Harness Care Cooperative Ltd Quality primary care services provided through local cooperation Company registration: 06584450 Job Description Job title: Nurse Practitioner /Lead Nurse ACCOUNTIBILITY The post holder will be accountable to: Clinical line management: Organisational Medical Director Non clinical line management: Harness Business Manager Location: GP Led Health Centre Wembley (the post holder may be required to work at other locations on occasions) Salary range: 39000 to 44000 JOB SUMMARY The post holder is an experienced nurse, who acting within their professional boundaries, will provide care for the presenting patient from initial history taking, clinical assessment, diagnosis, treatment and evaluation of their care. They will demonstrate safe, clinical decision-making and expert care for patients within the primary care. They will work collaboratively with the multi-disciplinary primary care team to meet the needs of patients, supporting the delivery of policy and procedures, and providing nurse leadership as required.. In order to work at this level, NMC requirements for advanced practice must be met. 1
1. SCOPE AND PURPOSE OF THE ROLE To deliver a high standard of patient care as Nurse Practitioner (NP) in primary care, using advanced autonomous clinical skills, and a broad and in-depth theoretical knowledge base To manage a clinical caseload, dealing with presenting patient s needs in a primary care setting for both registered and unregistered patients To lead the nursing team and ensure the highest standards of care are provided for the patients To be the clinical governance lead for nursing and allied health professionals including chairing the clinical governance group To develop the nursing services offered both for the practice and through the Harness Nurse Forum To provide clinical leadership within the practice. To work with the practice in the development of clinical skill mix and multi disciplinary working in the practice including non qualified roles ensuring clear lines of accountability To support the work of Harness in the business development of the organisation To work with the managing partner to define and implement a nursing strategy for the practice To provide professional advise to the Harness regarding the commissioning of nursing related services to patients including participating in the Harness Nurse Forum To ensure a high level of patient involvement and satisfaction with nursing services provided by the practice To ensure a continuous programme of audit and review to inform and maintain excellence in the provision of evidence based care 2. JOB DIMENSIONS To manage own clinical workload in primary care responding effectively to patient need and ensuring patient choice and ease of access to services. The development and use of referral pathways for NPs to the local acute NHS Trust services and to Diagnostic and Treatment Centres To mentor and support other nurses in developing and maintaining clinical skills To help develop clinical guidelines, patient group directions for nursing staff and practice s policies and protocol as agreed by supervising physician in the practice and the Organisational Medical Director. To support the achievement of key performance indicators such as access, QOF, contractual KPIs and enhanced service provision To report to the Harness clinical and service management staff with responsibility for nursing. 2
3. KNOWLEDGE, SKILLS AND EXPERIENCE REQUIRED See person specification 4. PRIMARY DUTIES & AREAS OF RESPONSIBILITY A. CLINICAL ROLE: The post-holder will: Provide the choice of direct access to a NP and / or GP, both in the Practice and over the telephone, for the registered and unregistered primary care population Participate in all treatment and preventative healthcare services in the practice as delegated and agreed by the supervising physician in the practice Make professionally autonomous decisions for which he/she is accountable Provide a first point of contact within the Practice for patients presenting with undifferentiated, undiagnosed problems, making use of skills in history taking, physical examination, problem-solving and clinical decisionmaking, to establish a diagnosis and management plan Instigate necessary invasive and non-invasive diagnostic tests or investigations and interpret findings/reports Where the post holder is an independent prescriber : to prescribe safe, effective and appropriate medication as defined by current legislative framework Provide safe, evidence-based, cost-effective, individualised patient care Offer a holistic service to patients and their families, developing where appropriate an on-going plan of care/support, with an emphasis on prevention and self-care Promote health and well-being through the use of health promotion, health education, screening and therapeutic communication skills Refer patients directly to other services/agencies as appropriate To work with the practice clinical leads and where appropriate take the Practice lead in developing and delivering specialist primary care services, such as long term disease management (diabetes, asthma, chronic obstructive pulmonary disease, coronary heart disease and hypertension) To work with the clinical leads to develop and deliver a vascular strategy in line with NHS Brent and Harness. Work with nursing, medical and health care assistant and health support worker colleagues to ensure that National Service Frameworks (eg Coronary Heart Disease/Older People/ Diabetes /Mental Health) are being delivered Work with the practice clinical leads to ensure the implementation of NICE guidance pertinent to the work of the practice Work with multi-disciplinary team within the Practice, and across the wider 3
