Advanced Clinical Practitioner - Frailty

Lowther Medical Centre; United Kingdom; On-site; GBP 60,000 - 85,000; Full time

Job summary

NCPC (North Cumbria Primary Care) invites an Advanced Clinical Practitioner to join the Frail Elderly Assessment Team (FEAT). You will deliver patient-centered care at home and in care homes, exercising high autonomy while coordinating with GPs, OTs, physiotherapists, social prescribers and community nurses.

The role focuses on complex frailty management, dementia and end-of-life care, with regular supervision and evidence-based practice within FEAT.

Qualifications

• Must hold a Master's in Advanced Clinical Practice and be registered with the NMC.
• Non-medical prescriber with current UK registration and ability to prescribe within scope.
• Experience in frailty, dementia and end-of-life care essential.
• Proven ability to work autonomously within professional boundaries.

Responsibilities

• Provide expert management of complex frailty syndromes and end-of-life needs.
• Assess, diagnose, and treat patients with minimal input from a medical practitioner.
• Monitor medications and adjust treatment plans autonomously.
• Lead weekly enhanced care home reviews and multi-agency collaboration.
• Conduct comprehensive geriatric assessments using appropriate tools.

Skills

Advanced clinical assessment

Frailty management

Dementia care

Autonomous practice

Care coordination

Geriatric clinical reasoning

Education

Masters degree in advanced clinical practice

NMC registered nurse

Non-medical prescriber

Tools

EMIS

Accurx

Job description

Job summary

We are looking for a motivated and experienced Advanced Clinical Practitioner to work within our Frail Elderly Assessment Team (FEAT). This is an exciting opportunity to deliver high quality patient-centered care to frail patients in their own homes and in our care homes. The role combines autonomous practice, care coordination, multi-agency collaboration, management of increasing frailty, dementia and end of life care. The postholder will work at an advanced level of clinical practice, exercising a high degree of professional autonomy and accountability while working within the NMC code and national ACP frameworks.

Main duties of the job

• Provide expert management of complex frailty syndromes, dementia, delirium, polypharmacy, falls risk and end of life needs.
• Exercise advanced clinical reasoning to assess, diagnose, treat, and manage patients without direct input from a medical practitioner, recognising own professional boundaries and seeking senior clinical support when required.
• Monitor medication use and adjust treatment plans working autonomously as required
• Escalate concerns appropriately
• Work closely with GPs, OTs, Physiotherapists, Care Co-ordinators, Social Prescribers and Community Nursing Team
• Support patients and families in understanding and managing frailty
• Promote lifestyle and self management strategies
• Conduct regular care plan reviews
• Identify patients in need of palliative support and facilitate advanced care planning discussions
• Communicating with distressed patients and relatives
• Caring for patients and relatives following receipt of bad news
• Communicating and caring for patients who have reduced understanding and insight due to cognitive impairments
• Participate/lead weekly enhanced care home reviews
• Undertake daily acute care home visits requested through our clinical triage system identifying clinical emergencies, deteriorating patients or patients at risk of deterioration
• Participate in regular clinical supervision
• Work using FEAT and champion evidence-based interventions
• Conduct comprehensive geriatric assessments using appropriate tools

About us

NCPC (North Cumbria Primary Care) was established in August 2019 in response to an increasingly fragile general practice provision within North Cumbria. NCPCs vision is to bring practices together to develop a sustainable, fully integrated primary care- built locally and delivered together. The Copeland NCPC area consists of 3 major practices, Fellview Health Care, Lowther Medical Centre and Seascale Health Centre as well as a shared PCN (Primary Care Network) which delivers services to patients across all 3 practices. We are a not-for-profit company with all money we receive in funding and other business activities going towards supporting the organisation, our staff, and our services.

Job responsibilities

Main Duties and Responsibilities

• Provide expert management of complex frailty syndromes, dementia, delirium, polypharmacy, falls risk and end of life needs.
• Exercise advanced clinical reasoning to assess, diagnose, treat, and manage patients without direct input from a medical practitioner, recognising own professional boundaries and seeking senior clinical support when required.
• Monitor medication use and adjust treatment plans as required, autonomously working within scope of practice and in line with prescribing competencies.
• Escalate concerns appropriately and initiate urgent or emergency interventions when required.
• Identify when clinical presentations fall outside of scope of practice and elevate appropriately to GP or senior clinicians.
• Work closely with GPs, Occupational Therapists, Physiotherapists, Care Co-ordinators, Social Prescribers and Community Nursing Team
• Attend the MDT meetings and case reviews
• Support patients and families in understanding and managing frailty
• Promote lifestyle and self management strategies to optimise health and independence
• Functions at a high level to carry out clinical decision making such as diagnosing and managing patients without input from a medical practitioner remaining within scope of a professional practice.
• Functions at a high level in relation to communication skills through patient consultation and nursing assessment of physical, psychological and social needs.
• Completing proactive, individualised clinical management plans for care home residents improving their health experience and reducing unnecessary and potentially harmful hospital admissions
• Conduct regular care plan reviews
• Identify patients in need of palliative support and facilitate advanced care planning discussions with patients and families
• Communicating with distressed/anxious/worried patients and relatives
• Caring for patients and relatives following receipt of bad news and supporting them in identifying realistic expectations in relation to clinical conditions
• Communicating and caring for patients who have reduced understanding and insight due to cognitive impairments
• Participate/lead weekly enhanced care home reviews
• Undertake daily acute care home visits requested through our clinical triage system identifying clinical emergencies, deteriorating patients or patients at risk of deterioration ensuring appropriate action
• Participate in regular clinical supervision, reflective practice and case-based discussions to maintain safe, effective and autonomous practice.
• Work using FEAT and champion evidence-based interventions
• Conduct comprehensive geriatric assessments using appropriate tools

