Job Title:                  Lead Nurse Practitioner

 

Grade:                       8b

 

Hours:                       37.5 hours per week

 

Responsible to:      General Manager PCT Primary Care Practices

 

Accountable to:      Manager Adult Community Nursing

 

Job location:   

 

 

STATEMENT OF JOB PURPOSE

 

  • To have overall responsibility for managerial decision-making within the practice using expertise from the practice team to inform those decisions.

 

  • To take overall responsibility for the strategic development, improvement and direction of the practice in line with national and local PCT health priorities.

 

  • To develop policies, protocols and guidelines to meet the specific needs of the [practice] client group in collaboration with the practice clinical team.

 

  • To be actively involved in any strategic management issues that may arise in the practice in conjunction with the Practice Manager or to take the lead in their absence on a day-to-day basis.

 

  • To lead on the provision of, and to contribute to programmes of education and training and development to the practice team and across the PCT as required.

 

  • To act as a resource of clinical expertise for patients and health professionals across the PCT with regards to issues relating to homelessness and substance misuse.

 

  • To lead on the achievement of national and local targets including QOF, the Balanced Scorecard and to be involved in PBC and the development of enhanced services.

 

  • To lead on clinical audit and future research.

 

  • To maintain close and effective working relationships with the PCT.

 

 

JOB SUMMARY

 

[Practice] is a nurse-led PCT managed medical services practice.  Patients register with the practice and are offered a full range of primary care services.  This position provides an exciting opportunity to lead an innovative primary health care service delivery.

 

The expectation of this advanced nursing position is for the practitioner to see patients presenting with undifferentiated / previously undiagnosed conditions.  Practitioners working to this level of competence must have the ability to use complex reasoning, critical thinking, reflection and analysis to inform their health assessments, clinical judgements and decisions.  They will have a deeper knowledge in areas such as therapeutics, social, biological and epidemiological sciences, the use and effect of drugs and have advanced skills in areas such as empowerment, communication, consultation and the ability to recognise when to refer to others with more advanced or more appropriate competencies.

 

The post requires close working with the wider team and affiliated professionals to ensure that the responsibility of the workload is effectively shared.  The post holder must demonstrate enthusiasm, drive, high levels of competence, judgement, integrity and personal and professional accountability.

 

It must be stressed that the ability to set standards, state objectives, strategically plan, organise, motivate others, provide support and supervision, monitor and evaluate self and workload are all components of this leadership role.

 

 

 

KEY RESPONSIBILITIES

 

Clinical

 

1.    Responsible for the identification of health and social care needs of the practice population by undertaking a practice profile in collaboration with the wider team and to develop a primary health care service provision to meet specific needs.

 

2.    To assess, plan and provide direct consultation to patient population with undifferentiated / undiagnosed conditions ensuring that practice is effective, relevant, evidence based and of a high standard. To make differential diagnoses utilising advanced decision making and problem solving skills.

To demonstrate clinical effectiveness and the rationale behind various methods chosen to meet the healthcare needs of patients. 

 

3.    Assess, diagnose and treat specific conditions in accordance with agreed practice clinical protocols, local clinical guidelines, nationally recognised guidelines and clinical management plans as agreed with the wider team.  To refer to another member of the practice team deemed appropriate by the practitioner.  To audit outcomes of care against standards and initiate changes accordingly.

 

4.    To undertake general practice nursing services in collaboration with the wider team to include wound care, diagnostic blood and urine tests, ear care and advice, new patient registration health checks within the surgery and in the home if appropriate.

 

5.    Provide specific evidence – based practical skills and knowledge in face-to-face and telephone consultation in the following areas:

·         Ophthalmologic examination

·         Soft tissue and ligament injuries

·         Diabetes

·         Asthma

·         Tissue viability

·         Ear care

·         Minor burns

·         Respiratory illness

·         Bony injuries

·         Dermatology

·         Cardiovascular disease

·         Gynaecology

·         Sexual health

·         Family planning

·         Gastric illness

·         Alcohol dependence

·         Substance misuse

·         Minor illness

·         Travel health

·         Immunisation

 

 

6.    To provide, in collaboration with the patients, evidence based management plans that includes evaluation and review, and that incorporates cultural preferences, health beliefs, behaviours and traditional practices.

