Download job description

NHS GRAMPIAN
JOB DESCRIPTION
POST REF NO: LF7501
CLOSING DATE: 26 FEBRUARY 2014
1. JOB IDENTIFICATION
Job Title:
Community Nurse Practitioner (Band 7)
Department(s):
Northfield and Mastrick Medical Practice , Aberdeen CHP.
Hours:
37.5 hours per week (part time applicants will be considered)
Band/Salary:
Band 7 - £30,764 - £40,558 per annum
2. JOB PURPOSE
To develop and provide a comprehensive, highly skilled, accessible, nurse practitioner led service, responsive to
the needs of the patients of Northfield and Mastrick Medical Practice.
To be proactive in the use of health promotion, preventative and anticipatory care.
To lead the development of appropriate new services including management of long term conditions and triage,
assessing, diagnosing and implementing a range of care interventions for patients who may present with
undifferentiated and undiagnosed problems.
To provide holistic care in the primary care setting.
As part of a multi disciplinary approach, to lead the Practice Nursing Team in developing and delivering
evidence/research based patient care, in line with practice need.
Evaluate the effectiveness of treatments and referrals through autonomous and accountable decisions in nursing
practice, supported by current research and in accordance with NHS Grampian guidelines and procedures.
Perform clinical audit in own specialist areas, and within the PN team.
Teach and supervise nursing students.
3. ORGANISATIONAL POSITION
Team Leader
Professional
Lead for
Practice Nurses
Nurse Practitioner
Other CHP
nurse
Practitioners
GP’s and
Practice Manager
Senior Practice
Nurse
4. SCOPE AND RANGE
The Community Health Partnership is a supportive and connected network of all parts of the NHS system and
local authority that provide and manage health and care services and have an influence on the health and
wellbeing of the population of Aberdeen and the commuter belt. It delivers this through a unified management
structure providing and developing health and care services in partnership with staff.
The Aberdeen Community Health Partnership (CHP) (Shadow) covers the geographical area of Aberdeen
City which has a population of approximately 270,000. Within Aberdeen City there are currently 36 GP Practices.
Aberdeen City is grouped into clusters based around the groupings of GP Practices.
The Clusters are:
North Cluster:
11GP Practices
Population approx. 88,000
30,551 Dwellings approx.
Central Cluster
15 GP Practices
Population approx. 112,000
41,721 Dwellings approx.
South Cluster
10 GP Practices
Population approx. 68,000
34,513 Dwellings approx.
In addition to General Practice, there is also the Middlefield Healthy Hoose, Smithfield Court, City Hospital,
the Homeless Practice, Torry Neighbourhood Centre, Sexual Health department at Woolmanhill and the Out
of Hours Nursing Service at David Anderson building.
Northfield and Mastrick Medical Practice caters for the needs of some 5,700 patients. Northfield/Mastrick
Medical Practice is based at Quarry Road and Greenfern Road Aberdeen. These are both areas of high
deprivation. High Turnover of patients on an ongoing basis.
High % of patient population are heavy users of the system as a result of issues that arise from living within
areas of high deprivation. As a result the Consultation rate per patient would be higher than national average.
Mental Health Register currently has 60 on the register – this is high in comparison to other City Practices of this
size.
The post holder is responsible and accountable for all clinical decision making and for all clinical assessment and
treatment under their management.
The post holder accepts referrals from G.P’s, various disciplines, hospital liaison, patients and carers/relatives.
The post holder has a responsibility to teach, supervise and assess student nurses, lower band and untrained
nurses.
The post holder has to plan, manage and prioritise workload and delegate appropriately to other staff members.
To build links with the Healthy Hoose, the local community, health promotion, social agencies, general
practitioners, community and midwifery services, community nurses and mental health in the pursuit of excellence.
To participate in the development and integration of General Medical Services with Practice Nursing Team to
maximise benefits for the patients of Northfield and Mastrick Medical Practice.
To provide a comprehensive nurse led primary care service.
To develop and provide advanced nurse led clinics.
Non medical prescriber
Autonomous practitioner
5. MAIN DUTIES/RESPONSIBILITIES
Clinical/management
To develop and provide a high quality, advanced nurse led primary care service that is responsive to the health
needs of the patient population. To lead the PN team in delivering a quality service.
