About this role
Job summary
We are seeking a motivated Advanced or Enhanced Clinical Practitioner for our Home Visiting Service at Belper PCN. This team provides holistic care for housebound, frail, elderly, and complex patients at home or care homes. Working with a multi-skilled team and partners, the service aims to deliver safe, effective care, develop new clinical pathways, and meet local and national standards.
The successful candidate will deliver expert clinical care to housebound patients within the PCN, using advanced skills and independent judgement for assessment, diagnosis, treatment, and management.
The successful candidate will enhance care quality through audits, evidence-based practice, supervision, teaching, colleague support, and professional leadership. They will apply clinical guidelines and contribute to the development of research and audit.
The successful candidate will lead the development of non-medical-led models of care within primary and community care settings, in collaboration with multi-professional colleagues, and will play a crucial role in improving the proactive management of patient care through timely assessment, referral, responsive intervention, and anticipatory care planning.
This is a full time role, or a part-time shared role for the right candidate.
We would welcome informal visits or discussions for anyone wanting to know more about the role and the opportunities at the PCN. Please contact Debbie Allen or Gillian Barnes on 01773 462960
Main duties of the job
Provide expert care to housebound patients with various medical conditions through comprehensive clinical assessments and an extended scope of practice. This includes conducting referrals, interpreting investigations, and independent prescribing.
Be instrumental in developing our Local Navigation Hub and alongside the clinical and management team participate in regular MDT meetings to ensure a no wrong door approach and preventative care.
Utilises a systematic approach to develop differential diagnoses and treatment plans while engaging patients, families, and caregivers in health priorities. Communicates sensitive information with empathy and refers patients to other practitioners as necessary. Evaluates therapeutic interventions and adapts management plans accordingly.
Assumes a leadership role in complex cases and maintains a strong clinical presence to enhance patient care outcomes. Offers guidance on therapeutic interventions, advance care planning, and decision-making for patients lacking capacity. Recognises patient deterioration and implements timely interventions.
Provides advice and education to relatives, caregivers, and professionals, applying expertise in palliative care. Demonstrates analytical thinking and professionalism to ensure a high-quality patient experience, integrating contemporary research and evidence-based practices in clinical pathways. Maintains accurate patient records in compliance with relevant standards.
About us
Belper PCN consists of 4 local GP practices working both together and with the broader health, social care, housing and voluntary organisations to improve the health and wellbeing of our local people. The vision for Team Up is to create one team across Health and Social Care that sees all housebound patients in a neighbourhood. Our team cover urgent, planned, and anticipatory care for our patients, working with a complete integration of local services. The team deliver care to those patients who are elderly, frail, and housebound.
Job description Job responsibilities
JOB DESCRIPTION
The ACP or ECP areas of responsibility include: providing same-day urgent response to housebound patients; collaborating with the clinical team to ensure care home residents receive coordinated medical care, including proactive care planning and consistent support from a multidisciplinary team; participating in multi-disciplinary team meetings; recognising opportunities for anticipatory care of suitable patients through treatment plans; working with registered practices to ensure seamless care; leading and coordinating across organisations; delivering high-quality, methodical, and well-informed patient diagnoses and care plans; developing expertise within the community to improve the lives and care of the elderly; promoting the use of supportive, non-statutory services to support self-care and social prescribing agendas; and maximising the quality of care in patients' care homes to reduce the need for hospital admissions.
This job description is an outline of the tasks, responsibilities and outcomes required of the role. The job holder will carry out any other duties as may reasonably be required by the Clinical Lead. The following areas of responsibility are an indication of the role but could be subject to change as the impact of primary care network commissioning evolves.
Key areas of responsibility
Patient Care Provides expert care and advice to housebound patients presenting with a diverse range of medical conditions. Undertakes first line comprehensive clinical assessment of patients, including those with complex presentations, employing an extended scope of practice beyond own profession including advanced clinical assessment skills, referral and interpretation of investigations and independent prescribing. Requests, reviews and interprets diagnostic investigations within the context of other available information utilising a systematic process of clinical reasoning to formulate a differential diagnosis. Develops and records a treatment plan consistent with the outcome of assessment and the most likely diagnosis. Involves patients, families and carers in the identification of patient-centred concerns and priorities about health and wellbeing and negotiates approaches available to prevent deterioration or promote comfort and wellbeing. Demonstrates empathy and compassion when communicating sensitive information and advice to patients, carers and relatives. Refers to other practitioners and agencies when necessary. Evaluates the effectiveness of therapeutic interventions and modifies the management plan accordingly. Maintains a visible clinical profile, having both advisory and clinical input into the medical management of patients presenting to the service. Advises health and social care teams with regard to medical management plans taking into account all aspects of clinical governance to improve the outcomes of patient care. Assumes a lead role in the safe and effective transfer of care for more complex cases.
