Advanced Clinical Practitioner - Urgent Community Response

Job overview

An exciting opportunity is now available for a qualified Advanced Clinical Practitioner (ACP) to join the Urgent Community Response Team at Lewisham Hospital. The ACP will practice with a high degree of autonomy supported by the Clinical Leads for Frailty.  Under the direction of the Frailty consultant and in conjunction with the UCR team, the ACP will use expert, evidence-based clinical practice to care for patients within the community. The ACP will be responsible for the assessment of patients, implementation and completion of agreed clinical management plans, requests and review clinical investigations, prescribe relevant medications and referral to other specialities and tertiary centres.

The successful candidate will work a shift pattern including out of hours and will primarily be based in the community setting.  This post holder will be able to evidence the completion of Master level studies in advanced clinical practice. In addition, applicants will have to provide a portfolio of evidence with the relevant advanced capabilities demonstrating relevant experience in frailty or related speciality.

We welcome applications from those interested in developing into the role of  ACP. You will initially be employed as a trainee ACP (band 7) and you will be supported through the Trust ACP credentialing program, once all the set elements of the program are completed and signed off, you will automatically progress into ACP Role (band 8a).

Main duties of the job

As an ACP, you will deliver advanced clinical care to acutely unwell patients in the community, undertaking comprehensive assessment, diagnosis, treatment planning and non-medical prescribing. You will work collaboratively across multidisciplinary teams to support admission avoidance, optimise patient outcomes and deliver high-quality, evidence-based care. The role also includes leading service improvement initiatives, supporting clinical governance, education and workforce development, contributing to research and audit, and providing leadership to drive innovation and continuous improvement across the UCR service.

The ACP provides clinical leadership within the multidisciplinary team, supports and supervises junior staff, contributes to workforce development and recruitment, and works collaboratively across services to ensure seamless patient care. The role also supports education and training through clinical supervision and teaching, participates in audit, research and quality improvement activities, and promotes evidence-based practice. In addition, the ACP contributes to resource and risk management by ensuring safe clinical practice, implementing governance processes, monitoring incidents, and supporting continuous service improvement.

Detailed job description and main responsibilities

Clinical Practice

Be able to provide advanced practice level of care to patients who are acutely unwell in the community with a variety of urgent conditions. The ACP will treat patients with various degrees of acuity from routine patient review to urgent presentations.

• Use advanced knowledge and skills for the delivery of the evidence based specialised clinical care in frailty, exercising a high degree of professional autonomy, demonstrating the ability to make sound decisions based on the knowledge and experience. This includes clinical history taking, physical examination, request and interpretation of secondary data (i.e diagnostics) and the use of clinical reasoning to formulate differential diagnosis and implement evidence-based management plans including nonmedical prescribing.

• Provide a holistic consultation of patients using a range of different assessment methods including medical history taking, physical assessment, clinical investigations, and risk stratifications tools, appropriate to the presentation within the scope of the role.

• Reach a valid, reliable, and comprehensive conclusion on complex clinical cases based on the history and clinical findings. These conclusions will involve facts or situations which require the analysis, interpretation, and comparison of a range of options. Utilise advanced practice skills for assessing and interpreting complex needs of patients/clients e.g. clinical assessment of multiple pathology and complex health and social needs/ conditions.

• Initiate drug therapy/medication within the parameters of agreed clinical guidelines for the management of patients with medical presentations and in accordance with present legislation for the supply and prescribing of medicines.

• Perform advanced skills in line with the Trust Standard Operating Procedures (SOPs) and safely perform complex procedures, where accuracy is important, but there is no specific requirement for speed. This level of skill may be required for manipulation of fine tools or material such as invasive clinical procedures. i.e., Ultrasound guided iv canulation, ascitic tap, lumber puncture.

• Communicate with patients in ways that empower them to make informed choices about their health and healthcare, providing and receiving complex, sensitive or contentious information, where persuasive, motivational, negotiating, training, empathic or re-assurance skills are required.

• Address safeguarding for adults and children with a high degree of professional curiosity.

• Work in partnership with other clinical teams making appropriate referrals to optimise health outcomes and resource allocation.

• In partnership with patients, clients, and other professions, make sound decisions which are ethically based and in the interest of patients and clients in the absence of precedents and protocols.

• Provide specialist knowledge, advice, resource information and support to clinical staff across the Trust.

• Responsible for the safe use of equipment other than equipment which they personally use, dismantling and assembling equipment for use by other staff or patients/clients.

• Be able to recognise, assess and refer patients with potential mental health needs for specialist support as required.

