Advanced Clinical Practitioner (ACP)

NHS; Nottingham; On-site; GBP 71,000 - 78,000; Full time

Job summary

NEMS Community Benefit Services (NEMS) in Nottingham is seeking an Advanced Clinical Practitioner to deliver autonomous clinical care across urgent care services. You will supervise and manage both telephone and face-to-face consultations, making safe decisions on admission, referral and discharge within local pathways.

The role requires an experienced clinician with advanced practice credentials, capable of working within governance frameworks and NHS policies, with flexibility across sites and

Qualifications

• Masters level in Advanced Clinical Practice with prescribing rights.
• Registration with NMC or HCPC and ongoing CPD.
• Experience in autonomous assessment and urgent care settings.

Responsibilities

• Provide autonomous clinical care across NEMS urgent care services.
• Mix of telephone and face-to-face consultations for urgent care.
• Assess, diagnose, treat and discharge or refer undifferentiated cases.
• Escalate when needed and maintain safety-net guidance.

Skills

Autonomous clinical decision-making

Telephone & face-to-face consultations

Clinical governance & safety-netting

Education

Masters level Advanced Clinical Practice

Independent non-medical prescribing

NMC/HCPC registration

Tools

Adastra / SystmOne / EMIS / Nervecentre

Job description

The Advanced ClinicalPractitioner will provide autonomous clinical care across NEMS urgent careservices. The role is designed to provide a true mix of telephone andface-to-face consultations, supporting patients across Integrated Urgent CareServices, urgent treatment centres and other agreed service models.

The post holder will be anexperienced registered clinician, able to assess, diagnose, treat, refer anddischarge patients with undifferentiated urgent care presentations. They willwork within their professional registration, agreed scope of practice, NEMSpolicies and local clinical pathways.

Telephone consultations willusually be undertaken within Integrated Urgent Care Services. Followinginduction, and where agreed by the service, some telephone consultation workmay be undertaken remotely from home, provided that the post holder is meetingagreed KPIs, quality standards, governance requirements and informationgovernance expectations.

Face-to-face work will includeassessment and management of patients presenting to NEMS urgent treatmentservices. The post holder will be expected to recognise serious illness,clinical deterioration, safeguarding concerns, mental health risk and presentationsrequiring escalation or transfer to another service.

Main duties of the job

Clinical Practice and ServiceDelivery

Work as an autonomous Advanced ClinicalPractitioner across NEMS urgent care services, providing both telephone andface-to-face consultations.

Assess, examine, diagnose, treat and safelydischarge or refer patients with undifferentiated urgent care presentations.

Make safe decisions around admission,transfer, referral, follow-up and safety-netting, working within professionalcompetence and agreed local pathways.

Recognise and act on serious illness,clinical deterioration, safeguarding concerns, mental health risk andpresentations that require escalation to another service.

Request and interpret appropriateinvestigations, including blood tests, urine tests, ECGs and imaging, in linewith local policy, competence and relevant regulations.

Prescribe, review and advise on medicineswhere qualified to do so, or use agreed local medicines mechanisms withinscope.

Maintain clear, accurate and timely clinicalrecords, including assessment findings, clinical reasoning, advice given,decisions made and onward plans.

About us

NEMS Community Benefit Services (NEMS) is a not-for-profit social enterprise and a Company Limited by Guarantee. It has been operating in Nottinghamshire for over 25 years, now providing a population of more than 1.2 million with urgent primary health care services. It operates out of 2 registered locations and four bases and deploys a team of more than 370 healthcare professionals, including 150+ sessional GPs, 90+ substantive staff, 30+ agency workers, and 140+ non-healthcare staff.

NEMS provides services to a population of circa 1.2 million under the following service portfolio headings;

• Care Co-ordination and non-clinical call handling
• Clinical Assessment and Care Navigation
• Support to Primary Care including General Practice Out-of-Hours and Urgent Treatment Centres
• Outbreak Management

The Board of Directors comprises non-executive Member directors and executive directors and is responsible for overall strategy and governance of the organisation. The Board of Directors is supported by two sub-committees Quality and People Committee and Finance and Performance Committee. An Operational Executive Team, comprising Executive Board Directors, together with other senior leaders, is being established to oversee the smooth running of the day-to-day activities of NEMS.

