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Job description

The post holder will be an integral part of the clinical management team, demonstrating advanced autonomous clinical practice skills across STHK Frailty service and Frailty in the Emergency Department.

Acting within their professional boundaries, they will demonstrate safe, clinical decision-making skills and will manage their own caseload including the treatment and care of patients from initial history taking, assessment, diagnosis, treatment and evaluation of care for older people and people living with frailty. The service also provides care and clinical supervision for the Urgent Community Response service (UCR) for patients 18+ and ED streaming and In reach.

The ACP will take the lead and participate in educational sessions; clinical supervision; research, audits as well as quality and service improvements, ensuring high quality, effective management and care of patients. The ACP will rotate around the Frailty offer.

This position requires an Enhanced DBS Certificate, with the checking of the Vulnerable Adult’s Barred List.

Interviews for this position will take place on 31st May 2023.

• Provide advanced levels of clinical practice, knowledge and skills in Geriatric Medicine / Frailty
• Undertake history and physical examination to accurately assess the patient’s condition
• Request, interpret and act upon relevant diagnostic tests and procedures.
• Interpret, convey and act upon complex and conflicting information to MDT members/patients/relatives including possible stressful situations, which may be delicate or offensive in nature (i.e. breaking bad news).
• Act as a clinical expert providing continuous support to nursing staff and other MDT members within and outside designated area of work.
• Undertake advanced (invasive and non-invasive) procedures pertaining to patient need, in accordance with appropriate training and clinical supervision.
• Prescribe and review medication in accordance with current legislation and trust policy.
• Maintain comprehensive, contemporaneous and accurate nursing/medical records and documentation, utilising information technology where available to facilitate caseload management that is consistent with legislation, policies and procedures
• Effectively manage acute life threatening conditions in accordance with current ALS/ATLS/ALERT guidelines (as appropriate to area of work/need).
• Act as a role model through demonstration of high standards of practice, providing a clinical environment that motivates and encourages effective working partnerships.
• Participate in multi-disciplinary case conferences, reviews, clinical and audit meetings.

St Helens and Knowsley Teaching Hospitals NHS Trust is the only acute Trust in Cheshire and Merseyside, and one of the few in the entire country, to achieve the title of OUTSTANDING, rated by the Care Quality Commission.

We provide a full range of acute adult services to our local population of circa 360,000 and provide tertiary services across a much wider area in the North West, North Wales and Isle of Man. We are a Major Trauma Unit and the Mersey Regional Burns Unit.

Our '5 Star Patient Care' strategy is at the heart of all that we do; supporting our vision to provide world class services for all our patients by getting it right for every patient, every time.

Our latest achievements include:

• Acute Trust of the Year – HSJ Awards November 2019
• Trust rates Outstanding by the CQC – Inspection August 2018
• Top 100 places to work in the NHS (NHS Employers and Health Service Journal)
• Best acute Trust in the North West for quality of care (NHS Staff Survey 2021)
• Best place to work in the North West (NHS Staff Survey 2021)

In the NHS Staff Survey 2021 the Trust scored the highest marks in the North West for the following areas;

