and review medication (as an independent prescriber) for therapeutic effectiveness appropriate to patient need in accordance with best/evidence-based practice, national/local protocols, and within the roles scope of practice and legal framework. This will be supported by the multidisciplinary team.

Use advanced communication skills to provide holistic nursing care, addressing physical, psychological, and social concerns, acting as an advocate for older people with cancer, as well as their families.

Facilitate and champion shared decision making within the SAOS and the wider Trust.

Collaborate with the different supportive oncology teams and specialised oncology teams at The Christie. Advise, communicate, and work in conjunction with a wide range of clinical colleagues, including primary care, community teams, and social care professionals, to ensure necessary levels of collaboration and efficient transfer of information across organisational boundaries. Initiate onward referral to specialist teams as appropriate. Collect, collate, evaluation and report information, maintaining accurate, confidential patient records.

Leadership

Co-lead in shaping and optimizing the model of care provided by the SAOS and the associated clinical governance, including updating standard operating procedures and relevant policies and guidelines.

Lead improvement and change within and beyond the SAOS, monitoring and evaluating activity and outcomes, proactively generating practice innovations, and identifying service redesign solutions to better meet the needs of patients and the service.

Consider the consequences of new local, regional, and national guidelines and policies on the SAOS, and strategically recommend changes to practice and pathways to meet the evolving needs of the service.

Engage stakeholders and use high-level negotiating and influencing skills to develop and improve practice.

Work 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.

Act as a visible positive role model, creating a supportive ethos to empower staff to contribute to the delivery of high-quality person-centred care.

Organise, attend, and participate in team and departmental meetings as necessary.

Research/Quality Improvement

Monitor the care provided by the multidisciplinary team (activity) and the impact of the service (outcomes), identifying opportunities for improvement both within the SAOS and the wider Trust.

Capture the necessary clinical data, using clinical audit and quality improvement methodology to support the development of the SAOS model of care.

Actively seek feedback and promote involvement from patients, families, carers, communities, and colleagues in the co-production of service improvements.

Prepare papers and abstracts for submission in professional journals and relevant conferences, and support colleagues to do the same

Encourage a culture where nursing/allied health professional audits and research are valued and promote the appropriate utilisation of those findings.

Enable and collaborate with clinical research activity within the SAOS.

Education

Create a supportive learning environment within the team, acting as a source of knowledge for patients, SAOS and other staff, by keeping up to date with developments in the field, and sharing best practice research findings.

Act as an educator and supervisor, identifying training needs and applying coaching and mentoring techniques to develop the competence and confidence of others across the team

Contribute to relevant educational initiatives within the Trust, including the annual Senior Adult Oncology study day hosted by the School of Oncology.

Identify own training and personal development needs, demonstrating a commitment to continuous personal and professional development (CPD) to maintain competency and to ensure best practice. Attend statutory and mandatory training as required by the Christie.

Person Specification

Qualifications

Essential

MSc Advanced Clinical Practice that includes history taking and clinical examination of patients/ Masters in specialist or professional practice Independent Non-Medical Prescribing Qualification Registered General Nurse or Registered Allied Health Professional Teaching/ Mentorship degree module/ENB998/PGCE.

Desirable

Psychosocial support Level 1 and 2 training Management / Leadership qualification Evidence of post registration CPD or relevant specialist qualification in oncology, geriatrics, or frailty Good Clinical Practice qualification

Experience

Essential

Significant post-registration experience in nursing Experience of care of complex older patients with frailty Experience of undertaking comprehensive geriatric and frailty assessments Demonstrates highly developed specialist knowledge and expertise, that is underpinned by a foundation of theory and continues acquired knowledge and skills through CPD Experience of service evaluation, clinical audit, and quality improvement Experience of supporting, mentoring, and coaching staff

Desirable

Experience of care of complex patients undergoing cancer treatments Experience of service development and implementation Experience of teaching in formal/informal environments Experience of patient engagement and involvement Experience of policy and procedure writing.

Skills

Essential

Excellent clinical skills, advanced clinical reasoning, governance and safeguarding skills Ability to work independently Ability to work collaboratively within a multidisciplinary team Well-developed leadership skills Ability to coordinate multidisciplinary teams Excellent written and verbal communication and interpersonal skills Ability to analyse, interpret and present clinical, performance and financial information Evidence of producing high quality written reports Excellent time management, organisational skills and ability to prioritise a busy/ unpredictable workload.

Desirable

Ability to think strategically in relation to long-term service development. Presentation skills. Reflective practitioner. Advanced communication skills

Knowledge

Essential

Knowledge of professional and NHS issues and policy relating to frailty, older patients, and multimorbidity Appreciate the accountability associated with advanced practice. Ability to use research findings in clinical practice

Desirable

Knowledge of the emerging evidence base in the field of onco-geriatrics Knowledge of prehabilitation and rehabilitation pathways in cancer care and relevance to supporting older adults with a cancer diagnosis.

Values

Essential

Ability to demonstrate the organisational values and behaviours

Other

Essential

Flexible in working patterns and to meet the needs of the role and the service. Highly motivating and able to motivate others Kind and compassionate Calm and objective Approachable

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