Frailty Clinical Nurse Specialist (CNS)

The post holder will work in close collaboration with the older adults and Emergency Department clinicians, other CNS's and multidisciplinary teams. The post holder will be mostly based in the emergency department in order to see, assess, treat and discharge older adults to provide admission avoidance, advice, teaching and audit.
Summary of main duties:
Clinical
· Delivery of the evidence based expert clinical care exercising a high degree of professional autonomy, demonstrating the ability to make sound decisions based on the knowledge and experience.
· Holistic individual consultation of patients using a range of different assessment methods including medical history taking, physical assessment, clinical investigations and risk stratifications tools, all of these appropriate to the presentation within the boundaries of the role.
· Order and interpret investigations, laboratory tests, appropriate imaging, and act on results as appropriate.
· Reach a valid, reliable, and comprehensive conclusion based on the history and clinical findings.
Initiate drug therapy/medication within the parameters of agreed clinical guidelines and in accordance with present legislation supply and prescribing of medicine
Communicate with patients in ways that empowers them to make informed choices about their health and healthcare.
Admission avoidance, safe, quality and evidence based care

Working for our organisation
Our people are our greatest asset. When we feel supported and happy at work, this positivity reaches those very people we are here for, the patients. Engaged employees perform at their best and our Equality, Diversity & Inclusion (EDI) initiatives contribute to cultivate a culture of engagement. We have four staff networks, a corporate EDI Team and a suite of programmes and events which aim to insert the 5 aspirations:
1. Improving representation at senior levels of staff with disabilities, from black, Asian, and ethnic minorities background, identify as LGBTQ+ and women, through improved recruitment and leadership development
2. Widening access (anchor institution) and employability
3. Improving the experience of staff with disability
4. Improving the EDI literacy and confidence of trust staff through training and development
5. Making equalities mainstream, 1. Clinical
· Delivery of the evidence based expert clinical care exercising a high degree of professional autonomy, demonstrating the ability to make sound decisions based on the knowledge and experience.
· Holistic individual consultation of patients using a range of different assessment methods including medical history taking, physical assessment, clinical investigations and risk stratifications tools, all of these appropriate to the presentation within the boundaries of the role.
· Order and interpret investigations, laboratory tests, appropriate imaging, and act on results as appropriate.
· Reach a valid, reliable, and comprehensive conclusion based on the history and clinical findings.
· Initiate drug therapy/medication within the parameters of agreed clinical guidelines and in accordance with present legislation supply and prescribing of medicines.
· Communicate with patients in ways that empowers them to make informed choices about their health and healthcare.
· Actively implement and manage, evidence based therapeutic programmes, which are in the interest of patient and improve health outcomes.
· Work in partnership with other clinical teams making appropriate referrals to optimise health outcomes and resources.
· In partnership with patients, clients and other professions, make sounds decision which are ethically based in the interest of patients and clients in the absence of precedents and protocols.
· Provide specialist knowledge, advice, resource information and support to clinical staff across the trust.
2. Service & Practice improvement
· Promote the improvement of quality and clinical effectiveness within the resource constraints.
· Develop practices that are appropriate to patient and service need thought understanding the wider implications of epidemiological, demographic, social, political, legislative, and professional trends and developments.
· Identify the need for change and proactively generate practice innovations to implement solutions to better meet the needs of patient and the service.
· Develop and undertake activities to monitor the progress and efficiency of the service and owns practice.
· Continually assess and monitor risk in their own and others practice and challenge others if necessary.
· Critically appraise and synthesise the outcomes of relevant research, evaluations and audits, and apply the information when seeking to improve practice.
3. Management and Leadership
· Contribute to the development of the specialist service and act as a change agent and facilitate the change process whilst encouraging other to be innovative and adaptable in the approach to change.
· Work across professional, organisational and system boundaries to proactively develop and sustain new partnerships and networks to influence and improve health, outcomes, and healthcare delivery systems.
· Review and update documentation and policies specially required by the team.
· To be conversant with all the relevant Trust policies and procedures and ensure they are correctly implemented.
· Lead the team in establishing and maintaining effective communication channels with the multi-disciplinary team, patients and their carers and external agencies.
· To work collaboratively with representatives of other clinical areas, disciplines and services to provide a seamless pathway of care.
· Coordinate, lead and manage the activities of clinics on a day to day basis.
· Assisting with the investigation of complaints and lead on the development of action plans to address areas of concern.
· Participate in the recruitment, selection and retention of staff.
· To represent the Trust on National forums related to the role and Advanced Clinical Practice.
· Prioritise, organise and manage own workload in a manner that maintains and promotes quality.
4. Information management
· Adhere to confidentiality at all times with sensitive personal data.
· Responsible for the systematic monitoring of investigations and appointments, in collaboration with administration and managerial staff.
· Ensure compliance with care pathways and service development.
· Provide reports of the statistics, service and practice developments when required.
· Provide high standards of documentation in accordance with the Trust documentation policy., · To participate in teaching programmes for nursing in the care of patients relevant to frailty and care of older adults.
· To exhibit a personal commitment to clinical education and development. Work in collaborations with others to plan and deliver interventions to meet the learning and development needs of their own and other professions.
· Raise awareness of the current local, regional, national and international perspectives in clinical specialities.
· Provide training and educations opportunities within the team, the Trust, local and national areas.
6. Audit and research
· Contribute/assist in the development of multidisciplinary research and clinical audit in frailty, implementing effective and evidence-based practice
· Develop research skills and provide support and appropriate implementation strategies for changes in clinical practice.
· Participate and contribute to any on-going regional and national research to evaluate the effectiveness of care strategies related to the patient experience within emergency and unscheduled care.
· To share best practice; through publications and attendance/presentation opportunities at conference level
7. Resource Management
· To apply sound financial evaluation to proposed service developments.
· Maintain accurate records in relation to equipment used and maintained by the frailty and ED teams.
6. Risk Management
· To ensure that systems are in place to manage, reduce and prevent clinical risk to self and others within the RDC department.
· To monitor incidents highlighted by members of the emergency team and communicate to appropriate areas to address risk issues.
Promote best practice in health & safety, utilising unit and Trust policies
Post holder will be based in the Emergency Department and will work closely with the Frailty team and ED team
We reserve the right to close the post before the stated closing date, please apply early. We do not contact applicants with the outcome of the shortlisting. If you have been shortlisted, you will receive an invite to an assessment day or interview.
As a local employer and anchor institution we work closely with our community to recruit locally and we welcome applications from the widest variety of people to ensure our workforce are reflective of the local communities which we serve. We encourage all suitable candidates to apply including if you are Black, Asian or other ethnic minorities, live with a disability (visible or not) or are LGBT+. We have a number of active staff networks including Disability, LGBT+, Multicultural Inclusion and Women's staff networks to bring staff together and celebrate diversity across our whole workforce.
Please note, not all roles will meet the criteria for a skilled worker visa.