• Standard of care
• Best place to work
• Care of patients being the Trust’s priority
• Staff engagement
• Staff morale
• Compassionate and inclusive
• Providing a safe environment for staff
• Gain informed consent from patients for procedures undertaken by self or on behalf of others, both written and verbal, according to Trust/Practice policy.
• Provide evidence based specialist knowledge and advice to patients, families/carers throughout the patient’s journey to meet their physical, emotional and psychological needs.
• Provide clinical expertise in the management of patients utilising specialist theoretical and clinical skills.
• Facilitate and support practice staff to develop effective working relationships with the wider multi-disciplinary teams to enhance the care and management of patients.
• Act as an autonomous Practioner exercising judgement, discretion and decision making in clinical care.
• Certify expected deaths as per policy.
• Undertake nurse prescribing as part of the designated role.
• To support junior nursing staff, sharing clinical workload and allowing junior clinical staff (where appropriate) to achieve training and development requirements.
• Support patients to adopt health promotion strategies that promote healthy lifestyles, and to apply principles of self-care and management.
• Work with patients in order to support compliance with and adherence to prescribed treatments. Providing information and advice on prescribed or over-the-counter medication, medication regimes, side-effects and interactions.
• Provide adhoc clinical advice to the Out of Hours Service Provider on a rota basis with other clinicians.
• Ensure patient experience remains the focal point for service improvement within the Practice
• Provide clinical support to complete complaints, SIRI/SUI investigations and staff development.
• Contribute effectively to service developments both within the Practice and at a wider strategic level.
• Attend Practice Governance and Business Meetings as required.
• Act as a role model by demonstrating excellent communication and listening skills with patients, relatives and staff.
• Active involvement and engagement in GP Practice Forums.
• Promote effective team working within the practice at Marshalls Cross Medical Centre.
• Participate in recruitment and selection of staff as required.
• Lead/guide nursing and medical staff in the appropriate and timely care of patients.
• Network locally, regionally and nationally to share and exchange ideas and principles.
• Actively market and promote the role of the Advanced Nurse Practitioner in General practice.
• Provide an effective leadership role in contributing to resolving own practice issues pertaining to clinical governance agendas and shared governance within the Trust e.g. maintaining standards, risk management, clinical audit and research, standard setting, benchmarking, evidence based practice, etc.
• Provide leadership to nursing and HCA staff with regard to training and development ensuring the delivery of consistently high quality care.
• To support the practice and trust management teams with ongoing clinical care provision and assist with safe, effective flow of patients.
• Ensure others in general practice nursing recognize the importance of data collection and quality assurance and ensure that findings and other results are disseminated in meaningful ways to staf

Educational Responsibilities

• Adherence to ACP competency framework
• Attend mentor meetings with respective GP.
• Take responsibility for one’s own professional development and continually assess and acknowledge areas

for development as they arise.

• Raise awareness of speciality conditions within area of practice by teaching and providing education across
• Marshalls Cross Medical Centre.
• Assist in identified training and educational needs of the nursing staff/medical staff and participate in its

delivery.

• Support in the facilitation of an appropriate learning/practice environment Nursing and Medical students and

junior Trainees and new starters providing direct supervision and training.

• Provide education to patients, carers and families in an environment that supports learning.
• Provide clinical supervision, mentorship, preceptorship and tuition to Practice nursing and medical staff.
• Research and Development, Quality and Service Improvement:
• Participate in COE and Frailty Audit and ED case finding for Frailty.
• Lead the reporting of clinical incidents/concerns and take appropriate action to address any safety and quality

issues raised using a structured framework e.g. root-cause analysis.

• Develop and implement policies and strategies in line with evidence based practice e.g. NICE/NHSe/ HEE

and in partnership with other clinical teams.

• Be involved in identification, development and implementation of relevant policy/guidelines to aid future

management by the MDT (e.g.clinical pathways).

• Assess the effectiveness of care delivery through self and peer review, benchmarking, formal evaluation and

consideration of patient responses.

• Facilitate and identify clinical audit/research and disseminate findings.
• Collaborate proactively with public health agencies and local authorities to ensure general practice nursing is

actively engaged in the health improvement strategies for the local community.

Personal Attributes:

• Develop good working relationships with all Staff and other members of the multidisciplinary team within Frailty/ Bevan and COE and other departments within the Trust and external bodies.

Act in accordance with the NMC guidelines/Code of Professional Conduct.

Safeguarding Responsibilities

• Know about the range of physical abuse, emotional abuse, neglect, and sexual abuse.
• Complete Safeguarding Level 3 in Adult safeguarding
• Be able to recognise signs of abuse appropriate to role and what action to take.
• Know about the Trust’s local policies/procedures.
• Understand the importance of sharing information, how it can help and the dangers of not sharing information.
• Be able to seek advice and report concerns, ensuring that they are listened to