Job overview
We have an exceptional opportunity for an innovative and inspirational leader to join our Acute Frailty Team as an Advanced Clinical Practitioner (ACP) for older people.
The ACP will take a senior role within the Care of Older People (COOP) team and will be responsible for co-ordinating the flow of frail older people through the Whittington hospital.
They will provide clinical leadership and be responsible for ensuring the provision of a high standard of holistic, patient centred care for frail older people as well as providing expert advice and support to professionals in elderly medicine around frailty syndromes including falls, dementia and delirium, and contributing towards service improvement in these areas. They will also support the Acute Frailty Pathway which works to avoid unnecessary admissions to hospital.
The successful candidate will be able to take a lead in the comprehensive geriatric assessment of patients referred to the Frailty Team under the supervision of a consultant geriatrician and will autonomously work as part of a multidisciplinary team providing patient-centred clinical care, encompassing the skills of assessment, examination, diagnosis and treatment of patients. The post is intended to improve patient outcomes by improving timeliness and consistency of care for older patients with frailty seeking emergency care and referred to the Acute Frailty Pathway, promoting same day discharge and community management of older patients with frailty.
Main duties of the job
Review patients screened as frail in the Emergency Department, Ambulatory care and the Acute Admissions wards, according to our Frailty Pathway criteria. In conjunction with the Consultant Geriatrician/Frailty MDT provide expert assessment of frail elderly patients on admission to determine the most appropriate pathway of care to meet the patient’s needs and direct patients accordingly.
Please see the Job Description and the Persons Specification for further details about the job role. If you are unable to access the PDF, the details of the job description can also be found in the 'Detailed Job Description and Main responsibilities' section.
Working for our organisation
Whittington Health serves a richly diverse population and works hard to ensure that all our services are fair and equally accessible to everyone. Nowhere is this more obvious than in the way we look after our staff. We aim to employ a workforce which is as representative as possible of this population, so we are open to the value of differences in age, disability, gender, marital status, pregnancy and maternity, race, sexual orientation, and religion or belief. The Trust believes that as a public sector organisation we have an obligation to have recruitment, training, promotion and other formal employment policies and procedures that are sensitive to these differences. We think that by doing so, we are better able to treat our patients as well as being a better place to work.
Detailed job description and main responsibilities
The post holder will:
• Work at a level of advanced clinical practice that pulls together the four ACP pillars of clinical practice, leadership and management, education, and research.
• Provide professional, clinical leadership in support of medical, nursing and AHP staff in the provision of services for older people. Ensuring that the Trust meets the requirements of national guidance and provides safe, compassionate care for frail, older people in accordance with local and national quality and performance targets.
• Undertake line management responsibilities as part of their Frailty ACP role.
• Lead on education to ensure that current best practice is being implemented for the benefit of frail older people and their families/carers. Including falls prevention, dementia and delirium detection, treatment and care, and supporting the Trust’s Enhanced Care training model.
• Act as the link between the Emergency Department (ED), Acute Admissions Unit (AAU) and the Elderly Medicine Wards to ensure excellent communication and continuity of care for older people.
• Assess the needs of older people with frailty admitted to The Whittington Hospital - coordinate referrals and signpost to specialist services ensuring that appropriate patients receive a comprehensive geriatric assessment.
• Ensure that the needs of carers/families are highlighted and that they are encouraged to be involved to the level that they wish to be.
• Support the role of the Trust’s Dementia Practitioner Specialist in implementing the Dementia Trust Strategy and support wards managers and their teams to develop dementia friendly environments.
• Support the falls prevention Trust strategy.
• Work in partnership with the discharge team and other specialist teams in acute, community and social services. Support the design and development of integrated pathways that facilitate safe and timely transitions of care, admission avoidance and improved outcomes of care for older people.
Clinical Responsibilities
Review patients screened as frail in the Emergency Department, Ambulatory care and the Acute Admissions wards, according to our Frailty Pathway criteria. In conjunction with the Consultant Geriatrician/Frailty MDT provide expert assessment of frail elderly patients on admission to determine the most appropriate pathway of care to meet the patient’s needs and direct patients accordingly.
Liaise closely with other members of the multidisciplinary team including community colleagues and within the hospital.
Ensure good communication between members of the multidisciplinary team to ensure safe and timely hospital discharge of identified patients as well as appropriate admission to hospital.
Act as patient and carer advocate.
Communicate with patients, carers and relatives - involve them in care planning and resolve concerns.
Provide patients and carers with individual details about their condition and management
Demonstrate ability to communicate complex and sensitive information through good communication skills even when there are significant barriers to communication.
Communicate information to patients and carers in an understandable way.
Assess the patients’ need for additional services and refer as necessary.
Gain valid informed consent to intervention and treatment.
Provide spontaneous and planned advice, teaching and instruction to patients, carers, relatives and other health professionals to promote long term condition management and ensure a consistent approach to patient care.
Manage potentially stressful, upsetting and emotional situations in an empathetic manner, including delivering bad news, providing palliative care support and discussions about future management and resuscitation.
Be able to manage their own workload
Arrange/attend team/family meetings in conjunction with other relevant members of the multidisciplinary team.
Act as a resource for medical doctors, nurses and allied health professionals across Whittington Health on the care of older people.
Act as a leader of the multidisciplinary team and ensure patients who are discharged receive a high standard of specialist care.
