JOB DESCRIPTION Nurse Practitioner



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JOB DESCRIPTION JOB TITLE: Nurse Practitioner NAME: SALARY: LOCATION: REPORTING TO: JOB SUMMARY Salary will be dependent upon qualifications and experience Pelham Medical Group Humberview Surgery Church View Health Centre and Stirling Medical Centre Cartergate Stirling Street Grimsby Grimsby DN31 1QZ DN31 3AE Professional Lead: Louise Andrews, Clinical Manager HR Lead: Vicky Donner, Acting Practice Manager To be a confident and competent autonomous Practitioner able to work independently and as part of a team in providing excellent, safe and evidence based patient care to the Practice population, within the surgery and also within the community. To provide nursing services to the patients of the practice including treatment, screening and advice within Nurse-led clinics. The post holder will work in accordance with the NMC Code of Conduct and within Practice Guidelines

MAIN TASKS CLINICAL DUTIES The post holder will: - Assess, diagnose, plan, implement and evaluate treatment/interventions and care for patients presenting with an undifferentiated diagnosis. - Clinically examine and assess patient needs from a physiological and psychological perspective, and plan clinical care accordingly. - Assess, diagnosis, plan, implement and evaluate interventions/treatments for patients with complex needs. - Proactively identify, diagnose and manage treatment plans for patients at risk of developing a long-term condition (as appropriate). - Diagnose and manage both acute and chronic conditions, integrating both drug and non-drug-based treatment methods into a management plan. - Prescribe and review medication for therapeutic effectiveness, appropriate to patient needs and in accordance with evidencebased practice and national and practice protocols, and within scope of practice. - Work with patients in order to support compliance with and adherence to prescribed treatments. - Provide information and advice on prescribed or over-the-counter medication on medication regimens, side-effects and interactions. - Prioritise health problems and intervene appropriately to assist the patient in complex, urgent or emergency situations, including initiation of effective emergency care. - Support patients to adopt health promotion strategies that promote healthy lifestyles, and apply principles of self-care. - Support and manage health needs of women presenting for family planning, cervical cytology or sexual health consultation. - Assess, identify and refer patients presenting with mental health needs in accordance with the NSF for Mental Health.

- Implement and participate in vaccination and immunisation programmes for both adults and children. - Advise, support and administer vaccinations for patients travelling abroad, where appropriate. - Promote and deliver evidence-based care for patients presenting with aural conditions. - Meet the needs of patients presenting for opportunistic wound care. - Undertake cryotherapy as appropriate to competence. - As a senior nurse you will be required to mentor/support/advise more junior nurses and health care assistants as required. Specific Core Responsibilities: Rapid Access Clinic - Provision of Daily Rapid Access Clinics by receiving patients with undifferentiated and undiagnosed problems by providing care for the patient from initial history taking, clinical assessment, diagnosis, treatment (including non-medical prescribing) and evaluation of care. - You will demonstrate safe, clinical decision making and problem solving skills, including assessment and diagnostic skills in prebooked or walk in rapid access clinics. - Ordering of necessary investigations, liaises with or refers to GPs or other members of the primary health care team or external services/agencies as appropriate. - You will screen patients for disease risk factors and early signs of illness and provide health education. Complex Chronic Disease Management - You will also be required to manage patients with complex needs, agree individual care plans with the patient and/or carers, and implement care working collaboratively with the primary health care team and other healthcare professionals. - You will prescribe and review medication for therapeutic effectiveness, appropriate to patient needs and in accordance with

evidence based practice and national and practice protocols, and within scope of practice. - The post holder will have a supportive role, providing counselling and health education in helping people to manage and live with illness. - You will develop with the patient, an on-going nursing care plan for health, with the emphasis on preventative measures, in particular with a view to avoiding unplanned admissions. - You will provide support and act as an expert resource to more junior colleagues in chronic disease management. Management of INR Level 4 Service - The post holder will be expected to see new and unstable patients giving results and dosage within service guidelines. You will ensure a quality assured and safe service by managing the NEQAS and RAT quality assurance processes. - You will support and be the advisor for junior nurses and Health Care Assistants regarding dosage and recall. General Practice Nursing - You will be required to undertake general Practice Nursing duties. You will be expected to participate in providing, screening, advice, treatment and health education to patients within the following Practice nursing services as required. - The nurse led services also involve assessment of patients, advice regarding treatment, screening and therapies and referral to other agencies as appropriate. - It is crucial that you have a good knowledge base or are willing to develop the skills required in order to manage these patients. These services include: - Nurse led cytology screening - HRT advice/checks - Nurse-led Family planning clinics - Taking swabs - Fitting and removal of Nexplanon - Venepuncture general - Telephone advice - Administer travel vaccinations

- Administer childhood immunisations - Ear syringing - Spirometry - Cryosurgery - Asthma checks - CHD checks - COPD checks - Diabetes checks - Epilepsy checks - ECGs (as part of a consultation or if required urgently by a GP). - Removal of sutures and clips - Health education, including diet and lifestyle advice - Hypertension health checks - Dressings and wound checks COMMUNICATION - Key working relationships are with the Practice s primary health care team including GPs, Clinical Manager, Business Partner, Acting Practice Manager, Receptionists and Administrative staff. - Involvement in nurse led services entails being aware of local and national developments. - Assist the Clinical Manager in developing and updating Practice guidelines. - Report any problems with workload/content to the Clinical Manager. - Demonstrate sensitive communication styles to ensure patients are fully informed and consent to treatment. - Anticipate barriers to communication and take action to improve communication. - Utilise communication skills to support patients to adhere to prescribed treatment regimes. - Communicate effectively with patients and their carers, recognising the need for alternative methods of communication to overcome different levels of understanding, cultural background and preferred ways of communicating. - Act as an advocate when representing the patients and colleagues viewpoints to others. TEAMWORK - Understand own role and scope and identify how this may develop over time. - Act as a role model and promote team work. - Identify and minimise interpersonal conflict. - Work as an effective and responsible team member, supporting others and exploring the mechanisms to develop new ways of working. - Delegate clearly and appropriately, adopting the principles of safe practice and assessment of competence. - Create clear referral mechanisms to meet patient need. - Prioritise own workload and ensure effective time-management