Job responsibilities

The Advanced ClinicalPractitioner will provide autonomous clinical care across NEMS urgent careservices. The role is designed to provide a true mix of telephone andface-to-face consultations, supporting patients across Integrated Urgent CareServices, urgent treatment centres and other agreed service models.

The post holder will be anexperienced registered clinician, able to assess, diagnose, treat, refer anddischarge patients with undifferentiated urgent care presentations. They willwork within their professional registration, agreed scope of practice, NEMSpolicies and local clinical pathways.

Telephone consultations willusually be undertaken within Integrated Urgent Care Services. Followinginduction, and where agreed by the service, some telephone consultation workmay be undertaken remotely from home, provided that the post holder is meetingagreed KPIs, quality standards, governance requirements and informationgovernance expectations.

Face-to-face work will includeassessment and management of patients presenting to NEMS urgent treatmentservices. The post holder will be expected to recognise serious illness,clinical deterioration, safeguarding concerns, mental health risk and presentationsrequiring escalation or transfer to another service.

The post holder will workflexibly across NEMS sites and services in line with service need. They willalso support clinical supervision, learning, audit, incident review and serviceimprovement, ensuring that care remains safe, effective, patient centred andfinancially sustainable.

The post holder will haveresponsibility for the following areas:

o Autonomous telephone and face-to-faceassessment of patients with urgent care needs

o Safe clinical decision-making, includingtreatment, discharge, referral, transfer and safety-netting

o Recognition and escalation of serious illness,clinical risk and safeguarding concerns

o Clinical leadership, supervision and supportfor the wider team

o Participation in governance, audit, learningand service improvement activity

Clinical Practice and ServiceDelivery

Work as an autonomous Advanced ClinicalPractitioner across NEMS urgent care services, providing both telephone andface-to-face consultations.

Assess, examine, diagnose, treat and safelydischarge or refer patients with undifferentiated urgent care presentations.

Make safe decisions around admission,transfer, referral, follow-up and safety-netting, working within professionalcompetence and agreed local pathways.

Recognise and act on serious illness,clinical deterioration, safeguarding concerns, mental health risk andpresentations that require escalation to another service.

Request and interpret appropriateinvestigations, including blood tests, urine tests, ECGs and imaging, in linewith local policy, competence and relevant regulations.

Prescribe, review and advise on medicineswhere qualified to do so, or use agreed local medicines mechanisms withinscope.

Maintain clear, accurate and timely clinicalrecords, including assessment findings, clinical reasoning, advice given,decisions made and onward plans.

Telephone Consultations

Undertake telephone consultations withinIntegrated Urgent Care Services, using safe clinical assessment,decision-making and documentation.

Recognise the limitations of remoteassessment and arrange face-to-face review, ED attendance, ambulance responseor other escalation where clinically required.

Provide clear advice and safety-netting topatients and carers, ensuring that the plan is understood and documented.

Undertake remote work from home where agreedafter induction, provided that performance, KPIs, quality standards andinformation governance requirements are being met.

Face-to-Face Urgent Care

Undertake face-to-face consultations acrossNEMS urgent care services, including assessment of minor illness, minor injuryand other appropriate urgent care presentations.

Carry out clinical procedures where trained,competent and required for patient care.

Provide safe clinical handover to ED,specialties, GPs, community services or other colleagues where ongoing care isrequired.

Support patient flow, streaming andredirection decisions where this forms part of the service model.

Clinical Leadership and TeamWorking

Act as a senior clinical presence on shift,supporting colleagues and contributing to the safe running of the service.

Provide advice, supervision and support totrainee ACPs, UCPs, nurses, AHPs, UCAs and non-registered staff.

Support induction, training, clinicalsupervision and competency development across the wider team.

Escalate clinical or operational concernsearly, particularly where patient safety, staffing, flow or professionalpractice may be affected.

Address unsafe practice or poor behaviour ina professional and proportionate way, escalating concerns where required.

Governance, Quality andService Improvement

Contribute to a culture where incidents,complaints, audit, feedback and day-to-day operational learning are used toimprove care.

Take part in incident reviews, significantevent analysis, complaint responses and shared learning activity whererequired.

