Advanced Clinical Practitioner - Frailty Warwick, West Midlands, England
Job description
An opportunity has arisen to join the dynamic, innovative and award winning Frailty Team at South Warwickshire NHS Foundation Trust as an Advanced Clinical Practitioner (Band 8a).
The role provides specialist assessment and management of Frailty patients in our award winning Frailty Assessment Area. Alongside which we also offer experience of working within ED, AMU and our Care of the Elderly, Frailty and Ortho-geriatric wards to enhance skills and knowledge.
The post holder will provide strategic nursing leadership to the delivery of Frailty services across the organisation, with a specific focus on acute frailty services.
The advanced clinical practitioner role will be primarily focussed within the acute frailty services based within the emergency services of the hospital. The acute frailty service consists of two short stay acute frailty wards, with dedicated therapy teams, a frailty take seeing new patients each day and a consultant led morning ward round seeing new older adults with frailty, based across acute services within the hospital.
Come and join a Trust rated Outstanding by the CQC. South Warwickshire NHS Foundation Trust have been rated as outstanding following our latest inspection by the CQC and we are recruiting new staff to come and help us improve even further.
We provide services across Warwickshire and beyond ranging from Hospitals in Warwick, Stratford-Upon-Avon, Royal Leamington Spa and Shipston-on Stour to Community Services across the county. We are a progressive, expanding organisation with great ambition around improving quality, integrating pathways and delivering high levels of productivity.
Our values can be summed up in one sentence. We are ‘Trusted to provide safe, effective and compassionate care’. Throughout the recruitment process you will be asked to think about how you demonstrate these values and how they impact on your work. It doesn’t matter what role you do, whether it is patient facing or not, we are all working in the same way with our values at the core.
Clinical Role
The role will be integral to the acute frailty team, primarily based across the two short stay acute frailty wards.
The core values of the acute frailty services are: that all older adults with frailty accessing acute services should have:
Rapid identification, comprehensive geriatric assessment at the point of contact by a dedicated team, and a clear plan for discharge from the point of contact.
All older adults with frailty should be encouraged to maintain mobility and full independence from the point of access with a view to early discharge home.
All people with frailty will be fully involved in decisions about them with shared decision making
The postholder will be based within the acute frailty team. They will be expected to take a leading role in managing the frailty flow across the Trust. They will work closely with the ward managers and frailty team to deliver high quality, comprehensive frailty care with a focus on promotion of independence and mobility.
They will be expected to attend ward rounds with the medical teams, alongside independent ward rounds on inpatients. They will be expected to provide leadership to the team, support in education and help drive the innovation and development of the ward processes and team members.
They will be expected to attend daily Multi-disciplinary meetings co-ordinating therapy care, and promoting early discharge.
Since May 2016 the over 75s FLOW project has led to the application of Lean principles to the frailty service. This has led to continual development and innovation within the frailty service with significant reductions in overall length of stay despite increasing admissions. There are great opportunities to become involved within the FLOW project and take a leading role in frailty service development throughout the trust.
Expertise & Excellence in Clinical Practice
Deliver evidence-based personalised and compassionate care which places quality at the heart of specialist practice. Care will responsive to individual needs and reflect current local protocols and national guidelines.
Act as the key accessible professional for the MDT proactively managing a clinical caseload for 80% of the role. This will necessitate high levels of autonomy and advocacy, using analytical and judgemental skills in undertaking differential diagnosis to ensure the delivery of appropriate care.
Work as an autonomous practitioner providing an expert level of care, developing own and others knowledge within the speciality.
Proactively manage a caseload of patients within speciality and prioritise workload to meet patient and service need.
Support consultant led ward rounds reviewing patients, requesting diagnostics, reviewing results and creating and implementing patient management plans.
Conduct independent ward rounds reviewing patients, requesting diagnostics, reviewing results and creating and implementing patient management plans.
Independent and supplementary prescribing including discharge summaries.
Take the lead in the development and implementation of Individualised management plans for the speciality through holistic needs assessment, planning and evaluation of care and all care interventions.
Effectively manages pathways of care, adapting to patients’ emerging needs by ensuring a planned and co-ordinated approach to care, reducing inappropriate admissions to improve patient experience and safety.
Receive and act upon referrals directly from health care professionals and makes referrals to other team members and specialist departments as necessary to ensure optimal quality of care.