Primary Care Trust (PCT), to promote integrated and seamless pathways of care Contribute to the practice achieving its quality targets to sustain the high standards of patient care and service delivery Participate in identification of community health needs and develop patient/family-centred strategies to address them Help develop and set up new patient services and participate in initiatives to improve existing patient services Be aware of and contribute to planning and delivery of practice-based commissioning Meet as appropriate with the primary care team on a regular basis to report on progress and contribute to the systematic development of local primary care provision. Attend and participate in weekly primary healthcare team and staff meetings Hold monthly nursing team meetings including management of agenda and recoding of minutes B. TEACHING AND MENTORING ROLE: The post-holder will: Promote a learning environment for patients, nurses and other health professionals. Contribute to the planning and implementation of the teaching for existing staff, such as medical students, NP students, GP registrars, Physician Assistants, Emergency Care Practitioners, Health Care Assistants and health support workers within the Practice. Promote well being through patient education and supporting self care C. PROFESSIONAL ROLE: The post-holder will: Promote evidence-based practice through the use of the latest researchbased guidelines and the development of practice-based research. Monitor the effectiveness of their own clinical practice through the quality assurance strategies such as the use of audit and peer review Maintain their professional registration and provide evidence to Harness Participate in continuing professional development opportunities to ensure that up-to-date evidence-based knowledge and competence in all aspects of the role is maintained Work within the latest NMC Code of Professional Conduct Record accurate consultation data in patients records in accordance with the latest NMC guidance and other pertinent standards Keep up to date with pertinent health-related policy and work with the practice team to consider the impact and strategies for implementation 4
Work collaboratively with colleagues within and external to the practice. Provide an exemplar of professional practice for the nursing team Demonstrate leadership in professional practice and fulfilment of the role To work collaboratively as a member of the practice team with all members of staff both employed and attached showing respect and maintaining positive working relationships To commit to the values of the practice and Harness and the achievement of the team vision and mission statement D. MANAGERIAL ROLE: The post-holder will: To represent nursing as part of the management team To work collaboratively and supportively with the colleagues in the practice and Harness management team Act as team leader and mentor for the nursing team and through this, support their personal development. Ensure compliance with all statutory and mandatory updating and training requirements for the nursing team Provide peer support and contribute to annual appraisals with the appropriate clinical and management leads Conduct regular one to ones with nursing team members where the Nurse Practitioner has line management responsibilities Under take line management responsibility as delegated Ensure adequate nursing cover at all times including production of a monthly rota one month in advance for administration of appointments system and maintain holiday and absence records appropriately informing the Harness Business Manager. To oversee the use of bank nursing to cost effectively provide adequate cover to the service Participate in clinical supervision for the nursing team, and act as nurse advisor to other members of the Primary Healthcare team. Implement practice IT strategy to reduce paper dependency and ensure high levels of information governance in nursing team Develop the IM&T capability of the nursing team Support the Harness in the development of clinical templates and consistency of Read coded recording Encourage and develop teamwork within the practice. Participate in multi-disciplinary protocol and Patient Group Directions development Identify appropriate opportunities to delegate both clinical and administrative tasks to more junior staff. Help the practice operate in a cost-effective manner. 5
