The Advanced Clinical Practitioner (ACP) will work as an integral member of the general practice multidisciplinary team, with a primary focus on acute, ontheday demand, alongside some longterm condition (LTC) management and home visits.
Main duties of the job
Job Purpose
Assess, diagnose and manage patients presenting with acute problems on the day, within an agreed scope of practice and competence.
Provide some planned reviews for stable longterm conditions and selected home visits, as agreed in the job plan.
Work autonomously but with readily available GP supervision, escalating complex or highrisk cases appropriately.
Help manage GP workload safely and effectively, while ensuring that GPs retain responsibility for undifferentiated, complex and highrisk presentations.
This role is complementary to, and not a substitute for, GPs. GPs remain responsible for overall clinical leadership and holistic management of complex patients.
Job responsibilities
Key Duties and Responsibilities
1. Acute, OntheDay Clinical Care (Primary Focus)
Provide sameday appointments (facetoface or telephone) for patients presenting with acute problems, within an agreed scope of practice.
Take focused but comprehensive histories and perform appropriate physical examinations.
Formulate differential diagnoses and management plans, seeking GP input where cases fall outside agreed competence or raise red flags.
Request, interpret and act upon appropriate investigations (e.g. blood tests, imaging, ECGs) within agreed protocols.
Prescribe medicines within professional competence and in accordance with local and national prescribing policies.
Provide clear safetynetting advice and arrange appropriate followup or GP review.
Recognise and respond to medical emergencies, escalating promptly to the duty GP and following practice emergency protocols.
2. LongTerm Condition Management (Secondary Focus)
Undertake planned reviews for selected, stable longterm conditions (e.g. hypertension, COPD, asthma, diabetes, heart disease) in line with practice protocols and national guidance.
Optimise treatment within agreed parameters, with GP support for more complex decisions or treatment changes.
Provide lifestyle advice and selfmanagement support (e.g. smoking cessation, weight management, exercise, inhaler technique).
Identify patients who require escalation to a GP or specialist service due to deterioration, complexity or safeguarding concerns.
3. Home Visits and Care Homes
Undertake home visits and/or care home reviews for appropriate patients, as agreed in the job plan and within the ACPs competence.
Assess, diagnose and manage acute and stable LTC issues in the home setting, with clear escalation pathways to the duty GP.
Contribute to anticipatory care planning and coordination with community teams, within agreed protocols and under GP oversight.
4. Multidisciplinary Team Working
Work closely with GPs, practice nurses, HCAs, clinical pharmacists and other MDT members to ensure coordinated, safe and efficient care.
Participate in practice clinical meetings, MDT meetings and case discussions, particularly around acute demand and complex LTC cases.
Contribute to the development and implementation of practice care pathways and protocols for acute presentations and LTC management.
5. Quality, Governance and Service Development
Maintain accurate, contemporaneous and comprehensive clinical records in line with practice and professional standards.
Participate in clinical audit, significant event analysis and quality improvement projects, particularly those related to urgent access and LTC care.
Support delivery of locally commissioned services and Health Board priorities as agreed in the job plan.
Contribute to the induction and informal teaching of other staff where appropriate (e.g. junior nurses, HCAs, new clinicians).
Adhere to practice policies and procedures, including safeguarding, infection control, information governance and health and safety.
6. Professional Development
Maintain and develop advanced clinical skills and knowledge relevant to acute primary care and LTC management.
Undertake mandatory and statutory training within required timescales.
Participate in annual appraisal and maintain a professional portfolio in line with advanced practice standards.
Maintain professional registration and revalidation with the relevant regulatory body (e.g. NMC, HCPC, GPhC).
Engage in regular clinical supervision with a named GP and seek advice when working at the limits of competence.
Scope of Practice and Supervision
The ACP will work within a clearly defined scope of practice, agreed with the GP partners and reviewed at least annually.
A named supervising GP will be available during clinical sessions for advice, case discussion and escalation.
The ACPs caseload, appointment length and level of autonomy will be adjusted according to experience, competence and ongoing review.
Complex, highrisk, uncertain or multimorbid cases remain the responsibility of GPs and should be escalated appropriately.
Terms and Conditions (to be locally determined)
Hours: Full time hours (pattern to be agreed; may include some extended hours sessions).
Salary: Depending on experience.
Annual leave, study leave and other benefits: As per practice policy / contract.
Location: Tal-Y-Bont Surgery
Person Specification
Qualifications
* Registered healthcare professional (e.g. Nurse, Paramedic, Pharmacist) with current registration (e.g. NMC, HCPC, GPhC).
* Completed Advanced Clinical Practice MSc or recognised ACP qualification (or equivalent portfolioevidenced advanced practice recognised by the employer).
* Evidence of advanced clinical assessment and decisionmaking skills.
Knowledge and Skills
* Commitment to highquality, patientcentred care.
* Flexible and adaptable approach to service needs, particularly around urgent ontheday demand.
* Commitment to ongoing CPD and reflective practice.
Experience
* Significant post registration clinical experience in a relevant setting (e.g. primary care, urgent care, emergency or acute medicine, community services).
* Demonstrable experience of managing a range of acute presentations and long term conditions.
* Experience of working within a multidisciplinary team.
* Advanced historytaking, physical examination and clinical reasoning skills.
* Ability to assess, diagnose and manage patients within an agreed scope of practice, including recognition of red flags and need for escalation.
* Understanding of primary care and longterm condition management in the Welsh context.
* Excellent communication and interpersonal skills, with the ability to explain complex information clearly to patients and colleagues.
* Competent IT skills and familiarity with electronic patient records.
* Ability to work autonomously while recognising professional limits and seeking supervision appropriately.
* Experience in home visiting and/or care home work.
* Experience in clinical audit, quality improvement or service development.
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.
Depending on experienceSalary Available Upon Request
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