Advanced Nurse Practitioner - Havering Health - North PCN
The post holderwill demonstrate courageous and critical thinking and is a caring,compassionate and committed experienced nurse who, acting within theirprofessional boundaries, will provide care for the presenting patient frominitial history taking, clinical assessment, diagnosis, treatment andevaluation of care. They will demonstrate safe, competent clinicaldecision-making and expert care, including assessment and diagnostic skills,for patients within the general practice.
The post holderwill commit to demonstrating critical thinking in the safe clinicaldecision-making process. They will communicate and work collaboratively withthe general practice team to meet the needs of patients, supporting thedelivery of policy and procedures, and providing nurse leadership as required.
Main duties of the job
Independently Assess, diagnose, plan, implement and evaluate treatment/interventions and care for patients presenting with an undifferentiated diagnosis.Clinically examine and assess patient needs from a physiological andpsychological perspective and plan clinical care accordingly.Proactively identify, diagnose and manage treatment plans for patientsat risk of developing a long-term condition (as appropriate)Diagnose and manage both acute and chronic conditions, integrating bothdrug- and nondrug-based methods into a management plan
Prescribe and review medication for therapeutic effectiveness,appropriate to patient needs and within scope of practice
Provide information and advice on prescribed or over-the-countermedication on medication regimens, side-effects and interactions.
Support patients to adopt health promotion strategies that promotehealthy lifestyles, and apply principles of self-care.
Support and manage health needs of women presenting for family planning,cervical cytology or sexual health consultation.
Assess, identify and refer patients presenting with mental health needsin accordance with the NSF for Mental Health.
Implement and participate in vaccination and immunisation programmes forboth adults and children.
Meet the needs of patients presenting for opportunistic wound care.
Undertake minor surgery asappropriate to competence.
About us
HaveringHealth is a membership organisation, and our remit is to deliver services onbehalf of our Practices, PCNs and Partners. With them, we share theresponsibility for delivering high quality, patient-focused services at scalefor our communities. Working in this way, we are able to maximise the opportunity of deliveringflexible care as close to our community as possible as well as developing newservices and responding to needs at speed and with impact.
Havering Primary Care Networks (PCNs) aregroups of GP practices that have come together to work more closely together toimprove the quality of care for patients in Havering. The ARRS staff provide a valuable resource and additional services to thePCNs and Practices in supporting the delivery of high-quality and integratedcare to patients across Havering. This staff group supports the otherhard-working staff in general practice.
Job responsibilities
Role Summary:
* The post holder as part of the PCN GP Multidisciplinary (MDT team), will be an experienced Advanced Nurse Practitioner who, acting within their professional boundaries and will utilise a range of advanced skills and expert knowledge for patients presenting with undifferentiated and undiagnosed conditions. The post holder will demonstrate critical thinking in the clinical decision-making process.
* The role will involve working closely with Lead Clinicians, care staff and pharmacists on the development and updating of personalised care and support plans and repeat medication. The Advanced Clinical Practitioner will be skilled in recognition and management of emergencies and minor illness that commonly present in primary care .
Primary Responsibilities:
Clinical Practice:
* Assess, diagnose, plan, implement and evaluate treatment/interventions and care for patients presenting with an undifferentiated diagnosis
* Clinically examine and assess patient needs from a physiological and psychological perspective, and plan clinical care accordingly
* Assess, diagnosis, plan, implement and evaluate interventions/treatments for patients with complex needs
* Proactively identify, diagnose, and manage treatment plans for patients at risk of developing a long-term condition (as appropriate)
* Diagnose and manage both acute and chronic conditions, integrating both drug- and non-drug-based treatment methods into a management 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
* Work with patients in order to support compliance with and adherence to prescribed treatments
* Provide information and advice on prescribed or over-the-counter medication on medication regimens, side-effects, and interactions
* Prioritise health problems and intervene appropriately to assist the patient in complex, urgent or emergency situations, including initiation of effective emergency care
* Support patients to adopt health promotion strategies that promote healthy lifestyles, and apply principles of self-care
* Support and manage health needs of women presenting for family planning, cervical cytology or sexual health consultation
* Assess, identify, and refer patients presenting with mental health needs in accordance with the NSF for Mental Health
* Implement and participate in vaccination and immunisation programmes for both adults and children
* Advise, support, and administer vaccinations for patients travelling abroad, where appropriate
* Promote and deliver evidence-based care for patients presenting with aural conditions
* Meet the needs of patients presenting for opportunistic wound care
* Undertake minor surgery as appropriate to competence
Communication:
* Utilise and demonstrate sensitive communication styles, to ensure patients are fully informed and consent to treatment
* Communicate with and support patients who are receiving bad news
* Communicate effectively with patients and carers, recognising the need for alternative methods of communication to overcome different levels of understanding, cultural background and preferred ways of communicating
Delivering a quality service:
* Recognise and work within own competence and professional code of conduct as regulated by the NMC
* Produce accurate, contemporaneous, and complete records of patient consultation, consistent with legislation, policies, and procedures
* Deliver care according to NSF, NICE guidelines, and evidence-based care
* Assess effectiveness of care delivery through self and peer review, benchmarking, and formal evaluation
* Evaluate patients response to health care provision and the effectiveness of care