To assess, implement and evaluate the care of client group and be proactive in the use of preventative and
anticipatory care including giving advice on lifestyle and health promotion.
To develop advanced nurse-led clinics with a triage service for the patients of the practice, which will undertake
comprehensive physical and psychological assessment: assessment, diagnosis, development of treatment and
intervention plans, referring on to a variety of agencies/services. Prescription of medications and treatments,
working within areas of knowledge. Initiation of laboratory requests and collection of samples as necessary.
To recognise abnormalities and early signs of illness, both minor and major, making decisions regarding whether
medical assistance or intervention is required. Initiating appropriate treatment, referring on and liasing with others
as necessary.
To develop and support specialist clinics for priority groups e.g. family planning, minor illness, health promotion
and healthy lifestyles, the management of long term conditions - in collaboration with medical colleagues., and the
PN and community nursing teams.
Responsibility for the assessment of care needs, development, implementation and evaluation of care plans and
setting standards of care.
To demonstrate current evidenced based practice in all aspects of work undertaken.
Encourage client empowerment.
To work to NHS-G or locally agreed protocols and procedures, and assist in the development of new protocols.
To participate in the education of Health Care Workers.
Overall responsibility for leadership and management of PN team , including liaison with other agencies.
Ensuring efficient and effective time and resource management. Direction and delegation of staff to optimise
human resources.
Prioritisation of own and others’ workloads, and acting as a point of reference and expertise.
Promoting safe standards of working practice for self and others, at all times.
Clinical Governance
Contribute to the development of a culture that supports clinical governance.
Demonstrate and implement good practice and evidence based practice, leading on this for the PN team.
To participate in audit and research, both in context of policies and procedures and in the direct provision of care
in specific areas.
To submit monthly activity data and annual report as required for evaluation purposes.
Ensure systems in place for monitoring and evaluating clinical practice through audit.
To be aware of and participate in, clinical governance and risk management of service.
Professional
Responsible for maintaining professional standards and knowledge of the law in relation to professional
accountability and responsibilities.
Contribute to own professional development using a personal development plan.
Maintain good links with GP trainers, specialist practitioners, training department,NES and others who support
learning and development and research.
Create an environment of mutual trust with the multi disciplinary team and participate in education and training of
staff.
Knowledge, understanding and compliance with NMC guidelines for all areas of nursing, but with special reference
to nurse practitioner post.
Contemporaneous record keeping. Develop appropriate use of existing records i.e. Single Shared Assessment.
Responsible for promoting and maintaining all aspects of confidentiality.
Maintain professional credibility and clinical competence as a specialist practitioner by continuously updating and
through ongoing professional development, in relevant fields.
To attend study days/ courses as part of professional development and to meet the changing needs of the client
group.
Demonstrate evidence based practice.
Deliver highly skilled nursing care.
Planning
To develop and monitor procedures in collaboration with clinical team, making recommendations for change where
appropriate.
Identify changing needs of the service and contribute to the planning processes to ensure effective delivery of the
service.
To participate in the overall management of the development of the service provision within Northfield and
Mastrick Medical Practice.
Take opportunities to influence policy or service change, as this is a new role, where service development is
continually being evaluated.
To be lead representative of the Practice Nursing Team at planning and operational meetings at the Practice and
within the CHP.
Communications
To develop strong networks and systems to liaise with the broader multidisciplinary team, including GP’s, Practice
Nurses, District Nurses, Health Visitors, Administration Team, Community Midwives, Community Psychiatric
Services, Social Services, Voluntary Services, in the pursuit of excellence
To maintain and communicate patient information to an optimum level, according to legal and general practice
requirements.
To co-ordinate the development of information and communication systems with the GP Practices of the CHP and
with NHS Grampian.
6. SYSTEMS AND EQUIPMENT












Required to use PC’s and have intermediate keyboard skills and the ability to use e-mail, excel and word.
Responsible for ensuring patient records are accurate and contemporaneous in accordance with NMC
guidelines on record keeping
Patient records
General practice IT systems e.g. Vision
PECOS Ordering System
Datix
Audit forms, maintenance of local data base
Clinical assessment tools e.g. Blood pressure monitoring
Emergency equipment
Diagnostic equipment, e.g. ECG machine, sphygmomanometer, glucometer, Coaguchek XS plus etc
Risk assessment.
