Clinical Practitioner (Care of the Elderly)

Job responsibilities

• Provide the choice of direct access to a NP, both in the Practice and over the telephone, for the general practice population, specific responsibility for this post is for those patients identified as being at high risk of emergency hospital admission (mainly elderly population)
• Acting as liaison with secondary care when patients are admitted and on planning discharge
• Act as a first contact within the practice for patients and carers to discuss changes in the care plan or any deterioration in condition.
• Educate patients and carers about the important indicators of any deterioration in their chronic conditions so that appropriate action can be planned and taken before they reach the point of needing hospital admission. Utilising community services like intermediate care, social services, voluntary sector etc when required
• Long term conditions management / annual reviews. When necessary to refer onto Sirona district nursing/long term conditions team. Supported by practice nursing team.
• Nursing home weekly visit e.g. Quarry House, Frenchay Park, The Elms and The Worthies.
• Make professionally autonomous decisions for which he/she is accountable
• Provide a first point of contact within the Practice for patients presenting with undifferentiated, undiagnosed problems, making use of skills in history taking, physical examination, problem-solving and clinical decision-making, to establish a diagnosis and management plan
• Instigate necessary invasive and non-invasive diagnostic tests or investigations and interpret findings/reports
• Where the post holder is an independent prescriber: to prescribe safe, effective and appropriate medication as defined by current legislative framework
• Provide safe, evidence-based, cost-effective, individualised patient care
• Offer a holistic service to patients and their families, developing where appropriate an on-going plan of care/support, with an emphasis on prevention and self-care
• Promote health and well-being through the use of health promotion, health education, screening, and therapeutic communication skills
• Initiate discussions with patients and carers around end-of-life care and preferred place of death. Sharing and documenting patient wishes about when they would not want to be resuscitated.
• Taking a lead role (alongside the lead GP) in the safeguarding of vulnerable adults and applying the principles of the Mental Capacity Act (2005)
• Refer patients directly to other services/agencies as appropriate
• Work with mutli-disciplinary team within the Practice, and across the wider NHS, to promote integrated and seamless pathways of care
• Contribute to the practice achieving its quality targets to sustain the high standards of patient care and service delivery
• Participate in identification of community health needs and develop patient/family-centred strategies to address them
• Management of vaccines to care home and housebound patients

Help develop and set up new patient services and participate in initiatives to improve existing patient services

• Be aware of and contribute to planning and delivery of practice-based commissioning

Person Specification

Knowledge and Skills

Essential

• Understanding and knowledge of policy developments related to the delivery of primary care services including General Practice, the GMS contract, Clinical Governance, Quality & Outcomes Framework
• Understanding of systems to gain an understanding of the health needs of the Practice population as they relate to primary care
• Understanding of the Mental Capacity Act (2005) and the principles of Safeguarding vulnerable adults
• Understanding of evidence based practice
• Knowledge of national standards that inform practice (eg National Service Frameworks, NICE guidelines etc)
• Understanding of their accountability arising from the NMC Code of Professional Conduct (2004) and medico-legal aspects of the Nurse Practitioner role
• Ability to assess and manage patient risk effectively and safely
• Well-developed word processing/data collection/IT skills
• Excellent interpersonal, verbal and written communication skills
• Reflective practitioner
• Time management and ability to prioritise workload
• Able to analyse data and information, drawing out implications for the individual patient/impact on care plan
• Able to establish and maintain effective communication pathways within the organisation, the local PCT and with key external stakeholders
• Understanding of equal opportunity and diversity issues

Desirable

• Experience of use of a medical software package
• Proven record of effective use of networking and influencing skills
• Ability to think strategically
• Experience of presenting information to wider audience

Competencies/Behaviours

Essential

• Patient Focused.
• Team Member.
• Drive, Energy and determination.
• Empathy.
• Ability to respond well under pressure.
• Self motivation.
• Resilience.
• Sense of humour!

Qualifications

Essential

• Registered General Nurse (Currently registered with the Nursing & Midwifery Council)
• Recognised NP qualification at minimum of degree level or equivalent

Desirable

• Independent Nurse Prescriber
• Teaching / Mentoring experience and /or qualification

Experience

Essential

• Minimum of 5 years post registration experience
• LTC management and community care for Frail and elderly
• Evidence of appropriate continuing professional development activity to maintain up-to-date knowledge and on-going competence in all aspects of the NP role
• Experience in management long term conditions e.g. asthma, COPD, diabetes, CHD
• Evidence of working autonomously and as part of a team
• Proven ability to evaluate the safety and effectiveness of their own clinical practice
• Previous experience of managing and developing a nursing team

Desirable

• Interpreting and implementing local and National policy agendas for health

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of ...