About this role
Job summary
An exciting new development for our community services LOROS Hospice is seeking an experienced Advanced Clinical Practitioner to join our ICSPC Team providing expert, compassionate care for people with complex palliative and end of life care needs. This new role is aimed at increasing the responsiveness of our community team across Leicester, Leicestershire and Rutland.
Working alongside palliative medicine consultants, neighbourhood teams and wider health and social care partners, you will practice autonomously at an advanced level, undertaking assessment, diagnosis, prescribing, care planning and clinical management. You will play a key role in supporting people to remain in, or return to, their preferred place of care, helping to prevent avoidable hospital admissions and support timely discharge.
You will also provide visible clinical leadership, expert advice, supervision and education across hospice and community services, whilst contributing to audit, research and evidence-based service improvement.
We are looking for a registered healthcare professional with advanced clinical skills, strong decision-making ability and experience in palliative, end of life, cancer or complex community care. You will be compassionate, confident working autonomously and committed to delivering high quality, person-centred care across organisational boundaries.
Main duties of the job
Practise autonomously as an Advanced Clinical Practitioner, undertaking expert assessment, clinical examination, differential diagnosis, clinical decision-making, prescribing, care planning and management for people with complex and unstable palliative and end of life care needs.
Provide advanced clinical assessment and decision-making across community settings, including patients' homes, care homes, community clinics and other appropriate locations.
Work collaboratively with the three Palliative Medicine Consultants and other ACPs to provide senior clinical expertise across the three neighbourhood areas. Provide senior clinical support to the approximately twenty five CNSs within the Community Specialist Palliative Care Service, enabling timely escalation and access to advanced clinical decision-making.
Prescribe medicines safely and effectively within professional competence, legal frameworks and agreed LOROS policies. Recognise and manage clinical risk, including situations requiring urgent escalation to medical, emergency or other specialist services. Make ethical, evidence-based decisions confidently and competently when faced with clinical complexity and uncertainty.
About us
LOROS Hospice is a local charity and every year we care for over 2,500 people across Leicester, Leicestershire and Rutland. We deliver free, high-quality, compassionate care and support to terminally ill patients, their family and carers.
Job description
Job responsibilities
Advanced clinical practice
Provide senior clinical support to the approximately twenty five CNSs within the Community Specialist Palliative Care Service, enabling timely escalation and access to advanced clinical decision-making. Work closely with the Rapid Response Team to support urgent assessment and management of people with deteriorating or complex palliative care needs.
Contribute to a responsive same-day specialist palliative care service, providing timely assessment, advice and intervention for people with urgent or changing clinical needs.
Assess and manage people with complex symptoms and rapidly changing clinical conditions, using advanced clinical reasoning to determine appropriate management, escalation, referral or admission. Request relevant investigations and diagnostic tests where appropriate and within the agreed Scope of Practice.
Interpret assessment findings and investigation results to inform diagnosis, treatment and specialist palliative care management.
Support people with complex palliative care needs to remain in their preferred place of care wherever this is clinically appropriate and safe.
Contribute to reducing avoidable emergency department attendances and hospital admissions through timely specialist assessment, treatment, anticipatory planning and coordination of care.
Support timely and safe discharge from acute hospitals and other inpatient settings by providing specialist community palliative care input and ensuring appropriate follow-up and escalation arrangements.
Contribute to proactive identification of people who may benefit from specialist palliative care, working with neighbourhood teams and other professionals to facilitate earlier intervention where appropriate.
Support advance care planning, including appropriate documentation of goals of care, treatment escalation planning, ReSPECT and preferred place of care.
Communicate effectively with patients, carers and professionals regarding complex and sensitive clinical information, ensuring that agreed plans are clearly documented and accessible to relevant professionals. Ensure that care is coordinated across organisational boundaries and that patients and carers experience a coherent and responsive service.
