Advanced Nurse Practitioner / Emergency Care Practitioner

An opportunityhas arisen for an ANP / ACP / ECP to join our friendly and supportive GeneralPractice Team. We are looking for aself-motivated, flexible individual, with good organisational andcommunications skills who can work effectively within our clinical team toundertake patient assessment, diagnosis and clinical management. You will needto have the ability to work in demanding and ever-changing situations. You will work autonomously within yourprofessional scope of practice adhering to the four pillars of advancedpractice : clinical practice, leadership and management, education andfacilitation of learning and evidence, research and development. You will needto demonstrate safe, clinical decision-making and expert care, includingassessment and diagnostic skills for patients within the general practicesetting. Collaborativeworking with the practice team is essential to meet the needs of patients andsupport the delivery of polices and procedures. Main duties of the job Assess andexamine patients, diagnose, plan, treat and review / evaluate. Assessment maybe face to face or via telephone, as part of a triage care team, and willinclude patients presenting with an undifferentiated diagnosis. Diagnose andmanage patients presenting with both acute and chronic conditions based on amanagement plan which includes a medication plan and other interventions. Identify healthpriorities amd make timely and appropriate interventions to support patientspresenting with complex or acute needs. Identifypatients at risk of developing a chronic illness and develop a plan forminimising the risk of worsening. Help to supportpatients with advice and education, promoting understanding, self-care, healthylifestyle choices, and sources of support and compliance with a treatment planand medication. Other responsibilities include ensuring all clinical-generated administration is completed in a timely manner., The post holder is an experienced health care professional, who acting within their professional boundaries, will provide care for the presenting patient from initial history taking, clinical assessment, diagnosis, treatment and evaluation of their care. They will demonstrate safe, clinical decision-making and expert care for patients within the general practice. They will work collaboratively with the multi-disciplinary general practice team to meet the needs of patients, supporting the delivery of policy and procedures, and providing professional support to colleagues within the practice as required. In order to work at this level, Department of Health (2010) requirements for advanced practice must be met. CLINICAL ROLE : Within the time constraints of the role the postholder will work with the GPs and management to develop the advanced care practitioner / emergency care practitioner role within the practice. Clinical roles can include :

• Undertake home visiting of patients
Provide the choice of direct access to an ACP / ECP, both in the Practice and over the telephone, for the general practice population Make professionally autonomous decisions for which he / she is accountable All patients are triaged by the duty team to the ACP / ECP. The ACP / ECP provide clinical support 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 Refer patients directly to other services / agencies as appropriate Work with multi-disciplinary team within the Practice, and across the wider healthcare community, 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-centered strategies to address them 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 TEACHING AND MENTORING ROLE : Promote a learning environment for patients, nurses and other health professionals. Contribute to the planning and implementation of the teaching for existing staff, such as medical students, nurse students, GP registrars, Health Care Assistants, within the Practice. PROFESSIONAL ROLE : Promote evidence-based practice using the latest research-based guidelines and the development of practice-based research. Monitor the effectiveness of their own clinical practice through the quality assurance strategies such as the use of audit and peer review Maintain their professional registration Participate in continuing professional development opportunities to ensure that up-to-date evidence-based knowledge and competence in all aspects of the role is maintained Work within the latest HCPC / NMC Code of Professional Conduct Record accurate consultation data in patients records in accordance with the latest HCPC / NMC guidance and other pertinent standards Keep up to date with pertinent health-related policy and work with the practice team to consider the impact and strategies for implementation Work collaboratively with colleagues within and external to the practice. Demonstrate effective teamwork Pro-actively promote the role of the ACP / ECP within the Practice, and externally to key stakeholders and agencies C. SUPERVISION EXERCISED The postholder has no direct line management responsibility but is empowered to use professional skills and judgments to advise, train and where necessary instruct, other members of the team in clinical and safety matters D. SUPERVISION RECEIVED For line management purposes the postholder reports to the Lead Advanced Nurse Practitioner E. DECISIONS EXERCISED The postholder is responsible for a wide range of clinical care and will usually work unsupervised. The postholder is required to exercise judgment and take decisions about the care provided to patients. Decisions will be taken in accordance with national, local and practice guidelines and protocols. Decisions should only be exercised within the postholders professional competencies. F. CREATIVITY There is a good deal of scope for creativity. The postholder is responsible for the assessment of patient care needs and the development, implementation and evaluation of programs of care. Key inputs are made in conjunction with the GPs over the introduction of new protocols and working practices. The ongoing development of evidence-based medicine; clinical governance and continuing professional development also afford opportunities for creativity.