Knowledge of suitable equipment available.
7. DECISIONS AND JUDGEMENTS









Post holder has a high degree of clinical autonomy and is required to make assessments and decisions based
on complex facts and with a variety of options open to them.
Post holder is expected to use best practice guidelines where they exist and use professional clinical judgment
for deviating from these where necessary.
Post holder will use advanced clinical skills and evidence based knowledge in identifying abnormalities and
screening patients for disease, thus allowing for early intervention and treatment.
The post holder will be comfortable and competent in carrying out clinical assessment and examination, and
with initiating certain investigations, liasing with medical staff as necessary.
Post holder responsible for ongoing identification of needs, the planning, development and implementation of
care as appropriate
Post holder required to make assessment and decisions on complex facts and a variety of options available to
them
Post holder operates within clearly defined policies and protocols but is accountable for own professional
actions
and is not directly supervised.
Post holder responsible for decision to make relevant referral to other agencies
Prioritisation and organisation of workload of self and to oversee the whole PN team.




Post holder operates with a high level of autonomy to make the correct clinical decisions based on research
evidence.
Using clinical judgement to accept referrals.
Support and guidance is available from Team Leader/Service Manager/Lead Nurse/ Prof Lead for Practice
Nursing when required and is given either face-to-face or by telephone
Post holder is required to meet regularly with line manager to discuss clinical issues, has appraisal meeting
with Line manager at least once per year. Objectives agreed annually.
8. COMMUNICATIONS AND RELATIONSHIPS
Internal
Professional Lead for Practice Nursing
Practice Nursing Team
Practice Manager and Administration Team
GP’s, Lead Clinicians.
Nursing and social care colleagues
Multi-disciplinary colleagues e.g. Speech & Language Therapy, Dieticians, Mental Health, Public Health etc.
Team Leader
Service Manager
Senior Service Manager
Lead Nurse
Professional interest groups
Other departments within NHS Grampian e.g. Human Resources, Finance, Payroll, IT Dept. Audit and research.
etc.
External
Patients
Relatives
General Public
NMC
Voluntary Services
Local Authority Departments e.g. Social Work Department, Education, Family Centres .
Use and knowledge of national guidelines, strategies and policies.
Aberdeen City Collective. NHS Grampian.
Statutory and voluntary sector. Social service and other agencies.
The post holder is regularly required to utilise negotiating, influencing and persuading skills when dealing with
staff, clients/relatives in order to agree care plans and assist with the implementation of the plan to ensure a
successful outcome.
Post holder is pivotal in communicating highly complex or difficult information to sick patients or relatives, and has
to overcome barriers to understanding of the different client groups. Communication difficulties might be
encountered while dealing with infants, children, elderly, foreign language or cultures, and patients might be under
the influence of drugs or alcohol. Information communicated includes; condition related information, which can
include terminal illnesses. Communicates such information to clients and relatives, which requires empathy and
reassurance.
The post holder will provide support in dealing with distressed, upset, angry, or anxious patients, carers, relatives
and staff , and needs to have enhanced conflict management skills.
The post holder would use well enhanced communication skills to de escalate situations, while minimising risk to
patient self and other staff.
9. PHYSICAL DEMANDS OF THE JOB




There may be occasions when violent or aggressive incidents occur. Sudden intense effort may be required
for a short period of time.
Highly developed clinical skills are required by the postholder - for example performing venepuncture or
suturing.
Manual handling skills- a degree of bending and some lifting may be required.
Use of IT systems
10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB
The post holder is required to effectively manage their caseload and prioritise workload whilst overseeing that of
the team.
Be flexible and adaptable to deal with rapid changes in patients conditions and needs. Manage patient safety and
well-being effectively in a constantly changing environment.
Adaptable to service needs and changes within the modernisation of the health service and in line with the joint
future agenda and managing within limited resources.
The post holder must work autonomously.
The post holder must set a good example, in clinical leadership and in use of resources.
The post holder will communicate effectively and professional at all times recognising that at times this involves
dealing with upset, bereaved or difficult patients or relatives/carers.