Initiate and implement changes in clinical practice which improve standards of care and health outcomes for patients.
Work within agreed medical, nursing and trust protocols as well as develop standards of practice against which quality of care can be measured.
Identify clinical issues and incidents that reduce quality of patient care and develop strategies to counter these to ensure safe and effective care.
Identify and resolve patient related or service problems and prioritise conflicting needs.
Education
Identify education needs in relation to care of older people. Develop a training strategy to increase understanding amongst staff of the needs of older people. Facilitate the development of knowledge and skills in staff, recognising and developing aspiring leaders within older people, frail elderly and dementia care services.
Critically appraise evidence-based literature and use this knowledge to lead on education programmes within the hospital and the community.
Employ a range of methods in education and training appropriate to the topic, participants, facilities available and event.
Prepare and provide learning materials.
Encourage and support research-based practice linking this to relevant service development.
Devise and provide written information for patients and carers to enhance their understanding.
Be responsible for identifying own training and development needs.
Participate in appraisal using reflective practice.
Continue own professional development through the pursuit of relevant professional and academic study.
Leadership, Management and Service improvement
Champion and lead the organisation’s commitment to provide a service for frail older people that is patient centred, flexible, comprehensive and clearly focussed on timely diagnosis, appropriate interventions and multidisciplinary discharge planning.
Contribute to the development of a strategic plan for the frailty service and other service development strategies with specific reference to the nursing contribution to service improvement objectives.
Support the Trust’s Dementia Specialist Practitioner to lead, support and sustain the implementation of the National Dementia Strategy across the Trust.
Provide a visible, accessible presence throughout the Trust, demonstrating clinical leadership and acting as a credible role model. Act as a resource for advice, guidance, support and decision making.
Provide leadership and support to enable a multidisciplinary approach to delivering improvements in patient safety for older people.
Represent the Acute Frailty Team at the Trust Dementia Strategy Group.
Motivate and empower staff to perform their role to ensure a confident, competent, questioning and enthusiastic workforce. Inspire others by action and example, challenging traditional practices and encouraging innovative problem solving by staff.
Lead and oversee the development of wards specialising in the provision of care to the frail elderly and dementia care.
Promote a culture where change is embraced and there is constant challenge to existing services in order to achieve and sustain improving standards of care and practice in relation to older people.
Monitor trends in incidents and promote service improvements that are responsive to patient feedback.
Ensure that clinical practice has patients, their families and carers at its centre, is evidence-based and supports patients to make informed decisions regarding their pathway of care. Engage with patients, families and carers in order to establish their views on services, promoting patient and public involvement in the evaluation and improvement of services.
Initiate projects that increase the profile of the COOP service and team members.
Represent the Trust on committees relevant to the care of older people nationally and locally.
Flexibly plan and organise own time to meet the demand of the service.
Be involved in the development of relevant care guidelines.
Undertake line management responsibilities as required
Research and Audit
Ensure audit programmes are consistent with the service objectives.
Undertake audit as required to support service development.
Be proactive in ongoing audit in order to assess the effectiveness of the service.
Participate in and critically evaluate research finding and to disseminate them appropriately.
Person specification
Education & qualifications
Essential criteria
1. Primary professional registration as a nurse, AHP or pharmacist
2. Relevant post registration qualification
3. Evidence of continued professional development
4. Educated to degree level
5. MSc Advanced Clinical Practice
6. Independent Prescribing qualification
Desirable criteria
7. Teaching qualification
8. Management/Leadership qualification
Skills & abilities
Essential criteria
9. Previous experience in working in care of older people
10. Experience of working independently
11. Excellent communicator
12. Teaching skills
13. Computer Literate
14. Problem Solving skills
15. Health Promotion skills
16. Ability to work as part of a team
17. Identify new ways of working to benefit the service and the patient experience
Desirable criteria
18. Expert practitioner in Elderly Medicine
Knowledge & experience
Essential criteria
19. Significant previous band 7 experience or above
20. Clinical Audit and presentation skills
21. Aware of national agenda
22. Displays leadership skills
23. Involvement in Quality Improvement
24. Knows relevant NICE guidance
Desirable criteria
25. Understands polypharmacy in relation to Elderly Medicine
26. Recent Evidence Based Best Practice in relation to Elderly Medicine
27. Line management/leadership experience
Personal qualities
Essential criteria
28. Flexible approach to work
29. Articulate
30. Personable
31. Reliable
32. Ability to lead and motivate others
33. Positive approach to change
34. Able to prioritise, organise and coordinate the work of self and others
SAFEGUARDING CHILDREN AND ADULTS
To comply with the Trust’s Safeguarding Children and Adults policies, procedures and protocols. All individual members of staff (paid or unpaid) have a duty to safeguard and promote the welfare of children, young people and vulnerable adults This will require you to:
35. Ensure you are familiar with and comply with the London Child Protection Procedures and protocols for promoting and safeguarding the welfare of children and young people.
36. Ensure you are familiar and comply with the London Multi Agency Safeguarding Vulnerable Adults Pan London Procedures.
37. Ensure you are familiar and comply with local protocols and systems for information sharing.
38. Know the appropriate contact numbers and required reporting lines.
39. Participate in required training and supervision.
40. Comply with required professional boundaries and codes of conduct
Whittington Health is committed to safeguarding all children and vulnerable adults and expects all staff and volunteers to share this commitment.