 

7.    Offer a holistic approach to travel health including comprehensive advice to patients prior to travel where appropriate.

 

8.    To provide a comprehensive family planning and sexual health service, to include advising on available methods and referring patients where appropriate.

 

9.    To provide interval health checks for those using hormonal oral or injectable contraception to include advising patients on reducing the risk of sexually transmitted diseases.  To teach patients correct condom use and to manage the whole service through evaluation.

 

10.  To take the lead in the achievement and maintenance of breast and cervical screening targets.  To include the initiation and co-ordination of measures to improve uptake where required.  To record and monitor results, including efficient call and recall systems.  To audit smears taken each year by all team practitioners to demonstrate accurate sampling.

 

11.  To provide an effective health promotion service, by the recognition of patients readiness to change in supporting their attempts to change unhealthy behaviours.  Undertake health surveillance and therapeutic interventions within the broader health promotion / public health strategy, and to ensure that these are linked to identified practice and national targets and outcomes.  To manage the service by evaluating the care given.

 

12.  To liaise with affiliated professionals when appropriate (health visitors, social workers, midwives) to ensure that issues around high-risk pregnancy, children at low – high risk and other family matters are addressed.

 

13.  To lead the practice team in organising, implementing and administering the annual influenza and pneumococcal vaccination programme.  To include the identification, targeting and immunisation of vulnerable patients within the practice population in accordance with local / national targets are met.

 

14.  To identify and maintain registers of those patients with chronic diseases such as asthma, chronic obstructive pulmonary disease, diabetes, thyroid disease, epilepsy and coronary heart disease.

 

15.  To lead on the development, implementation, delivery and evaluation of programmes of care for those patients with chronic disease in keeping with National Service Framework targets and to meet the quality indicators laid down in the PMS contract.

 

16.  To identify and maintain registers of those patients with substance misuse and alcohol dependence.

 

17.  To lead on the development, implementation, delivery and evaluation of programmes of care and treatment for patients with substance misuse and alcohol dependence.

 

18.  To ensure that all ‘high risk’ patients are screened for HIV, Hepatitis A, B, C status and vaccinated as per recommended programme. 

 

19.  To develop a comprehensive diabetes nursing service, to include development of a profile of diabetic patients within the practice, managing newly diagnosed patients under shared care protocols or in conjunction with the wider primary health care team and to audit outcomes of care against standards in order to initiate change as indicated.

 

20.  To develop a comprehensive respiratory nursing service, to include management of emergency asthma attacks and supporting patients and the wider team in the diagnosis of chronic obstructive pulmonary disease working within agreed practice and BTS guidelines.  To also manage patients with asthma, including diagnosis, reviewing condition, responsiveness to treatment and self management plans, auditing outcomes of care and initiating change in keeping with previously agreed clinical management plans based on local, national and BTS guidelines. 

 

21.   To lead on the initiation of protocols and templates to manage the practice programme for managing patients with coronary heart disease using evidence based research.  To manage this group reviewing condition / treatments, responsiveness to treatment and self care, auditing outcomes of care and initiating change in keeping with previously agreed clinical management plans based on local and national guidelines.

 

22.  To support and enable individuals, carers (when appropriate), and other agencies involved in the well being of homeless people and communities to take action to meet priority health needs.

 

23.  To ensure that your professional responsibilities are met as a practitioner prescribing as an Independent / Supplementary nurse prescriber.

 

24.  To assess patient understanding of treatment proposals, gain valid informed consent and works within the NMC Code of Professional Conduct to provide care for patients who lack the capacity to consent to treatment.

 

25.  To recognise and address the needs and further referral options for people suffering family violence, vulnerable adults, substance misuse and other addictive behaviours.

 

26.  To recognise, manage and refer appropriately either ‘in-house’ or to affiliated service providers those patients presenting with depression, severe enduring mental health illness, people who are or are at risk of self harm / suicide.