The post holder will be an experienced ACP with the skills to autonomously assess, investigate, treat, and refer patients identified as frail in the Emergency Department (ED). Applicants will have a full MSC in advanced practice or comparable qualifications and will be able to evidence a portfolio of practice with a relevant speciality. The post holder will work closely with the interdisciplinary teams and collaborate with colleagues to ensure that high quality patient care is maintained. The post holder will be expected to contribute to the daily management and auditing processes of the service and interact frequently with relevant stake holders both within the organisation and externally.

Lewisham and Greenwich NHS Trust, (LGT), is a community-focused provider of local and acute care, delivering high-quality services to over one million people living across the London boroughs of Lewisham, Greenwich, and Bexley. We provide whole-life care and are here to support our communities to live healthier lives as well as taking care of them when they need us the most.
Employing almost 7,500 colleagues, affectionately known as Team LGT, we provide services at Queen Elizabeth Hospital in Woolwich, University Hospital Lewisham, and at over a dozen community settings in Lewisham. We also provide some services at Queen Mary's Hospital in Sidcup.
We have recently launched our new vision and values to mark the LGT10 - the tenth anniversary of our Trust forming in 2013. Our trust vision is to be exceptional. In the quality of our patient care; our support for colleagues; and in the difference we make through our partnerships and in our communities.
To achieve this we value Respect, Compassion, and Inclusion; Being accountable over staying comfortable; Listening over always knowing best; and Succeeding together over achieving alone. You can read more about our visions and values here
Our hospitals and community sites provide a wide range of inpatient and outpatient services, as well as emergency and planned care. The Trust is rated as "good" or "outstanding" in over three-quarters of the services inspected by the Care Quality Commission.
Every year our work includes performing 10,000 procedures in our theatres; bringing seven and a half thousand new lives into the world; carrying out 570,000 visits to patients in their homes or communities and providing emergency care for more than 300,000 patients arriving in our busy Urgent and Emergency Departments.
LGT is a centre for the education and training of medical students enrolled with King's College London's GKT School of Medical Education. We are a training centre for nurses, midwives and allied health professionals. We are pioneering new roles that will support the changing needs of our patients and are one of the largest employers of physician associates in the country.
We are committed to working with our partners to deliver the best outcomes for our local communities. This means playing an active role in the South East London Integrated Care System (ICS), and in formal partnerships including the South East London Acute Provider Collaborative, provider partnerships with our local mental health trusts and borough-based boards of the ICS in Bexley, Greenwich and Lewisham.