Conduct appropriate follow-up, delegating and referring to other health and social care professionals and agencies when required. Make appropriate use of patient-reported outcome measures and other measures of clinical effectiveness to demonstrate patient outcomes and service impact. Collect and contribute to service data to support evaluation, quality improvement and evidence of effectiveness.
Work within appropriate legal frameworks, professional standards and LOROS policies. Maintain professional boundaries and comply with relevant NMC or HCPC requirements and standards for advanced clinical practice. Neighbourhood and integrated working
Contribute to the development of an integrated, neighbourhood-based model of specialist palliative care across three large geographical neighbourhood areas. Develop effective working relationships with GPs, community nursing teams, community services, care homes, acute hospitals, social care, voluntary organisations and other local partners.
Provide visible specialist palliative care leadership within the allocated neighbourhood while maintaining a whole-service perspective and contributing to cross-neighbourhood working. Work with neighbourhood partners to improve recognition of people approaching the end of life and facilitate timely access to appropriate specialist palliative care.
Support collaborative clinical decision-making across organisational boundaries, ensuring that care is provided by the right professional, at the right time and in the right place. Contribute to multidisciplinary discussions and case reviews involving people with complex needs.
Support effective communication and transfer of information between community, hospice and acute services.
Identify barriers to coordinated care and work collaboratively with partner organisations to resolve these. Promote the role of specialist palliative care within neighbourhood teams and support development of palliative care capability across the wider system. Contribute to service development and redesign to ensure that the community model remains responsive to population need and changing patterns of care.
Rapid response and same-day care Work collaboratively with the Rapid Response Team to provide timely specialist assessment and management of people with urgent or deteriorating palliative care needs.
Provide advanced clinical decision-making to support the Rapid Response Team when cases are complex or require senior clinical input.
Support rapid assessment and management of symptoms including pain, breathlessness, agitation, nausea, vomiting and other complex end of life symptoms. Contribute to decisions regarding treatment escalation, admission, discharge, hospice admission or continued management in the community. Support the development of clear escalation pathways between the Rapid Response Team, CNSs, ACPs, Consultants, GPs, community services and acute hospitals. 6. Contribute to reviewing urgent referrals and determining the most appropriate response from the Community Specialist Palliative Care Service.
Promote a culture of responsive, clinically appropriate intervention while ensuring that rapid response is integrated with proactive and planned specialist palliative care.
Clinical leadership and management
Provide visible clinical leadership across the Community Specialist Palliative Care Service, neighbourhood teams and partner organisations.
Work collaboratively with the three Consultants and two other ACPs to provide consistent senior clinical leadership and appropriate cross-cover across the three neighbourhoods. Support the CNS workforce through accessible senior clinical advice, case discussion, supervision and escalation.
Provide clinical leadership that promotes safe, coordinated and person-centred care. Act as a clinical role model, demonstrating high standards of professional behaviour, communication and decision-making.
Participate in clinical supervision and provide clinical supervision to colleagues within the Community Specialist Palliative Care Service as appropriate to experience and competence. Contribute to peer review and reflective practice for own practice and that of others. Identify gaps, risks and opportunities within community specialist palliative care provision and work with service leads and colleagues to develop and implement improvements.
Contribute to the development and implementation of local guidelines, protocols, pathways and standards. Support implementation of national policy and evidence relevant to specialist palliative and end of life care. Contribute to clinical governance, including incident reporting and investigation, complaints, risk management, clinical audit and learning from adverse events.
Promote effective use of LOROS resources and contribute to the development of cost-effective models of specialist palliative care. Promote the role and contribution of Advanced Clinical Practice within specialist palliative care and support the development of advanced clinical career pathways.
Contribute to workforce planning and service development as the neighbourhood model evolves. Support the development of a culture in which the whole community team works collaboratively across professional and organisational boundaries. Maintain professional registration and undertake continuing professional development appropriate to the role.