Support audit, quality improvement andservice evaluation work across NEMS urgent care services.

Contribute to the development and review ofclinical guidelines, SOPs, pathways and local standards, ensuring they arepractical, evidence-based and relevant to the way services are delivered.

Use available data, feedback and clinicalexperience to support improvements in patient flow, clinical quality,productivity and patient experience.

Education and ProfessionalDevelopment

Maintain professional registration, mandatorytraining, clinical supervision, CPD and revalidation requirements.

Maintain an up-to-date portfolio showingcompetence, scope of practice, reflective learning and prescribing practicewhere applicable.

Share learning with colleagues throughteaching, case discussion, supervision, peer review and practical shift-basedsupport.

Support students, trainees and developingpractitioners in a safe and constructive way, recognising their competence andlearning needs.

Professional Responsibilities

Work within relevant NMC, HCPC or equivalentcode of conduct NEMS policies and agreed scope of practice.

Communicate clearly with patients, carers andcolleagues, particularly where information is complex, sensitive ordistressing.

Involve patients in decisions about theircare and ensure that consent, capacity and best-interest issues are consideredand documented appropriately.

Maintain confidentiality and informationgovernance standards at all times.

Work flexibly across NEMS sites and serviceswhere reasonably required, in line with service need, competence andcontractual arrangements.

Undertake any other reasonable dutiesrequested by a manager, where these are appropriate to the role, grade andcompetence of the post holder.

Act in a manner that reflects andpromotes the values of NEMS.

Person Specification

Values

• Values and respects others, treats everyone as an individual, is non-judgemental
• Motivated to be genuinely kind and caring
• Helps and co-operates with colleagues
• Pro-active and takes responsibility
• Willing to learn, open to change
• Motivated to make a difference

Experience

• Experience of working clinically in a primary, community, urgent care, emergency care or out-of-hospital setting
• Experience of autonomous assessment and management of undifferentiated patients
• Experience of telephone or remote clinical assessment
• Experience of face-to-face urgent care consultations
• Experience of supervising, supporting or teaching other clinical staff or students
• Experience working in Urgent Treatment Centres, GP Out-of-Hours, Clinical Assessment Services or Emergency Departments
• Experience of acting as shift lead, clinical co-ordinator or senior clinician on duty

Knowledge

• NMC, HCPC or equivalent professional standards
• Medico-legal aspects of advanced practice
• Assessment and management of urgent care presentations, including recognition of red flags and clinical deterioration
• Safeguarding adults and children
• Mental capacity, consent and mental health risk
• Confidentiality and information governance
• Clinical governance, audit, incident learning and quality improvement
• Knowledge of NEMS services, local urgent care pathways and system partners
• National standards relevant to urgent care, out-of-hours and clinical assessment services

Qualifications

• Current professional registration with NMC, HCPC or equivalent professional body
• Evidence of working at an advanced level of clinical practice
• Masters level qualification in Advanced Clinical Practice, or equivalent evidence of advanced practice capability
• Independent non-medical prescribing qualification, or willingness to complete where required for the role
• Evidence of continuing professional development
• Minor illness or minor injury qualification
• IR(ME)R / imaging requesting training where relevant
• ILS, ALS or equivalent urgent care training

Other

• Full driving licence and the ability to travel between locations
• The ability to work flexibly when required in line with the demands of the role
• Ability to work across NEMS sites and services, including telephone and face-to-face clinical work
• Ability to work remotely for telephone consultations where agreed following induction, and where KPIs and quality standards are being met

Skills & Abilities

• Able to make safe, autonomous clinical decisions and recognise when to seek advice or elevate
• Able to undertake safe telephone and face-to-face clinical assessment
• Explains complex situations in ways that are accessible to patients, carers and colleagues
• Maintains clear, accurate and timely clinical records
• Able to work under pressure and manage competing clinical priorities
• Able to work collaboratively with teams across professional and organisational boundaries
• Flexible and adaptable to changing service needs
• Commitment to patient centred care and safe service delivery
• Competent in the use of Adastra, SystmOne, EMIS, Nervecentre or other relevant clinical systems
• Able to contribute to audit, service improvement and pathway 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.

£70,643.18 to £77,584.32 a yearunsocial hours enhancements