Raised patient and public expectation.
Violence and aggression incidents.
As an autonomous practitioner with a responsibility to their patients the post holder has occasional exposure to
distressing or highly distressing circumstances e.g. discussing poor prognosis’s, may be palliative or terminal
illness with patients and or their relatives. Bereavement support.
Frequent potential contact with body fluids, including blood, which may be potentially infectious and noxious
substances.
11. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB
Graduate in Specialist Practitioner in Community Nursing (or equivalent) with extensive experience at F or F/G
grade or above, or band 6 and broad post graduation experience in Primary care.
.
Must have current NMC Registration.
Educated to MSc in Nursing level or equivalent, or demonstrates post graduate Masters level thinking.
Willingness to undertake further training in relation to the post essential.
Nurse Practitioner qualification, or course modules desirable, e.g.
Minor illness
Non medical prescribing and use of the Formulary and independent prescribing
Advanced consultation skills
Advanced clinical examination skills
Other desirable qualifications include:
Diploma or degree level modules in Long Term Conditions, e.g. Diabetes, Asthma, COPD, IHD/Secondary
Prevention.
Family Planning certificate
Cervical Screening and Breast self examination
Triage
Awareness of Adult with incapacity Act
Knowledge of Public Health agenda
Extensive knowledge of local and national strategies, and relevant NHS G policies and procedures.
Awareness of Data protection
In depth knowledge of Primary care
Multi disciplinary/partnership working
Ability to build and maintain effective working relationships
Advanced communication and interpersonal skills
Effective organisational skills
Record keeping skills
Problem solving/analytical skills
Report writing skills
IT skills
The post holder is required to make use of skills in history taking, physical examination, problem solving and
clinical decision making to establish a diagnosis and management plan. Therefore theoretical knowledge is
required along with clinical expertise, acquired through in depth experience and theoretical study of a broad range
of conditions, techniques and processes. This equates to post graduate degree level or equivalent.
NHS GRAMPIAN
PERSON SPECIFICATION
The Person Specification should meet the demands of the job and comply with current legislation. Setting
unnecessary standards may, for example, unfairly discriminate against one sex, the disabled or minority
racial groups. Applicants should be assessed in relation to their ability to meet the real requirements of the
job as laid down in the job description. Shortlisted candidates MUST possess all the essential components
as detailed below.
POST/GRADE:
Community Nurse Practitioner
LOCATION/HOSPITALS:
Aberdeen City Community Health Partnership
WARD/DEPARTMENT:
Community Nursing
ATTRIBUTES
Qualifications
Experience
Special Aptitude
and Abilities
Disposition
Physical
Requirements
Particular
Requirements
of the Post
ESSENTIAL
First level reg.
Graduate in Specialist Practitioner in
Community or Practice nursing and /or Nurse
Practitioner or working towards Msc
Non medical Prescriber
Post graduate with broad experience in
Primary care.
Experience in minor injuries
Assessment and evaluation skills.
Autonomous practitioner.
Ability to prioritise/organise work load.
Ability to give high standard of care.
Clinically and professionally updated.
Demonstrate evidence based practice.
Professional and accountable.
Excellent communication skills-written and
verbal.
Leadership skills
Ability to impart information to both
colleagues/patients.
Multi-disciplinary working..
IT literate- ability to use clinical systems
Working knowledge of adult and child
protection
Adaptable, flexible, organised.
Pleasant professional approach
Willingness to undertake further training in
relation to the post essential.
Able to form good relationships with patients
and colleagues
Manual handling
DESIRABLE
Msc in Nurse Practitioner
Chronic disease management diplomas
or degree modules i.e. Asthma, Chronic
Obstructive Pulmonary Disease,
Cardio-vascular disease, Diabetes.
Reproductive Health/Family planning
qualification. Minor Illness qualification.
Willingness to undertake further training
and development
Ability to identify own training issues.
Car owner/Driver.
Update own work practice regularly and
efficiently
MAJOR RISKS IN DOING THIS JOB
Please indicate the major risks the job holder could face in doing this job e.g. lifting patients/objects, working
with hazardous substances, dealing with violence and aggression.
If there are no major risks for the job holder please tick this box