 

27.  To assist patients and their carers to meet their spiritual needs in the context of health and illness.

 

28.  To recognise the signs and symptoms of child abuse and have knowledge of other practitioners and agencies roles and take action in accordance with Trust and Child Protection Agency procedures.

 

29.  To use a range of verbal / non-verbal communication tools to communicate effectively with patients to ensure delivery of optimal healthcare.

 

30.  To be responsible for ensuring that clinical governance standards within the practice are met, including managing clinical risk pertinent to personal practice, leading on the formulation of practice policies and management of meetings to disseminate critical incidences occurring in the practice.

 

31.  To lead and co-ordinate the practice team and allied professionals (where appropriate) within practice meetings to ensure effective communication in order to ensure high standards and continuity of health care provision to the practice population.

 

32.  To utilise the benchmarking tools contained within the ‘Essence of Care’ to help and improve the quality of care provided, especially in areas of self-care, food and nutrition, record keeping, privacy and dignity.

 

33.  To lead the team in initiating and developing specific enhanced services under the PMS contract.

 

34.  To provide management and clinical support and guidance for locum staff (nurses and GPs).

 

35.  You will be expected to line manage the salaried GP’s, the nursing team and healthcare assistant(s) and the Practice Manager along with any locum support staff.

 

 

Practice Clinical Management and Administration

     

  1. Organise own day-to-day activities, plan and prioritise own clinical workload and advise the wider team accordingly regarding their delivery of services.

 

  1. To be responsible, as the clinical lead of the practice, for the strategic management of the clinical services and resources.  This includes the ordering and maintenance of equipment/ instruments / disposables, as well as the correct storage of vaccinations (maintaining cold chain), drugs and all clinical stock used in the practice.  To ensure that controls assurance standards for medical devices are implemented.

 

  1. To be responsible and accountable for the review and implementation of infection control measures within the practice and to support patients and team in adopting sound infection control measures.

 

  1. Ensure that clinicians maintain clinical areas as clean and tidy at all times and lead on health and safety measures, including spilt bodily fluids in accordance with the PCT Infection Control Policy.

 

  1. To ensure that all risks in clinical areas have been assessed according to guidelines laid down by Care of Substances Hazardous to Health (COSHH) legislation.

 

  1. To maintain accurate and contemporaneous patient records predominately computerised but to include manual when appropriate, in accordance with practice and NMC guidelines.

 

  1. To undertake the collection and interpretation of data for use in service or clinical audit and initiate and co-ordinate future research projects.

 

  1. To lead and work with the wider practice team and Primary Care Trust to ensure that practice, local and national targets are met.

 

  1. To be responsible for the continual review and development of clinical standards, objectives and care guidelines / protocols that demonstrate evidence based practice.

 

  1. To initiate and complete prescribed clinical audit within the practice in accordance with practice, local and national guidelines.

 

  1.  To lead the wider clinical team in formulating policies within the practice that informs decision-making processes affecting the care of patients.

 

  1.  To improve patient participation and satisfaction with service provision at practice level by designing and implementing a rolling programme of patient surveys and acting on the results.

 

  1.  As a clinical expert, to advise on educational opportunities that will enhance and develop the specialist skills and knowledge required to enhance clinical practice personally and by the wider team.

 

  1. To be responsible for the operational management of the practice clinical staff to meet prioritised patient need on a daily basis.

 

  1.  To ensure that the practice provides a high quality-learning environment for existing clinical staff and practice placements pre and post registration students (nursing / medical) and other affiliated professionals.

 

  1. To be involved in the recruitment and selection of new clinical staff in line with future anticipated expansion and development.

 

  1. To provide induction, mentorship and ongoing clinical evaluation to all new members of staff.

 

  1. To provide both clinical and managerial supervision to the practice nursing team and to other nursing professionals within the PCT.

 

  1. To take responsibility in disseminating and recording patient clinical results received via the LAB LINK system.

 

  1. To prepare patient reports (legal, housing, travel passes and works and pensions documentation) and ensure prompt response to such requests.

