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Advanced Nurse Practitioner

4 months ago


Cinderford, United Kingdom Forest Health Care Full time

Job summary

An exciting opportunity has arisen for a Advance Nurse Practitioner at Forest Health Care for 6-8 sessions.

We are looking for someone who is dynamic, motivated and a flexible team player to join our Practice.

You will be a registered nurse, paramedic, or other allied healthprofessional, with a non-medical prescribing qualification in the context of abroad scope of practice.

This role is subject to an enhanced DBS check

Main duties of the job

Our Clinical Practitioners provide care through the assessment, diagnosis, treatment and discharge or referral of patients with undifferentiated and undiagnosed injury/illness, or acute exacerbation of existing conditions. You will assist in the development of an integrated approach to the delivery of patient care across the whole system of health and social care, working in partnership with all relevant stakeholders.

The key elements of the role include but are not limited to:

Working as an autonomous practitioner providing clinical assessment, diagnosis (where possible), and treatment (where appropriate) for adult and paediatric patients invited to attend Primary Care Centres or during remote consultations. Accurately triaging & prioritising all patients, demonstrating the use of a variety of techniques to elicit the history of an event / illness including past medical and drug history. Undertaking home visits to patients who are unable to travel to a primary care centre. Referring patients to alternative care settings, where appropriate. Supporting with triage of calls that have come via the NHS111 pathway during the core daytime surgery opening hours. To work as part of the clinical team of GPs, Primary Care Pharmacists, Specialist Practitioners, Psychiatric Nurses, Nurse Practitioners, Practice Nurses, Health Care Assistants and other associated roles.

Please note that the support of a senior clinician is always available.

About us

Our 3 partner practice has a patient population of over 11500+ patients and a staff of 3 further salaried GPs, 3 ANPs and a full complement of nurses, HCAs, dispensers, receptionists and admin staff all working alongside a growing number of additional PCN roles.

Based in the Forest of Dean, our Cinderford surgery serves the surrounding town and rural communities. In spacious, environmentally friendly new premises, we occupy the first purpose-built, dementia-friendly surgery in the UK. Patients can also access a full range of services at our branch site in the local village of Ruardean & Westbury-on-Severn

Job description

Job responsibilities

Clinical Practice

You will work with the GPs to manage patients throughoutthe day who present with urgent requests and needs, requiring on-the-dayassessment.

You will work within the practice team to deliver careco-ordination to patients identified as at-risk, with the aim of avoiding whereverpossible hospital admission and to ensure that patients receive the requisitecare in the most appropriate setting.

Youwill manage the process of clinical care co-ordination, undertaking surgeryconsultations and home visits. The provision of clinical input will be at thediscretion of the GP partners. Clinicalinput could include aspects of managing long-term conditions holistically.

You will contribute to the identification of patients atrisk of emergency hospital admissions, using of risk stratification tools aswell as identification through GPs and multi-disciplinary team meetings.

You will ensure that follow-up and proactive planningtakes place for at risk patients being discharged from acute care.

You will provide organisational support to the Practice whichmay include planning, implementing and evaluating care plans for patients onbehalf of the Practice. You will need toliaise with the GPs in the process of writing any care plans and will ensure suchplans are agreed with patients and shared appropriately.

You will be a point of contact for patients, carers andtheir families in relation to clinical management and care plans; you willsignpost and liaise with other agencies including the voluntary sector on theirbehalf.

You will:

Act as an autonomous clinician within competencies with thefull support of our clinical team. Ensure your clinical practice is safeand effective, and remains within boundaries of competence. Undertake daily visits, including anyemergency visits that arise, asrequested by the doctors. Clinically examine and assess patientneeds from a psychological perspective, and plan clinicalcare accordingly Take a comprehensive patient history,carry out physical examinations and use expert knowledge and clinical judgmentto identify the potential diagnosis Refer patients for investigationsand/or the appropriate specialist care where appropriate Use your experience to plan and provideskilled and competent care to meet patients health and social care needs,involving other members of the wider health care team as appropriate Ensure the provision of continuity ofcare including the planning of follow-up consultations or visits Assess and evaluate with patients, theeffectiveness of the treatment and care provided and propose changes when indicated Support patients to adopt healthpromotion strategies that promote healthy lifestyles and apply principles ofself-care Read OOH reports and hospital dischargeletters, act on information therein. Follow up any complex hospitaldischarges on the next working day, including a visit to the patient ifrequired Provide care for the presenting patientincluding initial history taking, recording observations, clinical assessment,diagnosis, evaluation and treatment recommendations Demonstrate safe, clinicaldecision-making and expert care, including assessment and diagnostic skills Prioritise and triage the needs ofpatients accordingly making any necessary referrals for investigations in theappropriate manner Participate in chronic diseasemanagement Discuss as appropriate any referral with a GP,where a referral to secondary care is indicated.

Liaising with patients, families and carers

Ensurethat all patients with a care plan know how to contact the appropriate help intimes of need and act as a focal point of communication between them and otherclinical and non-clinical members of the practice and community team. Understandand facilitate clinical activity as required to ensure optimal and timelyclinical care is delivered to patients. Act as an information resource for patients, multi-disciplinarycolleagues and other stakeholders.