strategies. - To lead by example and deliver a safe, reliable, knowledgeable and beneficial service. - Make use of professional, clinical and managerial supervision as agreed with your line manager. LEADERSHIP - Take responsibility for own learning and performance including participating in clinical supervision. - Support new and existing staff development in order to maximise potential by sharing of knowledge and experience. - Contribute to the development of local guidelines, protocols and standards. DELIVERING A - Recognise and work within own competence and professional QUALITY SERVICE code of conduct as regulated by the Nursing and Midwifery Council (NMC). - Produce accurate, contemporaneous and complete records of patient consultation, consistent with legislation, policies and procedures. - Prioritise, organise and manage own workload in a manner that maintains and promotes quality. - Deliver care according to the NSF and the National Institute for Clinical Excellence (NICE) guidelines and evidence-based care. - Assess effectiveness of care delivery through self and peer review, benchmarking and formal evaluation. - Participate in the maintenance of quality governance systems and processes across the Practice and its activities. - Support and participate in shared learning across the practice and wider organisation. - Understand and apply legal policy that supports the identification of vulnerable and abused children and adults, being aware of statutory child/vulnerable adult health procedure and local guidance. AUDIT/RESEARCH /ADMINISTRATIVE You may be expected to assist with Clinical Audit or provision of statistics and data, you will: - Be expected to respond to results of audit in your specialist field appropriately. - Be involved in a high level in achieving practice targets, especially in your area of expertise. - Your personal practise should be research/audit based, and if in doubt should be discussed. TRAINING - Required to undertake training specific to the role and maintain up to date skills. - Provide training in specific tasks to identified members of staff - Undertake mandatory training as directed by the Practice. - Required to attend protected time sessions as directed by the Partners or members of the Practice Management team.

GENERAL - Other work and general duties as delegated within the overall remit of the post. - This job description reflects the current main organisational priorities for the post. - In the context of change taking place within the NHS, these priorities will develop and change in consultation with the post holder in line with service business needs and priorities. - You are required to be flexible in your working hours and provide a reasonable amount of overtime during periods of holidays, sickness and other absences in order to meet the needs of the Practice. QUALIFICATIONS - Registered first level nurse - Relevant nursing/health degree - Extended nurse/independent nurse prescribing - Certificate in at least one chronic disease management area - Minor illness certificate/qualification - Update skills relevant to duties - Any other relevant certificates/qualifications CODES OF CONDUCT - To have a full knowledge of and work towards at all times the practice codes of conduct. PERSONAL RESPONSIBILITIES As well as the Health Care rules and procedures, which you are required to observe and follow, the Practice has developed a number of general policies and procedures that apply to your employment. Whilst the Practice recognises specific responsibilities fall upon management, it is also the duty of all employees to accept personal responsibility for the practical application of these policies, procedures and standards. You should familiarise yourself with these, and ensure that you understand and adhere to them. Particular attention is drawn to: Health and Safety: Under the Health & Safety at Work Act 1974 it is the responsibility of individual employees at every level to take care of their own health and safety at work and that of others who may be affected by their acts at work. This includes co-operating with management in complying with health and safety obligations, particularly by reporting promptly any defects, risks or potential hazards.

Fire Procedure: The postholder must adhere to the Practice Fire Policy, including attending annual Fire training. Equal Opportunities & Diversity: The Practice has policies covering Equal Opportunities and Harassment and Equality & Diversity. The aim is to ensure that no colleagues, potential employees, patients/clients are harassed, or receive less favourable treatment on the grounds of disability, age, sex, sexual orientation, marital status, race, colour, religion or ethnic/national origin. Security and Confidentiality: The post-holder must adhere to a range of policies, procedures and legislation relevant to security and confidentiality; these include: - Data Protection Act 1998 - Copyright, Designs and patents Act 1988 - Access to Health Records Act 1990 - Computer Misuse Act 1990 - BS7799 (Information Governance) - Caldicott - Document and Records Management Additionally, all staff are required to attend an annual briefing on Information Governance and Security and participate in annual Information Governance Training including the on-line Information Governance training tool.

PERSON SPECIFICATION Criteria Essential Desirable Qualifications Registered first level nurse Member of professional body Extended/independent nurse prescribing Minor illness certificate/qualification Evidence of Continual Professional Development Experience Minimum 5 years post registration experience At least 2 years recent primary/ community/out of Hours/A&E nursing experience Nurse-led management of minor illness, minor ailments and injuries Nurse-led triage Relevant nursing/health degree Mentor/teaching qualification Certificate in at least one chronic disease area Chronic disease management INR Management Compiling protocols and clinical guidelines Knowledge & Skills Advanced clinical practise skills Management of patients with complex needs Accountability of own role in a nurseled service Excellent communication skills, both written and verbal Able to effectively communicate difficult messages to patients and families Local and national health policy Knowledge of Quality & Outcomes Framework (QoF) Other Self-directed practitioner Highly motivated and enthusiastic Effective time management Team player Ability to work across boundaries Adaptable to and embracing of change Career Focussed