Act as a patient advocate to facilitate the process of shared decision making in respect to health, choice of treatment and care. Use interpersonal and communication skills where there may be significant barriers in order to build confidence. Ensure that patients’ individual needs are expressed and valued and individual care plans are understood.
Advise on the complex disease and symptom management for patients within the speciality in both inpatient and outpatient settings. Evaluate response to interventions and advise on the adaptation of management.
Empower patients to self-manage their condition, undertaking risk stratification to determine those who can self-manage following education, those who will need guided support to self-manage and those who will need on-going face to face support.
Work autonomously in the development and delivery of clinics in line with National guidance and local service need.
Provide clinical advice and input to commissioning in relation to frailty services.
Act as a resource providing clinical expertise, specialist advice and support across service boundaries to ensure optimum liaison and co-ordination of care.
Undertake clinical competencies relevant to this specialist service to demonstrate expertise in extended clinical roles. Assess and effectively manage individual psychological reactions to diagnosis, treatment and associated side effects of interventions and medication.
Actively integrates theory and practice.
Management & Leadership
Work with partner agencies including commissioners and influence their strategies in health and personal care of which frailty will be a part.
Be a credible and visible source of clinical expertise and leadership to others across the organisation, acting as a role model demonstrating high standards of holistic care.
Supervise the patient caseloads of more junior members of the clinical team assuming overall responsibility where applicable.
Lead and line manage junior members of the team of specialist clinicians including responsibility for annual appraisal where applicable.
Contribute to budget management where appropriate.
Analyse complex information including trends to support the delivery of frailty services and review performance against defined targets.
Lead or contribute to annual service review and write annual report to reflect service activity and development.
Contribute to service re-design, leading on areas where appropriate.
Promote an ethos of continual service improvement and lead specific projects, monitoring progress in terms of milestones and key measures of performance.
Demonstrate transformational leadership through open communication, transparent decision making, seeking to motivate and involve others in developments in the speciality.
Embed public and patient involvement within the sphere of practice.
Lead on elements of the clinical governance agenda where appropriate to service.
Help scope, develop and implement the frailty strategy/service.
Support the further development of common frail conditions, including inpatient services and outpatient clinics.
Attend Care of the Elderly weekly meetings for junior doctors and frailty as well as contribute to the agenda and the strategic nursing vision.
Represent the Trust by contributing to and participating in meetings locally, regional and nationally relating to the speciality.
Communication
Take personal responsibility for ensuring effective communication between all service providers.
Act as a role model for excellent advanced communication skills and expertise. Demonstrate advanced empathetic interpersonal and communication skills in supporting, informing and advising patients and carers through diagnosis, treatment, disease progression, prognosis and supportive and palliative care where applicable. This will involve frequently imparting significant news or supporting patients and carers during and following such consultations.
Effectively and sensitively communicate highly complex and sensitive information to emotionally distressed patients and family/carers at key points along the care pathway on a frequent basis.
Participate and lead patient focussed family liaison meeting, discharge planning meetings, best interest meetings and end of life discussions.
Refer to other health professionals and outside agencies to ensure optimum care and on-going support for individual patients/carers, and to ensure the seamless transition from primary to secondary care appropriate to patients’ individual needs and circumstance.
Maintain links with local and national organisations, which support the care of patients within this speciality.
Network both locally across the sector and nationally to ensure that services within the Trust are at the leading edge of development in frail elderly care.
Create, manage and maintain robust links across the frailty wards/service to ensure appropriately screened patients are identified and moved swiftly into specialist care to improve flow and patient outcomes.
Education
Provide clinical leadership to all staff involved in the care of frail older patients, their families and carers.
Identify and use advanced educational strategies to deliver complex information to patients and carers.
Lead the development of patient focused education including training to support self-management and health promotion activities.
Influence the development of other professionals by leading or contributing to Trust wide specialist education and training.
Deliver formal and informal teaching initiatives as part of the Trust’s education strategy as agreed with the appropriate senior nurse to ensure practice development, staff empowerment and improved care for patients.
Act as a mentor/clinical supervisor as appropriate.
Take personal responsibility for life-long learning and personal development through clinical supervision and appraisal. Actively engages with learning and development opportunities needed to work as an advanced practitioner and take appropriate action to ensure these needs are met.
Contribute to promoting educational links with local providers of higher education and deliver lectures on a range of courses.
For full details of the responsibilities associated with this role, please see the attached Job Description.
