Job Description

Job Summary The post holder will be expected to work within the existing Advanced Clinical Practice (ACP) team. As a qualified or trainee ACP, the post holder is expected to hold or be working towards an MSc level award or equivalent, and demonstrate the competencies and capabilities outlined within the multi-professional framework for advanced clinical practice, encompassing the four pillars of clinical practice. This role is predominantly focused on the autonomous assessment, investigation and management of patients presenting with urgent problems within the primary care setting. Therefore an ability to manage the complexity, uncertainty and risk associated with undifferentiated and undiagnosed conditions is essential.



The post holder must demonstrate expert level clinical decision making and critical reasoning skills, based upon both a breadth and depth of relevant underpinning knowledge and experience. Established ACPs are encouraged to diversify their role and develop areas of special interest, including but not limited to home visits/frailty, womens health or cardiovascular; this aids innovative service delivery and offers opportunity for the provision of specialist clinics. Educational sessions, provided by those with areas of special interest, benefit both individual clinicians and the wider team. It is expected that the post holder would demonstrate an awareness of ones own requirement for continuing professional development, whilst engaging in both receiving and facilitating learning within the team.

Primary Duties and area of responsibilities Clinical Practice:

The post holder will: Deliver a high standard of care using advanced clinical skills and in-depth theoretical knowledge. Provide the first point of contact for clinical queries from the Patient Advisors on the Unscheduled Care Team, providing specialist advice and support. Be responsible for telephone triage of patients. Undertake Unscheduled Care clinics for patients who need to be seen on the day.



Undertake home visits as part of the visiting team. Practise in compliance with respective code of professional conduct and within own scope of practice, being responsible and accountable for decisions and actions. Clinically examine, assess, diagnose, plan implement and evaluate treatment/ interventions and care for patients, using expertise and decision-making skills to inform clinical reasoning approaches when dealing with differentiated and undifferentiated individual presentations and complex situations; using information from multiple sources to make appropriate, evidence-based judgements and/or diagnoses. Diagnose and manage both acute and chronic conditions, initiating, evaluating and modifying a range of interventions which may include prescribing and reviewing medicines for therapeutic effectiveness (appropriate to patient need and in accordance with evidence based practice and national protocols within scope of practice) , therapies, life style advice and care into a management plan.



Work in partnership with individuals, families and carers, using a range of assessment methods as appropriate (e.g. of history-taking; holistic assessment; identifying risk factors; mental health assessments; requesting, undertaking and/or interpreting diagnostic tests; and conducting health needs assessments). Offer a holistic service to patients and their families, supporting people in making decisions, planning care or seeking to make positive changes, with an emphasis on health promotion and self-care. Where the post holder is an independent prescriber: to prescribe safe, effective and appropriate medication in line with current guidance and legislation.



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 on medication regimens, side effects and interactions. Support and manage health needs of women presenting for family planning or sexual health consultation. Assess, identify and refer patients presenting with mental health needs in accordance with the NSF for Mental Health Collaborate with other members of the Primary Health Care Team, accepting referrals and referring to them. Refer patients directly to other services and agencies as appropriate.



Exercise professional judgement to manage risk appropriately, especially where there may be complex and unpredictable events and supporting teams to do likewise to ensure safety of individuals, families and carers. Act as a clinical role model/advocate for developing and delivering care that is responsive to changing requirements, informed by an understanding of local population health needs, agencies and networks. Deliver care according to NSF, NICE guidelines and evidence-based care. To record accurate data in the patient records to an agreed standard.

Leadership and management The post holder will:

Pro-actively initiate and develop effective relationships, fostering clarity of roles within teams, to encourage productive working. Prioritise, organise and manage own workload in a manner that maintains and promotes quality. Role model the values of the Practice, demonstrating a person-centred approach to service delivery and development. Evaluate own practice, and participate in multi-disciplinary service and team evaluation, demonstrating the impact of advanced clinical practice on service function and effectiveness, and quality (i.e.



outcomes of care, experience and safety). Actively engage in peer review to inform own and others practice, formulating and implementing strategies to act on learning and make improvements. Help the practice operate cost-effectively. Actively seek feedback and involvement from individuals, families, carers, communities and to help improve services.



Critically apply advanced clinical expertise to enhance quality, reduce unwarranted variation and promote the sharing and adoption of best practice. Demonstrate team leadership, resilience and determination, managing situations that are unfamiliar, complex or unpredictable and seeking to build confidence in others. Continually develop practice in response to changing population health need, engaging in horizon scanning for future developments (e.g. impacts of genomics, new treatments and changing social challenges).



Attend and contribute to the UC planning meetings. Demonstrate receptiveness to challenge and preparedness to constructively challenge others, escalating concerns that affect individuals, families, carers, communities and colleagues safety and well-being when necessary. Education, teaching and mentoring The post holder will: Maintain a clinical portfolio that evidences advanced health assessment skills and competencies. Assess and address own learning needs, growing a personal development plan that reflects the breadth of ongoing professional development across the four pillars of advanced clinical practice.



Engage in self-directed learning, critically reflecting to maximise clinical skills and knowledge, as well as own potential to lead and develop both care and services. Participate in regular performance review with clinical supervisor and take part in the annual appraisal review where personal learning requirements will be identified and in accordance with Practice requirements. Undertake further specialist training as required by service needs and the changing requirements of service provision Advocate for and contribute to a culture of organisational learning to inspire future and existing staff. Promote a learning environment for patients, clinicians and other members of the Practice Share learning and best practice, contributing to the learning experience of medical and clinical staff in practice such as medical students, nurse students, GP Registrars etc.



Provide supervision and coaching/ mentoring to others in the practice to help development of the practice team. Take part in the in house education events, delivering sessions where appropriate Research The post holder will: Engage in research activity, adhering to good research practice guidance, so that evidence based strategies are developed and applied to enhance quality, safety, productivity and value for money. Monitor the effectiveness of their own clinical practice through quality assurance strategies such as the use of audit and peer review, using the results to underpin own practice and to inform that of others. Support and participate in shared learning across the practice and wider organisation Take a critical approach to identify gaps in the evidence base and its application to practice, alerting appropriate individuals and organisations to these and how they might be addressed in a safe and pragmatic way.



Actively identify potential need for further research to strengthen evidence for best practice. Disseminate best practice research findings and quality improvement projects Facilitate collaborative links between clinical practice and research through proactive engagement, networking with academic, clinical and other active researchers, including Practice Research team