Interfacingwith other agencies

Liaisewith other agencies to enact care plans for patients. Direct and refer individuals, families and carers to the mostappropriate agencies / services to support the implementation of their careplans. Contribute to the evaluation of patient outcomes using clinicalexperience and other patient experience tools. Actively participate in clinical discussions at multi-disciplinarymeetings optimising clinical reasoning skills and other areas ofprovision. Maintaina strong working interface between the GPs, Practice Team, District Nurse Teamand other key stakeholders, offering clinical support and advice to patients onat-risk lists. Supportpatients and help to develop and initiate self-management plans. Communicateself-management plans to other health care providers who may be involved in theacute care provision. Createand maintain contacts with voluntary organisations that may be able tohelp/support their cohort of patients Age Concern, Alzheimers Support,local Link schemes. Sign-postpatients with administrative issues related to daily living to Social Servicesor Citizens Advice; consider a referral to the Social Prescribing service.

Clinical Governance

Take an active clinical role in the processes for monitoring andimproving the quality of care provided to patients. This includes riskmanagement, clinical audit and compliance with CQC requirements. Understand, identify and appropriately refer any safeguardingconcerns. Ensure that patients receive the information they need and aretreated with dignity and respect. Co-operate with carrying out risk assessments and must adhere tosafe systems of work. This includes understanding and adhering to the reportingprocedures for clinical and non-clinical incidents/near misses. Post holdermust attend relevant courses and mandatory updates, take a pro-active role incontributing to risk identification and management and be responsive to lessonslearned from incidents and near misses. Report clinical and non-clinical incidents to Practice Manager,GPs and proactively manage risk tovulnerable adults. Promote an environment conducive to effective learning and tocomply with statutory and mandatory responsibilities in line with current Localand National Monitoring requirements.

Managing and using Information

Maintain accurate legible and contemporaneous records and writtenreports in line with Practice Policies and procedures and professional codes ofconduct. This will include accuratedocumentation on clinical IT systems and electronic reporting systems. Ensure the maintenance of an accurate computerised database of atrisk patients and input activity and outcomes measures in order to supportservice development and meet contractual requirements.

Management

Organiseand manage your own time according to delegated workload. Workindependently and autonomously, providing, support and advice to individuals,within guidelines and protocols identified for the role

Quality/ClinicalGovernance/Research and Audit

Maintainaccurate and cotemporaneous records Recordactivity on a clinical data base for both Practice and the ICB. Assistin the monitoring and protecting of groups and individuals whose health andwell-being may be at risk vulnerable adults. Practicethe principles and philosophy of individualised patient care in accordance withPractice Policy, procedures and regulatory bodies guidelines

IndividualPatient Care

Undertake specific clinical tasks as recognised from thepreliminary clinical assessment and asappropriately delegated from other clinicians within primary care andneighbourhood teams. Ensure the needs and wishes of the individual aredocumented. Enable patients to reach their optimum level ofindependence. Meet a range of patient and carer needs, includingclinical interventions where appropriate in order to prevent hospital admissionor reduce length of stay. Communicate with individuals about routine and dailyactivities, this may include overcoming difficulties (eg. hearing/language)

OtherFactors

Uniformmay need to be worn. Thepost is based at Forest Health Care GP Practice but will involve travel acrossthe area, including lone working; you will need to have your own vehicle andappropriate car insurance.

Inaddition to the duties and responsibilities listed above, the post-holder maybe required to assist with covering nursing staff during absence and to also performother duties assigned by the GPs or Practice Manager when required.

Person Specification

Qualifications

Essential

Registered Nurse with Nursing and Midwifery Council Masters certificate, diploma or full Masters in Advanced Clinical Practice, Digital badge or RCN credentialed Qualified Independent Nurse Prescriber on the NMC register Meets NMC revalidation requirements in accordance with the NMC Revalidation booklet Meets the standards for registered ANP working at advanced level Minor illness qualification

Desirable

Qualified triage nurse

Experience

Essential

Experience of practice within the four pillars Experience of working in a primary care environment Experience of prescribing and undertaking medication reviews Good interpersonal skills with patients and staff. Experienced in working within a computerised environment. Experienced in working autonomously. Able to work under pressure and prioritise workload.

Desirable

Experience of working as a practice nurse or community nurse

Clinical Knowledge and Skills

Essential

Wound care/removal of sutures and staples Clinical knowledge and skills (add/delete as applicable) including: ECGs Venepuncture New patient medicals Chaperone procedure Requesting and processing pathology tests Advising patients accordingly Diabetes Hypertension Asthma Spirometry CHD Immunisations (routine and childhood) Ability to record accurate clinical notes Ability to work within own scope of practice and understand when to refer to GPs

Other Requirements

Essential

Disclosure Barring Service (DBS) check Right to work in the UK Occupational health clearance Meet the requirements and produce evidence for nurse revalidation Evidence of continuing professional development (CPD) commensurate with the role of an ANP Access to own transport and ability to travel across locality on a regular basis