To take responsibility for ensure all delegated claims are made in a timely and efficient manner including the monthly Prescription Pricing Authority return To maintain clinical supplies and oversee the stocking of consulting and clinical rooms To manage with in a delegated indicative budget for medical supplies in agreement with the Harness Business Manager To over see compliance with the practice medicine management protocols and policies To oversee pharmacy stock control procedure in line with agreed protocol Identify and manage nursing care risks on a continuing basis. Participate in compilation of monthly performance reports and progress monitoring as required. Participate in audits, research and inspections as appropriate. Ensure compliance with clinical governance frameworks such as Standards for Better Health Contribute to the practice business planning processes and implementation of the Harness practice development plan Attend and participate in the annual Harness development event Work closely with the doctors and administrative managers in the setting up and/or improving of practice systems for monitoring/measuring performance against Clinical Governance and Quality Indicator targets. Ensure that all Practice Policy s are fully implemented and evaluated Maintain necessary review of Occupational health records for clinical staff and compliance with statutory testing for immunity to blood borne viruses. 5. HEALTH AND SAFETY/RISK MANAGEMENT The post-holder must comply at all times with the Harness Health and Safety policies, in particular by following agreed safe working procedures and reporting incidents using the organisations Incident Reporting System. The post-holder will comply with the Data Protection Act (1984) and the Access to Health Records Act (1990). Manage and assess risk within the areas of responsibility, ensuring adequate measures are in place to protect staff and patients Ensure appropriate supervision of safe storage, rotation and disposal of vaccines and drugs. Oversee the monitoring, stock control and documentation of controlled drug usage according to legal requirements where appropriate 6
Ensure the nursing team undertakes mandatory and statutory training requirements Apply infection-control measures within the practice according to local and national guidelines Liaise with NHS Brent s infection control nurse and complete regular self assessment against agreed standards Advocate for policies that reduce environmental health risks, are culturally sensitive and increase access to health care for all 6. EQUALITY AND DIVERSITY The post-holder must co-operate with all policies and procedures designed to ensure equality of employment. Co-workers, patients and visitors must be treated equally irrespective of gender, ethnic origin, age, disability, sexual orientation, religion etc. The post holder will comply with all practice policies relating to equal opportunities, harassment, respect and dignity and discrimination at all times. 7. RESPECT FOR PATIENT CONFIDENTIALITY The post-holder should respect patient confidentiality at all times and not divulge patient information unless sanctioned by the requirements of the role. The post holder will ensure comply with practice information governance policies and processes at all times. 8. COMMUNICATION & WORKING RELATIONSHIPS The post-holder will establish and maintain effective communication pathways within the organisation, the NHS Brent and with key external stakeholders 9. REHABILITATION OF OFFENDERS ACT 1994 (optional) Because of the nature of the work, this post is exempt from the provisions of Section 4(2) of the Rehabilitation of Offenders Act 1994 (Exceptions) Order 1995. Applicants for posts are not entitled to withhold information about convictions which for other purposes are spent under the provisions of the Act and in the event of employment any failure to disclose such convictions could result in disciplinary action or dismissal by the Practice. Any information given will be completely confidential and will be considered only in relation to an applicant of a position to which the order applies. 7
. 10. PERFORMANCE MANAGEMENT The post holder will participate in the practice appraisal system and one to one review meetings on regular basis with the appropriate Harness clinical lead and management lead with responsibility for nursing. 11. SUSTAINABILITY The post holder will endeavour to ensure compliance with the Harness Sustainable Business Policy through environmentally friendly practices. 12. JOB DESCRIPTION AGREEMENT This job description is intended to provide an outline of the key tasks and responsibilities only and is not exhaustive. There may be other duties required of the post-holder commensurate with the position. This description will be open to regular review and may be amended to take into account development within the Practice. All members of staff should be prepared to take on additional duties or relinquish existing duties in order to maintain the efficient running of the Practice. This job description will be subject to change from time to time in discussion with the post holder whose agree should not be unreasonably be with held. December 2008 8