Service & Practice Improvement

• Promote the improvement of quality and clinical effectiveness.

• Evaluate and audit own and others’ clinical practice, selecting and applying valid, reliable methods, then acting on the findings.

• Take a critical approach to identify gaps in the evidence base and its application to practice, alerting appropriate individuals and organisations to these and how they might be addressed in a safe and pragmatic way.

• Develop and implement robust governance systems and systematic documentation processes, keeping the need for modifications under critical review

• Lead new practice and service redesign solutions in response to feedback, evaluation and need, working across boundaries and broadening sphere of influence.

• Implement practices that are appropriate for patient and service need through understanding the wider implications of epidemiological, demographic, social, political, legislative, and professional trends and developments.

• Identify the need for change and proactively generate practice innovations to implement solutions to better meet the needs of patient and the service.

• Develop and undertake activities to monitor the progress and efficiency of the service and owns practice.

• Continually assess and monitor risk in their own and others practice and challenge others if necessary.

• Critically appraise and synthesise the outcomes of relevant research, service evaluation and audits, and apply the information when seeking to improve practice.

Management and Leadership

• Contribute to the development to the specialist service and act as a change agent and facilitate the change process whilst encouraging others to be innovative and adaptable in the approach to change.

• Demonstrate and role model inclusive attitudes and behaviours to pro-actively initiate and develop relationships, fostering clarity of roles within teams, to encourage productive working

• Support the development of junior ACPs in line with the trust SOP.

• Work across professional, organisational and system boundaries to proactively develop and sustain new partnerships and networks to influence and improve health, outcomes, and healthcare delivery systems.

• Review and update documentation and policies specially required by the team.

• Be conversant with all the relevant Trust policies and procedures and ensure they are correctly implemented.

• Work collaboratively with representatives of other clinical areas, disciplines and services to provide a seamless pathway of care.

• Coordinate, lead, and manage the activities of clinics on a day-to-day basis.

• Assisting with the investigation of complaints and lead on the development of action plans to address areas of concern.

• Prioritise, organise and manage own workload in a manner that maintains and promotes quality.

• Evaluate own practice and participate in multidisciplinary service and team evaluation, demonstrating the impact of advanced clinical practice on service function and effectiveness and quality.

• Demonstrate team leadership, resilience and determination, managing situations that are unfamiliar, complex, or unpredictable and seeking to build confidence in others.

• Actively engage in peer review to inform own and other’s practice, formulating and implementing strategies to act on learning and make improvements.

• Actively seek feedback and involvement from individuals, families, carers, communities and colleagues in the co-production of service improvements.

• Participate in the recruitment, selection and retention of staff.

• Represent the Trust on national forums related to the role and Advanced Clinical Practice.

• Demonstrate receptiveness to challenge, and preparedness to constructively challenge others, escalating concerns that affect individuals’, families’, carers’, communities’ and colleagues’ safety and well-being when necessary.

Information Management

• Always adhere to confidentiality with sensitive personal data.

• Responsible for the systematic monitoring of investigations and appointments, in collaboration with administration and managerial staff.

• Ensure compliance with care pathways and service development.

• Provide reports of the statistics related to service and practice developments as required.

• Provide high standards of documentation in accordance with the Trust documentation policy.

Education and Training

• Lead and participate in development teaching programmes for Nurses, Doctors and ACPs in the care of patients relevant to the UCR department.

• Achieve trust credentialling status as set out in the Trust SOP for advanced practice including speciality credentialling were applicable.

• Exhibit a personal commitment to clinical education and development. Work in collaboration with others to plan and deliver interventions to meet the learning and development needs of their own and other professions.

• Raise awareness of the current local, regional, national and international perspectives in clinical specialties.

Audit and Research

• Proactively contribute to the development of multidisciplinary research and clinical audit in the service and, implementing effective and evidence-based practice

• Participate and contribute to any on-going regional and national research to evaluate the effectiveness of care strategies related to the patient experience.

• Share best practice; through publications and attendance/presentation opportunities at National and Trust conferences.

• Facilitate collaborative links between clinical practice and research through proactive engagement, networking with academic, clinical, and other active researchers.

Resource Management

• Apply sound financial evaluation to proposed service developments.

• Maintain accurate records in relation to equipment used and maintained by the UCR team.

Risk Management

• Ensure that systems are in place to manage, reduce and prevent clinical risk to self and others within the UCR department.

• Monitor incidents highlighted by members of the emergency team and communicate to appropriate areas to address risk issues.

• Promote best practice in health & safety, utilising unit and Trust policies.