Maintain personal standards of conduct and behaviour consistent with LOROS Values & Behaviours and relevant professional guidance. Education and development.
Contribute to the development and delivery of specialist palliative care education for LOROS staff, community teams, primary care colleagues, care home staff and other professionals.
Person Specification
Experience
Essential
- Extensive post qualification experience
- Portfolio of evidence showing achievements in practice speciality
- Supervision experience and the ability to support trainee practitioners in their development and career progression.
- Ability to work autonomously at advanced practice level and make expert clinical decisions to support the development of services and inform practice.
- Ability and evidence to lead on related research and audit in relation to the development of advanced practice.
- Communication of difficult messages to patients and families.
- Evidence of multi-agency or professional working
- Negotiation and conflict management skills within the context of multi-agency working.
- Demonstrates efficient experience in leadership of teams in the context of multi-agency working
Desirable
- Experience of electronic prescribing, digital clinical assessment or remote consultation systems.
- Post qualification experience in Specialist Palliative Care
- Experience of leading patient involvement and patient feedback
- Relevant previous experience of working at an advanced clinical level.
- Recent experience in primary and or community setting
- Experience of resource management
Qualifications
Essential
- Relevant Professional Qualification
- Registered General Nurse or Paramedic
- Primary degree
- Master's degree in Advanced Practice and or Palliative Care
- Non-medical Prescriber V three hundred
- Clinical Examination and Diagnostics modules if not part of Masters qualifications
Desirable
- Advanced Communication Skills Training
- Advance Care Planning or Respect training
- Mentor qualification
Clinical skills and abilities
Essential
- Advanced clinical assessment
- Clinical decision making
- Symptom management
- Risk assessment - able to identify, assess and manage clinical risk
- Diagnostics -able to appropriately use clinical investigations and diagnostic information to support assessment and management while recognising the limitations of investigations in advanced illness
- Evidence of influencing motivating and negotiating with others to achieve change in relation to care
- Demonstrate self, staff and patient management competencies
- Skills for analysis of service delivery, risks and options for improvement
- Experience of implementing change in clinical practice or service delivery to improve the quality of patient care
- Ability to problem solve with a strong solution-focussed approach
- Highly developed clinical judgement in holistic assessment of patient needs
- Emotional resilience
Desirable
- Experience of specialist palliative care emergencies and complex pharmacological management
- Experience of point-of-care diagnostics or community-based investigations
- Experience of complex best-interest decision-making
Knowledge
Essential
- Awareness of current national and local agendas in health and social care.
- Demonstration of high-level knowledge of multi-agency working i e housing, social services, independent sector etc
- Knowledge and understanding of Clinical Governance
- Quality improvement and change management
- Demonstrate the ability to work in a highly demanding environment.
- Teaching and mentorship clinical setting.
- Ability to work independently and make autonomous clinical decision within own area of competence
- Knowledge of community profiling and health needs assessment to respond to community needs
- High level communication skills, both written and verbal
- Knowledge of audit research and experience of analysing findings to improve practice
- Clinical supervisor and ability to reflect on own practice
Desirable
- Knowledge and implementation of research
- Development and implementation of protocols and clinical guidelines
- Working with community development initiatives
Other skills and abilites
Essential
- Excellent communication skills
- Car driver with access to a car as the post holder will be required to travel to fulfil the full requirements of the role
- Ability to work flexibly
- Excellent organisation skills, show the ability to plan and organise workload and facilitate learning events
- Positive role model
- Proficient IT skills
- Excellent interpersonal skills, including negotiation, influencing and presentation
- Ability to work under pressure and manage a diverse workload
- Self-management and motivation skills
- Confidence to challenge traditional practice and persistence to address difficult issues
- Able to work and make decisions autonomously and take initiative
Desirable
- Experience of electronic prescribing, digital clinical assessment or remote consultation systems
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
LOROS Hospice
Address
Groby Road
Leicester
LE3 9QE
United Kingdom