To deliver a high standard of patient care as Advanced Care Practitioner / Emergency Care Practitioner in general practice, using advanced autonomous clinical skills, and a broad and in-depth theoretical knowledge base, The postholder will be a qualified Paramedic with current HCPC registration or Advanced Nurse Practitioner and will work towards gaining modules in Advanced Practice including prescribing. I. SPECIAL CONDITIONS The post-holder is required to travel independently between practice sites (where applicable), and to attend meetings etc. hosted by other agencies. The post-holder will have contact with body fluids wound exudates, urine etc. while in clinical practice. J. OTHER REQUIREMENTS Knowledge of Health and Safety guidelines including infection control Knowledge of CQC requirements Excellent communication skills Ability to work with minimum supervision and to organise own workload Ability to contribute effectively to the Primary Health Care Team An understanding of the main requirements of the GP contract and enhanced services,
• Registered General Nurse (Currently registered with the Nursing & Midwifery Council) / or paramedic Registered with The Health and Care Professions Council HCPC
• Recognised NP qualification at Masters level or equivalent
• Experience :
• Minimum of 2 years post registration experience including 2 years in Primary and Community Care
• Experience in management long term conditions asthma, COPD, diabetes, CHD
• Evidence of appropriate continuing professional development activity to
• maintain up-to-date knowledge and on-going competence in all aspects of the ACP role
• Proven ability to evaluate the safety and effectiveness of their own clinical practice
• Knowledge :
• 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 evidence based practice
• Knowledge of national standards that inform practice ( National Service Frameworks, NICE guidelines etc.)
• Understanding of their accountability arising from the NMC / HCPC Code of Professional Conduct and medico-legal aspects of the Nurse Practitioner role including Safeguarding
• Understanding of equal opportunity and diversity issues
• Skills :
• 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 CCG and with key external stakeholders
• Self-motivated
• Organisational skills
• Enthusiastic
• Car driver / access to car
Desirable
• DESIRABLE
• Teaching / Mentoring experience and / or qualification
• Independent prescribing
• 3- 5 years post registration experience
• Interpreting and implementing local and National policy agendas for health
• Evidence of working
• autonomously and as part of a team
• 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
• Ability to work flexible hours when required
• Sickness level below 5%
  
  Our main site is in the middle of Taunton overlooking thecricket ground and we have a branch surgery at Norton Fitzwarren which is asmart modern purpose-built facility. The postholder will work out of bothsites.
We have a highly experienced GP team. We are a GP Training Practice (we have justbeen assessed as excellent for this and we usually have a F2 doctor from thehospital for 4 months at a time on rotation. We also have student doctors inthe practice. Our Practice Nursing Team includes mentors, so we do take nursingstudents on placement. We have a strong Practice Nurse Team providing a full suiteof chronic disease management care and the usual treatment room functions, plusvaccinations etc. We try to make the best use of clinical IT and have aspecialist team handling issues such as clinical coding, data quality,templates, protocols, screen pop-ups, hot keys, searches, audits, recalls. Examples of recent successes have been thereduction in workflow items being sent to clinicians, including the diversionof prescription related items to our prescribing desk function. We are all supported by our Patient Services Team (used tobe called Receptionists) who handle thousands of contacts per week. The Practice is part of the Taunton Central Primary CareNetwork.