About this role
Job summary
Truro Primary Care Network is looking for an experienced Frailty Specialist Nurse / Practitioner to join its Integrated Neighbourhood Team. Joining the existing Frailty team, you will work closely with the wider MDT which currently exists in the locality to provide a pro-active and responsive service for those in the population living with frailty. You will be part of the primary healthcare multi-disciplinary team and will utilise the skills of the wider existing primary care team.
Main duties of the job
This role focuses on identifying, assessing and managing patients living with moderate to severe frailty, with the aim of improving patient outcomes, reducing avoidable admissions, and supporting patients to remain safely at home.
Working autonomously, you will assess individual patient needs, initiate investigations, and initiate appropriate holistic, evidence-based treatment and care.
Please note, Truro PCN is not approved by the Home Office and is therefore not able to offer candidates support for an application for a Health and Care Visa.
About us
Truro PCN consists of two GP Practices (Lander Medical Practice and The Three Spires Medical Practice), both operating from Truro Health Park and together we have a dedicated team of GPs and staff caring for around 36,000 patients. We are learning practices, hosting GP trainees and Medical Students from the Peninsula School of Primary Care and the University of Exeter Medical School. We are a friendly, forward-looking PCN who values the work-life balance we are able to provide allowing us to enjoy the beautiful coast and countryside of Cornwall.
Truro PCN has a shared ambition to innovate general practice and build a sustainable model for general practice for the future. We believe in the national strategies for bringing together local health organisations, voluntary and community sectors and teams to improve health and care outcomes for all residents across Truro.
Job description Job responsibilities
Main Duties and Responsibilities
1. To participate in rationalised identification of patients who may benefit from the input of the Frailty Service or the input of the wider Integrated Neighbourhood Team.
2. To provide care and support for registered patients allocated to the team and maintain appropriate records of treatment given and NHS services provided. When appropriate, to make a relevant diagnosis and management plan, implement this plan and subsequently evaluate it.
3. Carry out consultations and physical assessments as requested, formulate a diagnosis and maintain high quality contemporaneous records using SystmOne.
4. Use assessments, clinical findings, health records, information from wider teams and crucially information from patients, relatives and carers to identify patient priorities to co-create personalised support plans, and then work in a patient-centred way to facilitate access to services and interventions as required.
5. Manage a caseload of own patients and assist with the management of referrals, waiting list, and team caseload in order to ensure patient safety and continuity of care.
6. To work with a level of clinical and professional autonomy as could be expected of an Enhanced Practitioner whilst the maintaining professional standards of the appropriate regulatory body and framework and recognising the limits of individual scope of practice. This may require seeing and assessing patients independently; escalating concerns and requesting support when required to ensure clinical effectiveness and patient safety; keeping contemporaneous notes, records and documentation of activity; and ensuring good communication through handovers to maintain continuity and safety.
Further information can be found on the attached job description.
Person Specification
Qualifications Essential
Registered Nurse with Nursing and Midwifery Council (NMC) registration. MSc or equivalent in Advanced Clinical Practice. Significant experience in primary care, community, or elderly care. Advanced clinical assessment and decision-making skills. Full UK Driving License.
Desirable
Non-Medical Prescriber qualification (or working towards)
Skills and attributes Essential
Able to adapt one's approach to challenging patient scenarios and being able to hold sensitive conversations with empathy and professionalism. Highly organised and able to work and manage a workload in a dynamic environment with evolving priorities. With support, working with a degree of autonomy expected of an Enhanced Practitioner.
Desirable
Agile and flexible approach to service delivery, readiness to adopt news ways of working. Experience or interest in quality improvement, transformation and service development.
Experience Essential
Experience of working with patients living with frailty, frailty pathways or geriatric populations. Knowledge of Comprehensive Geriatric Assessment (CGA). Leadership or service development experience.
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 The Three Spires Medical Practice
Address Truro Health Park
Infirmary Hill
Truro
Cornwall
TR1 2JA
Employer's website https://www.threespiresmedical.co.uk/ (Opens in a new tab)