Integrated Neighbourhood Team Clinician

We are looking for experienced paramedics / nurse practitioners to work within the PML Neighbourhood Team as a registered Clinician within North, South and West Oxfordshire. The team works closely with colleagues across Oxfordshire to provide support for patients in their own home environment. This can be during an acute illness, to prevent hospital admission, or to facilitate discharge from hospital. We are developing our frailty service which focuses on providing elderly frail patients with support and care planning to help them stay at home. This rewarding and diverse role and would suit any clinician looking to move from the acute sector or ambulance service and those already working in the community / primary care. Main duties of the job We are looking for flexible individuals (full time / part time) who are passionate about delivering excellent patient care. It would also suit anyone with a passion for caring for the frail, elderly, and housebound community in their own home. In return for your skills and commitment we offer wide-ranging staff benefits. We believe that ongoing support and opportunities to further enhance your clinical skills and knowledge are extremely important, and we will work with you to maximise your potential. For all clinicians, the role will require you to deliver a range of assessments and interventions to patients in their own home to ensure timely treatment and facilitate early discharge and admission avoidance. Skills required for the role includes, clinical triage, and assessments, phlebotomy, ECGs urinary catheterisation, palliative care, and wound care (a training programme can be offered to establish this skill set)., The successful candidate will join the Neighbourhood Team; a team that takes pride in its can do approach, in what can be a busy, often demanding, but highly rewarding environment. The post holder will be required to provide direct patient care whilst also influencing the clinical development and operational delivery and quality of the Neighbourhood Team by working within PML Federation Services the post-holder will, in summary :

• Work within the Neighbourhood Team to undertake on the day requests from GP Practices for patient home visits to a protocol mutually agreed with Clinical Leads.
• Provide timely, high quality, person centred clinical care to patients addressing their needs within the current urgent care needs and their long-term self-management.
This is achieved by collaborating with all health and social care agencies and including local community services and within primary care provision.
• Prevent inappropriate hospital admissions by providing / co-coordinating the provision of specialist care by other agencies for the patient in the most appropriate and agreed environment.
• Ensure the learning of new specialist skills and knowledge with the appropriate training and qualification and within a competency framework.
• Develop specialist knowledge and skills within the team in the management of minor illness / injury and chronic diseases, working with agreed protocols in collaboration with medical clinicians and chronic disease practitioners within the community.
• Write up full and discursive notes of patient encounters in the organisations clinical system. Ensure full and effective communication with GP Practices regarding patient assessment and outcomes.
Neighbourhood Team Registered Clinicians The Neighbourhood teamwork across Oxfordshire and provide care to patients in their own homes. The work is varied and differs day to day. The role includes the assessment of patients on behalf of their GPs, the management of patient with new conditions requiring support, and treatment and follow up of long-term conditions and one-off treatments. The role would suit any clinician who likes to work autonomously and has a degree of diligence. Training in clinical skills is available for staff development as is regular clinical supervision with training pathways implemented where identified. The team provides high quality, person centred clinical care, addressing individual needs within a patients own environment to encourage their long-term self-management. This is achieved by collaborating with all health and social care agencies and integrating with other services across primary and secondary care. The team work collaboratively to meet the demands of the service, preventing admission to hospital and facilitating discharges. The robust induction period will have scope for personal identification and skills gap analysis allowing you to facilitate the demands of the service. We are looking to expand the current team and can be flexible with hours and shifts to accommodate flexible working.,
• To act as a self-directed practitioner who directs, provides, and evaluates the highest standard of evidence based clinical care to patients within their own home, founded on agreed management care plans and protocols.
• To work independently, without direct supervision and perform comprehensive patient assessments based upon history taking and physical examination in a variety of clinical settings and in the home environment, prioritising workload to meet the regular unpredictable situations that may occur within this role.
• To make clinical decisions within the home autonomously and in liaison with GPs, hospital clinicians and other agencies in preventing some hospital admissions.
• Demonstrate highly developed clinical reasoning and decision-making.
• Acquire a variety of specialist clinical skills and knowledge to include assessments of chronic diseases in the home, such as heart failure and respiratory disease, diabetes, and general medical conditions.
• Undertake the learning of other professional skills and knowledge to include social assessment and social care planning in accordance with PML Risk Management Policies and Procedures
• Work in close collaboration with the Clinical Lead for the delivery of an effective service by defining and overseeing the development of service standards in-line with Government, NMC / HCPC guidelines and PML Policy.
• Liaise with patients, carers, and colleagues to assess the safety of a patients home environment, acting quickly to protect patients and staff from potential risk.
• To ensure that appropriate, consistent, and realistic information is provided to patients and families.
• To provide sensitive and complex information to relatives and patients in sometimes hostile, and emotive atmospheres.
• Use expert communication skills to create and sustain new alliances. Using the highest level of interpersonal skills, to break down the barriers and develop inter-professional collaborative working relationships with staff in primary and secondary care.
• Be a clinical resource for the patient / carer especially within their home as well as to colleagues, GPs, and other agencies.
Recognise levels of competence and always work within them. Professional / Ethical Practice
• Acting in accordance with Principal Medical Limited (PML) protocols and policies and the Law.
• Obtaining informed consent from the patient before initiating any procedure or intervention and documenting this within the patients notes.
• Maintaining confidentiality and communicating patient information in accordance with the Caldicott (1997) principles.
• Working in a non-judgmental anti-discriminatory way, regarding the cultural and religious beliefs of individuals and groups.
• always working within boundaries of competency and knowledge.
• Escalate concerns in line with PML and national guidance.
Patient Care
• Appropriately assessing patients and their carers within sphere of competence, including physical and mental health assessment alongside social care needs.
• Making appropriate referrals to relevant partner agencies with the patients consent.
• If necessary, seeking advice from a registered practitioner for matters outside the post holders sphere of responsibility, knowledge, or skills.
• Educating, supporting, and advising patients and their carers appropriately and within own competency and knowledge.
• Maintaining accurate patient records within agreed timescales and utilising relevant IT systems.
• Participating in clinical audit as deemed appropriate.
Communication
• Coordinate, organise and prioritise own workload daily.
• Support new staff to ensure compliance with induction and signpost to support as necessary.
• Contribute to new ways of working, offering ideas and support for change.
• always act as a role model.
• Reporting any issues in the workplace that may put health and safety at risk.
• Being aware of and abiding by Lone Worker policy.
• Summoning immediate help for any emergency and taking appropriate action to contain it.
• Contemporaneous data inputting to the relevant clinical systems
Personal / Professional Development
• Attending staff meetings, team meetings and in-service training as directed
• Participating in annual appraisal to identify personal / professional development plan.
• Create personal development objectives through close working and supervision sessions.
• Taking an active part in learning opportunities and keeps their own personal learning and development portfolio.
• Participate in clinical supervision and 121 as per individual requirement.
• Act as a link practitioner on specialist subjects to support the development of the team and service.
Safeguarding
• Promoting the welfare and safeguarding of children, young people, and adults.
• Supporting the organisation in ensuring service users are protected from abuse, or the risk of abuse and that their human rights are respected.
• Ensuring concerns are responded to appropriately in line with PMLs Safeguarding Policy.
• Complying with recruitment and other checks as requested.
• Manages patients in line with best practice to promote wellbeing.
• Adheres to National and Local guidance with regards to infection control and prevention.
Governance
• Ensure delivery of care in line with PML policy and national standards
• Adheres to PML policy and standard operating procedures when completing patient care / treatment.
• Promotes standards and participate in audits to confirm adherence to policy.
• Works within professional boundaries.
  