Demonstrates a high degree of autonomy, analytical skills, competency and multidisciplinary knowledge in caring for the older person. Assesses capacity, gains valid informed consent and works within a legal framework with patients who lack capacity to consent to treatment. Provides guidance to the clinical team with regard to therapeutic interventions, advance care planning and best interest decision-making for patients who lack mental capacity to make informed choices about their care. Recognises deteriorating patients, implements early interventions and escalates care where appropriate. Empowers patients to manage their long-term conditions as independently as possible. Provides verbal and written advice, teaching and instruction to relatives, carers and other professionals, to promote understanding and to ensure a consistent approach to patient care. Applies expert knowledge in palliative care to symptom control, recognition of dying and advance care planning. Demonstrates analytical thinking, decision making, professionalism and leadership to ensure a high quality patient experience within a multi-professional arena. Facilitates the integration of contemporary research and best practice through advanced clinical reasoning and decision making and the implementation of evidence-based protocols of care and clinical pathways. Maintains accurate and legible patient notes in accordance with the memorandum of understanding and professional guidance.
Strategy and Service Development
Professional Leadership and Consultancy Shares and contributes expertise locally and nationally. Facilitates and promotes a learning culture that encourages others to develop their full potential. Communicates, motivates and inspires others to deliver excellent standards of care. Acts as an acknowledged source of expertise to assist with the development of service delivery modelsand clinical guidelines and to promote their application throughout the organisation. Challenges restrictive cultures and champions new ways of working to deliver enhanced patient focused care and improved productivity amongst the workforce. Works closely with medical, social care and therapy colleagues to deliver fully integrated team led care. Contributes to the development of Advanced Clinical Practice across organisations. Encourages other healthcare professionals to disseminate good practice. Supports the development of a learning organisation by identifying, challenging and reporting poorperformance and alerting managers to resource issues which may affect patient safety. Actively contributes to appropriate service developments and quality improvements.Training, Education and Staff Development Participates in the development of a research portfolio and clinical audit programme in relation to care of the elderly. Disseminates research findings within clinical teams and identifies strategies for implementation in practice. Assumes responsibility for own continuing professional development in relation to role and contributes to the continuing professional development of other healthcare professionals. Makes effective use of learning opportunities whilst contributing to developing the workplace as a learning environment. Undertakes annual mandatory training updates and other relevant courses in line with PCN policy. Acts as a resource for the clinical team.Practice and Service Development Makes recommendations for and leads change. Shapes services for older people in accordance with local and national policies and drivers. Monitors and challenges risk in relation to their own practice and that of colleagues. Acts as a champion and advocate for the care of the frail older person.Financial Resources/Management Manages available resources efficiently. Prescribes and manages medications in accordance with local prescribing guidelines and prescribing budget Advises budget holders on value for money purchasing of equipment required in this area of clinical practiceInformation Resources/Information Systems Analyses and interprets highly complex information gained during clinical examination and historyDiagnose an individuals problem or illness and to decide on an appropriate course of action or treatment Identifies evidence based interventions to meet an individuals complex health needs within the context of the overall management plan. Undertakes critical analysis of contemporary research studies and incorporates valid research findings into the PCN and member practices Identifies areas which require further research or audit and instigates collaborative research/audits Evaluates the quality of own work and current practices through the use of evidence based practice Develops benchmarks for best practice, identifies quality outcome measures and contributes to audit programme Identifies and agrees the minimum data set to be collected by self and others within the team and implements agreed methods of data collection. Analyses the information obtained using appropriate methods and reports the findings in a timely manner Supports the team in collating and analysing the information obtained in relation to their area of responsibility and encourages timely reports of the data and information obtained. Maintains contemporary knowledge of clinical guidelines relevant to practice and acts consistently with associated quality standardsAutonomy/Scope within Role Assumes clinical accountability for the delivery of patient care. Practices competently and autonomously without direct supervision in accordance with professional code of practice and local policies and procedure Acknowledges limitations in own professional competence and only undertakes practice and accepts responsibilities for those activities for which competence can be assured. Exercises professional judgment and expertise to create precedents and deal with ambiguous or novel problems Applies best practice policy guidelines where appropriate and in the absence of specific guidance
Person Specification
Qualifications Essential
Professional registration with NMC, HCPC Evidence of post-registration study at Master's Level Experience of mentoring and coaching PGDip in Advanced Clinical Practice (or equivalent). Independent Prescriber and completed Clinical Decision Making module to be practising at ECP level
Experience Essential
Experience of working with older individuals who have complex needs Involvement in a multi-professional team Expertise in end-of-life care Practical knowledge of primary care and community services
Disclosure and Barring Service Check This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.
UK Registration
Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).
Employer details Employer name Belper PCN
Address Belper PCN Ltd,.
59 Bridge Street Belper
Belper
Derbyshire
DE561AY
United Kingdom