 

  1. To meet, on a regular basis, with team leaders from linked statutory and non-statutory service providers to formulate patient care plans that improve patient care.

 

22. To Chair and manage the agenda for the weekly team meeting.

 

  1. To lead on informing other service providers the ethos of [practice] through presentations, seminars and clinical meetings.

 

  1. Manage, implement and evaluate accessibility to clinicians by patients and act on findings. 

 

 

 

Information Technology

 

  1. To lead on data collection and read coding on EMIS software system in order to meet local & national quality targets, and for clinical audit.

 

  1. Enter clinical information in accordance with practice policy adhering at all times to patient confidentiality policies.

 

  1. Prepare teaching materials and presentations to a professional level.

 

  1. To comply with the requirements of the Data Protection Act.

 

 

Professional

 

  1. To be professionally accountable and responsible for all aspects of personal work including the management of the practice and patients in your care, always adhering to the NMC Code of Professional Conduct.

 

  1. To maintain a professional portfolio which reflects personal development and to attend clinical supervision (peer / medical mentor).

 

  1. To maintain competency to practice through one’s own personal and professional development activities. To maintain an annual professional development plan through appraisal, in accordance with the PCT Performance Development Scheme, and ensure it’s relevance to the practice development plan.

 

  1. Adhere to Trust Information Security Policy at all times, in particular ensuring that there is no breach of confidentiality as a result of your actions.

 

  1. Work in accordance with practice and PCT policies and guidelines at all times.

 

 

Further Information and General Responsibilities

 

  1. To communicate with practice staff and patients in a polite and

courteous manner at all times and to be the first point of contact for  visitors to the practice in the absence of the practice manager.

 

 

2.    To deal sensitively with patients that may have high levels of anxiety and    aggression caused by lifestyle, pain, and dementia or limited mobility.

 

  1. To have responsibility for the health, safety and welfare of self and others and to comply at all times with the Health and Safety regulations.

 

  1. To ensure confidentiality at all times, only releasing confidential information obtained during the course of employment in an official capacity.

 

  1. To attend any mandatory training and induction courses as designated by the PCT.

 

  1. To report all clinical and non-clinical accidents or near misses promptly and when required and to co-operate with any investigation undertaken.

 

  1. To contribute to the development of the PCT’s agenda for quality through the Clinical Governance Agenda and to be aware of one’s own responsibility to deliver high quality services at all times.

 

  1. To contribute, deliver and implement the PCT’s Equality and Diversity Agenda by;
    1. Ensuring that appropriate and measurable actions are in place in order to eliminate unlawful discrimination, promoting equality of opportunity and good relations between people of different groups.
    2. developing and maintaining an inclusive approach to work and embedding equality and diversity into all work activities.
    3. ensuring that patients and the public are involved and informed of all aspects of service delivery and that services are developed which are patient centred.

 

  1. To implement and monitor PCT and departmental policies and procedures for Health and Safety.

 

  1. To ensure all staff, including temporary/locum staff has an induction programme.

 

  1. To implement the PCT’s Improving Working Lives (IWL) Action Plan.

 

  1. To comply with the PCT Manual Handling Policy and practice and local therapeutic handling guidance at all times.

 

  1. The job involves frequent exposure to unpleasant working conditions on a regular basis due to high incidence of mental health patients, substance misusers, alcohol dependant patients and the exposure to bodily fluids including blood, sputum, urine, vomit and noisome situations.

 

  1. The client group cared for by this service (socially excluded and hard to engage groups often with poor communication skills) carries a daily risk of verbal and physical aggression.

 

  1. The daily disclosure by clients relating to life incidences can result in increased stress levels when compared to normal expectations of this role.

 

 

 

This job description is a reflection of the current position and the post holder is expected to view it as a guide rather than an exact description of all duties and responsibilities.  It may be subject to variation from time to time.

 

 

 

Job Description prepared by …………..

 

Agreed job description

 

Post holder name:                                                                   Date:                          

 

Post holder signature:                                                             Date:                          

 

 

 

Managers name:                                                                     Date:                          

 

Manager’s signature:                                                              Date: