Job Description

Salisbury Hospital is developing its Frailty Same Day Emergency Care(SDEC) services and is looking for Advanced Clinical Practitioners(Nurse or AHP) to join its existing team. We are looking for colleagues with a passion for the care of Older People, who want to work in the dynamic environment of SDEC. You will be completing Comprehensive Geriatric Assessment in the emergency department and SDEC areas, supported by Consultant colleagues, a therapy team and links with community services.



The Advanced Clinical Practitioner in Frailty will provide autonomous specialist advanced clinical care to patients with Frailty at SFT, with a focus on the 'front door' areas of ED and SDEC, working with the OPAL therapy team, Consultant Geriatricians, ED Consultants, and the wider MDT. The ACP will work towards delivering an integrated Frailty service across the Integrated Care System. The post holder will spend a minimum of 70% of their time in direct clinical practice, and will initiate and co-ordinate Comprehensive Geriatric Assessment, including advanced care planning and communication with health and social care partners. The ACP will display leadership behaviours in clinical areas that manage patients with Frailty, in service and quality improvement, education, evidence-based practice and research.



We are an acute Trust, rated "Good" by the CQC, with a track record of high performance providing regional and super regional specialist services such as: Burns, Plastics & Reconstructive Surgery, Wessex Regional Genetics Laboratory, Wessex Rehabilitation, Spires Cleft Centre and the Duke of Cornwall Spinal Treatment Centre. We have about 470 beds and employ over 4000 staff.



We support flexible working and will consider requests taking into account the needs of the service. We think working here is pretty rewarding. You can access a range of NHS discounts, receive a minimum of 35 days paid holiday (pro rata), and we offer a generous pension scheme. On-site benefits include car parking (fee applies), leisure centre, day nursery and holiday play scheme.



Salisbury is an attractive place to live and work and really gives you the best of everything. With easy access to London and local airports, the city of Southampton is only a short train or car journey away or if you prefer the sea, Bournemouth is also accessible. Don't just take our word for it, why not explore what Salisbury has to offer by visiting www.experiencesalisbury.co.uk



Clinical Care



To work closely with the Consultant Nurse for Older People, OPAL therapy team, Consultant Geriatricians, AMU and ED clinicians to provide effective, flexible and responsive SDEC services for patients with decompensated frailty to ensure rapid delivery of assessment, diagnosis, treatment, care planning, early transfer of care and hospital admission prevention where appropriate.



2. Develop, deliver and ensure high quality, safe clinical practice. Be proactive in clinical decision making, underpinned by an advanced level of theoretical and practical knowledge and be able to demonstrate improved patient care outcomes.



3. To work autonomously utilising advanced clinical practice skills including history taking, clinical examination, formulation of differential diagnoses, clinical testing, problem identification, diagnosis, and treatment planning.



4. To be responsible and accountable for their own decisions, actions, and omissions at this level of practice. Demonstrating a critical understanding of own level of responsibility and autonomy and the limits of own competence, capabilities, and professional scope of practice, including when working with complexity, risk, acuity and uncertainty.



5. To act as the Lead Clinician undertaking Comprehensive Geriatric Assessments for older people presenting with frailty. This will involve working as part of a multi-disciplinary team, planning, implementing, and evaluating the care delivery according to changing healthcare needs.



6. To prescribe, de-prescribe and review medication (as an independent non-medical prescriber) for therapeutic effectiveness appropriate to patient need and choice and in accordance with best/evidence-based practice and national and local protocols and within the post holder's professional scope and the role's scope of practice and legal framework.



7. Demonstrate a high level of knowledge in relation to the common comorbidities of older age, markers of condition progression and ranges of treatment available at each stage of disorder or condition. Seek advice from and involve specialist teams wherever appropriate.



8. Demonstrate an ability to safely and effectively prioritise need within fluctuating clinical workloads to achieve the best possible outcomes for patients, showing an ability to delegate where appropriate and to manage and escalate any concerns where workload exceeds capacity.



9. To be responsible for the delivery of a detailed, accurate and, where required, complex clinical handover and to document detailed and accurate written information within the medical notes regarding all clinical assessments, investigations completed and requested, and treatments administered.



10. To advise, communicate and work in conjunction with a wide range of clinical colleagues and systems partners; including primary care and community teams and Adult Social Care professionals, leading and facilitating a patient-focused, co-ordinated case management approach for people requiring complex discharge planning and who are at high risk of re-admission to hospital.



11. Effectively manage and balance risk in decision making and communicate and negotiate risk with patients, their families or carers and holders of power of attorney where available. Always considering what matters most to the patient, ensure shared decision-making is at the core of the service provided.



12. To proactively participate in and influence efforts across the health and social care system to shape multi-disciplinary pathways designed to support patient choice, improve quality of life, promote self-management, and assure early intervention through the proactive provision of care in or as close to the patient's own home as possible.



13. Participate in the development, implementation and review of protocols, guidelines, and policies for an integrated Frailty service. This will include working with wider system partners including from HCRG, Primary Care, Adult social care, BSW ICB.



14. As an SDEC service responding to clinical demands the postholder will need to work across a variety of clinical areas and shift patterns.

Responsibilities for Leadership:

1. Act always with Compassion, and be committed to delivering high quality care, using effective communication, clinical competence and courage when needed.



2. Act as a role model, mentor, educator, and clinical support for the existing service and as it expands. Ensure sustainability through succession planning within the team, identifying talent and skills within the team and fostering its development.



Participate in the recruitment, selection and retention of both trained and untrained staff which will include the development of job descriptions, short-listing of candidates and interviewing.



Review the effectiveness of clinical care provided ensuring that patient safety is maintained, and care delivery meets the standards required by the Trust and the Care Quality Commission.



Manage change through strategic thinking, use of negotiating skills, self-awareness, and effective communication. Be an active participant in the Trust's "Improving Together "strategy.



Although this is not a budget-holder post, the post holder is expected to maintain responsibility for delivering cost effective care and services, including appropriate ordering of investigations, equipment, and other resources.



Education, Development and other Professional Responsibilities.



Act as a constant source of clinical and theoretical knowledge for all grades and disciplines of staff as well as patients and their significant others, providing support and clinical advice in specialist areas, based on evidenced based research and accepted best practice.



Promote a learning environment within the clinical area of responsibility, and the wider hospital environment, in which individuals take ownership for their professional development. Take an active role in undertaking staff training needs analysis as appropriate.



Critically assess and address own learning needs, negotiating a personal development plan that reflects the breadth of on-going professional development across the four pillars of advanced clinical practice, ensuring own appropriate and on-going clinical support.



Disseminate best practice research findings whilst developing and contributing to local guidelines, interpreting and adapting national protocols and standards to enhance patient care and safety.



Ensure own compliance with mandatory training, revalidation requirements and CPD, including what is required as a non-medical prescriber, following relevant Trust policy. Through supervision and mentorship identify personal learning needs; participating in personal continuing education to broaden educational and professional knowledge and skills. Ensure compliance with NMC / HCPC revalidation requirements.



Other Factors



The nature of this role, working autonomously in unscheduled and emergency care environments, includes potentially stressful situations with fluctuating workload and occasional unmet need, which will require the post-holder to have resilience, excellent communication skills, and self-care capabilities. The job will include dealing with emotionally charged situations, distressed patients and relatives, and the postholder will need to be able to deal with these situations effectively and professionally whilst recognising their own limits and being able to seek help and relief when required.



We are a friendly team with a broad range of experience in the care of older people and Frailty, including Nursing and Physiotherapy. We are passionate about the care of older people and applying advanced practice to improve the outcomes for our patients. We are very well supported by our Consultant colleagues both in the Emergency department and in Older persons medicine. We have great links to the wider MDT including front door therapy and Community services including Hospital@home. Salisbury is a great place to live and work with a genuine family atmosphere.