Confidentiality:

In the course of seeking treatment, patients entrust us with, or allow us to gather, sensitive information in relation to their health and other matters. They do so in confidence and have the right to expect that staff will respect their privacy and act appropriately. In the performance of the duties outlined in this Job Description, the post-holder may have access to confidential information relating to patients and their carers, Practice staff and other healthcare workers. They may also have access to information relating to the Practice as a business organisation. All such information from any source is to be regarded as strictly confidential. Information relating to patients, carers, colleagues, other healthcare workers or the business of the Practice may only be divulged to authorised persons in accordance with the Practice policies and procedures relating to confidentiality and the protection of personal and sensitive data

Health & Safety:

The post-holder will assist in promoting and maintaining their own and others health, safety and security as defined in the practice Health & Safety policy, the practice Health & Safety manual, and the practice Infection Control policy and published procedures. This will include:

• Using personal security systems within the workplace according to practice guidelines
• Identifying the risks involved in work activities and undertaking such activities in a way that manages those risks
• Making effective use of training to update knowledge and skills
• Using appropriate infection control procedures, maintaining work areas in a tidy and safe way and free from hazards
• Actively reporting of health and safety hazards and infection hazards immediately when recognised
• Keeping own work areas and general / patient areas generally clean, assisting in the maintenance of general standards of cleanliness consistent with the scope of the job holders role
• Undertaking periodic infection control training (minimum annually)
• Reporting potential risks identified

Equality and Diversity:

The post-holder will support the equality, diversity and rights of patients, carers and colleagues, to include acting in a way that recognizes the importance of peoples rights, interpreting them in a way that is consistent with Practice procedures and policies, and current legislation. Respecting the privacy, dignity, needs and beliefs of patients, carers and colleagues. Behaving in a manner which is welcoming to and of the individual, is non-judgmental and respects their circumstances, feelings priorities and right.

Personal/Professional Development:

The postholder will participate in all training programmes implemented by the Practice, including annual performance reviews and competency assessments, and will take responsibility for their own ongoing development, learning and performance. They will maintain a comprehensive professional portfolio demonstrating autonomous clinical practice, clinical supervision, CPD and reflective learning, ensuring that clinical competencies required for safe autonomous practice in frailty care are continually met. The postholder will contribute to clinical governance activities such as audits, incident reviews and quality improvement initiatives, while engaging in regular clinical supervision and reflective discussions to support safe, accountable practice. They will also support the development of colleagues by sharing specialist frailty knowledge, offering mentorship and demonstrating skills and activities to others undertaking similar work.

Quality:

The post-holder will strive to maintain quality within the Practice and will assess own performance and take accountability for own actions, either directly or under supervision. Contribute to the effectiveness of the team by reflecting on own and team activities and making suggestions on ways to improve and enhance the teams performance. Work effectively with individuals in other agencies to meet patients needs. Effectively manage own time, workload and resources

Communication:

The post-holder should recognise the importance of effective communication within the team and will strive to communicate effectively with other team members, communicate effectively with patients and carers and recognise peoples needs for alternative methods of communication and respond accordingly.

Person Specification

Personal skills, attributes and requirements

Essential

• Advanced communication skills
• Ability to work as an autonomous Practitioner
• Able to work on own initiative
• Must be personable, polite and approachable
• Must be a team player
• Must be adaptable to change
• Commitment to ongoing training and education to develop clinical skills
• Have the ability to prioritise workload
• Able to work under pressure and remain calm
• Full clean driving licence

Experience

Essential

• Demonstrate high level of competence/advanced skills in clinical examination and diagnosis
• Interpret pathology/radiology results/reports and action where appropriate
• Excellent interpersonal and communication skills, providing enhanced discussions with patients and families regarding end of life wishes/planning
• Familiar with the complex geriatric assessment, 4AT, GPCOG
• Knowledge in EMIS clinical system
• Knowledge of the Accurx system
• Effective time management skills

Desirable

• Experience of working in a primary care setting would be beneficial

Qualifications

Essential

• Masters degree in advanced clinical Practice
• Registered Nurse on the NMC register
• Non-medical prescriber

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.

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).