  Registered clinicians will require a minimum of two years experience in the community or emergency / urgent care settings as a Registered Nurse / Paramedic or allied health professional with current registration with the NMC / HCPC., Support patients to remain within their own home environment.
• Avoid unnecessary admissions to hospital.
• Influence service development to deliver high quality holistic acute care., Have NMC / HCPC registration
• Paramedics are required to have completed two years post qualification consolidated experience. Knowledge in UCC / Triage environment or primary care would be beneficial.
• Sound knowledge and understanding of healthcare economy and accessing services across the community setting.
• Represent their profession in accordance with best practice standards and code of conduct with their relevant regulatory body.
• Approach Continuing Professional Development and appraisal in an open and constructive manner.
• Have a minimum of 2 years working within the community.
• Transferrable skills such as Phlebotomy, Catheterisation, Chest Auscultation, and clinical assessments, Educated to GCSE level with at least a C grade in English and Maths
• RN Level 1 or equivalent professional registration Current registration with the NMC / HCPC or equivalent registration
• Clean Driving Licence
Desirable Minor Injuries / illness qualification / experience Skills and Knowledge Essential
• Effective written & oral communication skills
• Understand team dynamics and work collaboratively within a multi-disciplinary team
• Excellent administrative skills
• Proficiency in the use of Windows based software including Word and Excel
• Ability to manage own workload, work under pressure and to strict timescales
Desirable Competence in the use of clinical database IT packages Experience Essential
• Experience working in healthcare
• Experience working in a community setting
  
  PML is a successful not-for-profit, GP-led organisation providing various NHS community and primary care clinical services to patients across Oxfordshire and Northamptonshire.
We have evolved as a NHS healthcare provider since 2004 and in the last few years have grown significantly, now employing around 300 staff with a turnover of circa £16m. PML holds GMS contracts, as well as being a GP Federation representing circa 50 GP practices covering approximately 650,000 patients.