* Support and participate in shared learning across the practice and wider organisation
* Use a structured framework (e.g. root-cause analysis) to manage, review and identify learning from patient complaints, clinical incidents, and near-miss events
* Working with the practice management monitor and develop the performance of the GPN team in accordance with local policies
Leadership personal and people development:
* Act as a clinical leader in the delivery of practice nursing services ensuring that the needs of the patient are a priority
* Take responsibility for own learning and performance including participating in clinical supervision and acting as a positive role model
* Support staff development in order to maximise potential
* Work with practice management to ensure sufficient staff of appropriate ability, quality and skill-mix are available to meet current and future service delivery, that selection and recruitment processes are effective and that equality of treatment of the team incorporates quality HR principles and processes
* Contribute to the development of local guidelines, protocols and standards
* Understand own role and scope and identify how this may develop over time
* Work as an effective and responsible team member, supporting others and exploring the mechanisms to develop new ways of working
* Delegate clearly and appropriately, adopting the principles of safe practice and assessment of competence
* Create clear referral mechanisms to meet patient need
Management of Risk:
* Manage and assess risk within the areas of responsibility, ensuring adequate measures are in place to protect staff and patients
* Monitor work areas and practices to ensure they are safe and free from hazards and conform to health, safety and security legislation, policies, procedures and guidelines
* Ensure appropriate supervision of safe storage, rotation and disposal of vaccines and drugs. Oversee the monitoring, stock control and documentation of controlled drug usage according to legal requirements where appropriate
Managing Information:
* Use technology and appropriate software as an aid to management in planning, implementation and monitoring of care, presenting and communicating information
* Review and process data using accurate Read codes in order to ensure easy and accurate information retrieval for monitoring and audit processes
* Understand responsibility of self and others to the practice and primary care trust regarding the Freedom of Information Act
Learning and development:
* Undertake mentorship for more junior staff, assessing competence against set standards
* Disseminate learning and information gained to other team members in order to share good practice and inform others about current and future developments (e.g. courses and conferences)
* Assess own learning needs and undertake learning as appropriate
* Provide an educational role to patients, carers, families and colleagues in an environment that facilitates learning
Person Specification
Experience
* 5 years post registration experience including 6 months experience in a GP practice/ Walk in Centre/ Urgent Care Centre
* Nurse-led management of minor illness, minor ailments, and injuries
* Nurse-led triage
* Compiling protocols and clinical guidelines
* Clinical Leadership
* Audit
* Research
* Nurse prescribing
* Experience of chronic disease management
* Project management
* Working with community development initiatives
* Health-needs assessment
Clinical Knowledge & Skills
* Immunisations (routine, childhood, B12, travel)
* Wound Care / Treatment of advanced injuries / Removal of sutures & staples
* Dressings
* Diabetes review
* Cardiovascular disease primary prevention
* Coronary Heart Disease
* Blood pressure
* Mental Health
* ECGs
* Asthma
* Ability to work within own scope of practice and understanding when to refer to GPs
* Advanced clinical practice skills Management of patients with long-term conditions
* Management of patients with complex needs and chronic diseases
* Clinical examination skills
* Ability to record accurate clinical notes
* Clinical governance issues in primary care
* Patient group directions and associated policy
* Understands the importance of evidence-based practice
* Understanding of Extended brief interventions (NICE guidelines)
* Cytology certificates
* Local and national health policy
* Venepuncture
* New patient medicals
* Chaperone procedure
* Requesting pathology tests and processing the results, advising patients accordingly
* Knowledge of public health issues in the local area
* Able to identify determinants on health in the area
* Awareness of issues within the wider health arena
Qualifications
* Registered first level nurse
* MSc in a nursing related subject
* Clinical supervision training and experience
* Non-Medical Prescriber
* Level 3 Extended brief interventions (NICE guidelines)
* NMCs 'Academic Assessors', 'Practice Supervisors', and 'Practice Assessors accreditations
Personal Qualities
* Polite and confident
* Flexible and cooperative
* Motivated, forward thinker
* Problem solver with the ability to process information accurately and effectively, interpreting data as required
* High levels of integrity and loyalty
* Sensitive and empathetic in distressing situations
* Ability to work under pressure / in stressful situations
* Effectively able to communicate and understand the needs of the patient
* Commitment to ongoing professional development
* Punctual and committed to supporting the team effort
General Skills
* Excellent communication skills (written and oral)
* Clinical leadership skills
* Negotiation and conflict management skills
* Clear, polite telephone manner
* Competent in the use of Office and Outlook
* Competent in the use of patient record management systems: EMIS / SystmOne
* Competent in Document Management systems: Docman
* Competent in other portals: Open Exeter, Coordinate my Care
* Effective time management (Planning & Organising)
* Ability to work as a team member and autonomously
* Good interpersonal skills
* Problem solving & analytical skills
* Ability to follow clinical policy and procedure
* Experience with audit and able to lead audit programmes
* Experience with clinical risk management
* Change management
* Teaching and mentorship clinical setting
* Resource management
* Facilitation of Learning for patients, carers, other staff and students
* Leadership and management skills, as part of a general practice nursing team with delegated accountability and responsibility for patient care
* Evidence, research and development - has an enquiring approach to practice to ensure best quality care is offered within any constraints of the service
Disclosure and Barring Service Check
This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.
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