Advanced Nurse Practitioner Critical Care Outreach

Chelsea and Westminster Hospital NHS Foundation Trust; Greater London; On-site; GBP 70,000 - 95,000; Full time

Job summary

Chelsea and Westminster Hospital NHS Foundation Trust is seeking an experienced Advanced Clinical Practitioner to lead the Critical Care Outreach Team. You will deliver autonomous assessment and complex care, supervise outreach staff, and drive improvements in patient safety and escalation pathways.

The role requires extensive experience in critical care, independent prescribing and advanced critical care skills, with a focus on education, governance and service development within the Trust.

Qualifications

• Current NMC or HCPC registration.
• MSc Advanced Clinical Practice (or equivalent) meeting national ACP standards.
• Independent Non-Medical Prescribing qualification.
• Advanced Life Support (ALS) Provider/Instructor.
• Intensive Care Course or equivalent critical care qualification.

Responsibilities

• Provide advanced autonomous clinical assessment, diagnosis and management of acutely deteriorating patients.
• Undertake comprehensive patient assessments including physical, psychological, social and environmental factors.
• Interpret and act upon complex clinical information including investigations and imaging.
• Develop and implement evidence-based management plans for complex cases.
• Prescribe medications and treatments as an Independent Prescriber.
• Lead and support deterioration pathways and escalation processes.

Skills

Advanced clinical assessment

Autonomous decision-making

Effective communication

Staff development

Education

MSc Advanced Clinical Practice

Independent Non-Medical Prescribing

ALS Provider/Instructor

Intensive Care Course

Tools

POCUS ultrasound

NIV/High-flow equipment

Tracheostomy management

Job description

Detailed job description and main responsibilities

Clinical Practice

The post holder will:

• Provide advanced autonomous clinical assessment, diagnosis and management of patients experiencing acute deterioration or recovering from critical illness.
• Undertake comprehensive patient assessments including physical, psychological, social and environmental factors influencing health outcomes.
• Interpret and act upon complex clinical information including diagnostic investigations, arterial blood gases, imaging and laboratory results.
• Develop and implement evidence-based management plans for patients with complex and unpredictable healthcare needs.
• Independently manage a caseload of outreach patients within agreed Trust protocols and professional scope of practice.
• Prescribe medications and treatments as an Independent Prescriber.
• Support clinical teams with management of sepsis, respiratory failure, tracheostomy emergencies, non-invasive ventilation and high-flow oxygen therapies.
• Provide expert clinical advice regarding treatment escalation plans, DNACPR discussions and end-of-life decision-making.
• Promote early recognition and timely escalation of clinical deterioration through NEWS2 and other deterioration pathways.
• Respond to and support Martha's Rule activations, ensuring timely senior clinical review and escalation where concerns are identified.
• Contribute to reducing avoidable cardiac arrests, unplanned ICU admissions and critical incidents associated with delayed recognition of deterioration.
• Maintain accurate, contemporaneous patient records and documentation.

Leadership and Management

The post holder will:

• Provide professional leadership for the Critical Care Outreach Team.
• Line manage Outreach Practitioners and support staff, undertaking appraisal, performance management, attendance management and development reviews.
• Lead workforce planning, succession planning and capability development within CCOT.
• Act as a visible clinical leader and role model for advanced practice across the organisation.
• Promote effective multidisciplinary working between Critical Care, ward teams, medical staff and allied health professionals.
• Lead service improvement initiatives that deliver measurable improvements in patient safety and clinical outcomes.
• Represent Critical Care Outreach at Trust, divisional and governance meetings.
• Support investigation of incidents, complaints and patient safety events in accordance with Trust policies.
• Contribute to strategic planning and future development of outreach services.

Deteriorating Patient Strategy and Martha's Rule

The post holder will:

• Lead implementation and ongoing development of the Trust's deteriorating patient strategy.
• Ensure delivery of robust pathways for recognition, escalation and management of deteriorating patients.
• Support organisational compliance with Martha's Rule and associated patient safety requirements.
• Develop escalation routes for patients, relatives and healthcare professionals who have concerns regarding deterioration.
• Monitor key performance indicators relating to deterioration, critical care referrals, cardiac arrests and emergency escalations.
• Support organisational learning from deterioration-related incidents and reviews.
• Drive improvements in early intervention and patient-centred escalation processes.

Education and Workforce Development

The post holder will:

• Lead and support competency-based education programmes for nurses, medical staff and allied health professionals.
• Deliver education relating to recognition and management of deteriorating patients, sepsis and critical illness.
• Act as an expert resource and mentor for trainees, ACPs and clinical staff.
• Develop and facilitate outreach education programmes across the organisation.
• Support continuing professional development and advanced practice development within the Trust.
• Promote excellence in patient assessment, escalation and clinical decision-making.

Quality Improvement, Governance and Research

The post holder will:

• Lead and participate in quality improvement projects relating to deterioration, sepsis, outreach and critical care.
• Monitor and evaluate outreach activity, patient outcomes and service performance.
• Develop, review and implement policies, procedures and clinical guidelines.
• Participate in audit programmes and ensure implementation of learning from findings.
• Support data collection, analysis and reporting relating to outreach services and patient outcomes.
• Critically evaluate evidence and translate research findings into clinical practice.
• Contribute to publications, presentations and dissemination of best practice where appropriate.

Professional Responsibilities

The post holder will:

• Practice in accordance with the four pillars of Advanced Clinical Practice.
• Maintain professional registration and comply with relevant professional standards and codes of conduct.
• Demonstrate accountability for autonomous clinical decision‑making.
• Maintain competence through continuous professional development and education.
• Promote equality, diversity and inclusion in all aspects of practice.
• Act as an advocate for patients, relatives and staff.
• Uphold the Trust's PROUD values and contribute to the delivery of outstanding patient care.

Person specification

Qualifications

Essential criteria

• Current NMC or HCPC registration
• MSc Advanced Clinical Practice (or equivalent) meeting national ACP standards
• Independent Non-Medical Prescribing qualification
• Advanced Life Support (ALS) Provider/Instructor
• Intensive Care Course or equivalent critical care qualification

Desirable criteria

• Leadership qualification
• Quality Improvement qualification
• Ultrasound qualification

Experience

Essential criteria

• Significant experience in Critical Care, Critical Care Outreach or Acute Care setting
• Experience of autonomous assessment and management of deteriorating adult patients
• Experience of leading teams or line management responsibilities

Desirable criteria

• Experience leading quality improvement projects
• Experience developing clinical guidelines, SOPs or pathways

Knowledge and skills

Essential criteria

• Advanced clinical assessment and diagnostic skills
• Expert knowledge of deteriorating patient management and critical illness
• Knowledge of NHS governance, patient safety and risk management processes
• Knowledge of relevant clinical skills - NIV; high flow; tracheostomy management

Desirable criteria

• Ultrasound-guided vascular access skills
• Point of Care Ultrasound (POCUS) skill

Leadership and communication

Essential criteria

• Excellent communication and influencing skills
• Evidence of teaching and staff development experience
• Ability to lead service improvement and change initiatives

Right to work

If you need sponsorship to work in the UK, please visit the Home Office website for information on sponsorship and visa status before you fill in your application form. Due to recent changes in the UK immigration rules which affect Skilled Worker Visas, Global Business Mobility, Higher Skill Level and Increased Salary Thresholds, please ensure that you are able to meet the requirements to live and work in the UK before applying. Further information about eligibility is available on