Job Description

Job summary:

To work as a Nurse Prescriber, providing quality clinical and administrative support in an efficient manner to patients in a residential, care home or local setting, under the direction of the Medical Director.

We are looking for bank staff or there is a possibility of a FTC (fixed term contract) depending upon experience and availability.

Pay:

Depending upon experience and qaulifications

We reserve the right to withdraw the advert at any time for business needs.

Unfortunately, we are not able to sponsor visa's due to not holding any licences

You will need to be immunised for Hep B, MMR and be able to evidence this.

1. Role Purpose

The Anticoagulation Service Clinician--who may be a

registered nurse, pharmacist, or experienced healthcare assistant (HCA)

--will play a key role within a

multidisciplinary team (MDT)

delivering safe, effective, and patient-centred anticoagulation management.

The post holder will contribute to the delivery of a comprehensive

Warfarin Monitoring Service

and

Direct Oral Anticoagulant (DOAC) Initiation and Review Service

, operating across

primary care hubs, GP practices, and community settings

. Some staff will also undertake

home visits

for patients who are unable to attend clinic appointments due to mobility or health constraints.

This flexible and dynamic role involves close collaboration with GPs, pharmacists, nurses, and administrative colleagues to ensure continuity of care, safe prescribing, and robust follow-up. The clinician will be responsible for maintaining high standards of clinical governance, supporting quality improvement initiatives, and helping to develop and expand the service.

The service's overarching aim is to ensure all patients prescribed anticoagulants receive

timely, accurate, and evidence-based care

, minimising risk and optimising therapeutic outcomes.

2. Key Responsibilities

2.1 Clinical Duties

Warfarin Monitoring and Management

Perform point-of-care (POC)

INR testing

in clinic settings or during home visits (for those in the home-visiting role). Record and interpret INR results accurately, following local or national dosing protocols. Adjust Warfarin doses under approved protocols and within the clinician's professional scope of practice. Communicate INR results and dosing changes promptly to patients, carers, and GPs. Escalate out-of-range INR results, bleeding risks, or potential adverse events to the Clinical Lead or prescribing clinician. Support patient adherence, education, and follow-up scheduling.

DOAC Initiation and Ongoing Review

Conduct baseline clinical assessments prior to DOAC initiation, including renal and hepatic function review, drug interactions, and clinical suitability checks. Educate patients and carers about DOACs, including how to take medication safely, recognition of side effects, and adherence strategies. Review existing DOAC patients to ensure ongoing appropriateness of therapy, correct dosing, and safe monitoring intervals. Record all interventions, test results, and recommendations in the clinical system (e.g. INRstar, EMIS, or SystmOne). Identify and escalate any issues requiring prescriber intervention (e.g. declining renal function, new contraindications, or potential drug interactions).

Patient Care and Communication

Deliver compassionate, patient-centred care with an emphasis on education and empowerment. Use clear communication tailored to the patient's understanding, language, and cultural needs. Support self-management and encourage patients to take an active role in their anticoagulation therapy. Coordinate care with GP practices, community services, and hospital anticoagulation clinics to maintain continuity.

Clinical Safety and Governance

Maintain meticulous and contemporaneous records, ensuring compliance with data protection regulations and information governance standards. Adhere to local clinical governance frameworks, ensuring all activity aligns with agreed protocols and best practice. Report adverse drug reactions, significant events, and near-misses through the appropriate reporting mechanisms. Ensure equipment calibration, maintenance, and infection control procedures are consistently upheld. Participate in clinical audit and contribute to quality improvement cycles focused on safety and effectiveness.

3. Service Development and Quality Improvement

Support the ongoing development of the Anticoagulation Service in line with national guidance (e.g. NICE, BSH, MHRA). Work with the Clinical Lead to design, test, and implement new care pathways or digital solutions that enhance patient care and efficiency. Contribute to audits such as Time in Therapeutic Range (TTR) analysis, patient satisfaction surveys, and adverse event reviews. Help identify and address service gaps, risks, or inefficiencies through proactive feedback and innovation. Participate in regular multidisciplinary meetings to discuss complex cases and review clinical data. Promote best practice in anticoagulation and ensure the service remains evidence-based and patient-focused.

4. Teamworking and Collaboration

Collaborate effectively with the multidisciplinary team, including GPs, nurses, pharmacists, HCAs, and administrative staff. Work across multiple primary care hubs or boroughs, sharing expertise and ensuring consistency in service delivery. Attend regular team meetings, contributing to clinical discussions and service improvement planning. Provide mentorship and informal training for new or junior staff within the anticoagulation team. Liaise with secondary care anticoagulation clinics, ensuring smooth transitions for newly discharged patients or complex cases.

5. Professional Standards and Governance

Maintain appropriate professional registration (e.g. NMC, GPhC) and comply with respective codes of conduct and scope of practice. For HCAs, work within clearly defined competency frameworks under appropriate supervision. Participate in annual appraisals, clinical supervision, and personal development planning. Undertake mandatory and role-specific training, ensuring competence in clinical governance, safeguarding, and infection prevention. Uphold patient confidentiality at all times in compliance with GDPR and information governance standards. Contribute to clinical governance structures, including participation in root cause analyses and incident reviews.

6. Home Visiting (Where Applicable)

Provide safe and professional anticoagulation monitoring services to housebound patients. Manage portable INR testing devices and supplies safely, ensuring equipment integrity and infection control standards. Follow lone working and risk assessment policies to ensure personal and patient safety. Document outcomes immediately after visits and communicate findings to the wider team. Treat patients and carers with respect and sensitivity within their home environment.
Note: Not all staff will undertake home visits. Allocation will depend on individual contracts and local service configuration.

7. Flexible Working and Mobility

Work flexibly across hubs, boroughs, or practices according to service demand. Participate in extended hours or weekend clinics if required to support patient access. Be adaptable to new models of care, including digital and virtual consultations. Provide cover for colleagues during absences to ensure service continuity.

8. Leadership and Support of the Clinical Lead

Support the Clinical Lead in maintaining a safe, effective, and high-quality anticoagulation service. Assist with implementing quality improvement initiatives and clinical governance actions. Provide feedback from frontline service delivery to inform leadership decisions and strategic planning. Represent the service professionally at local or borough-level meetings when delegated.

9. Data, Systems, and Record Management

Use clinical systems (e.g. INRstar, EMIS, SystmOne) to record results, doses, and patient communications accurately. Ensure data integrity and contribute to regular audits of record quality. Support collection and reporting of performance indicators, such as number of patients reviewed, INR control, and safety incidents. Comply with data security and confidentiality standards at all times.

10. Education, Training, and Patient Empowerment

Deliver patient education regarding Warfarin and DOAC therapy, including dietary guidance, side effects, and red-flag symptoms. Provide written and verbal advice to support medication adherence and lifestyle choices. Participate in staff training, peer review, and clinical updates to ensure continuous learning. Keep up to date with current anticoagulation evidence, national standards, and device innovations. Support or deliver internal training sessions for new team members or students under supervision.

11. Equality, Diversity, and Inclusion

Provide equitable and accessible care to all patients, respecting cultural and linguistic diversity. Adapt communication and educational materials to meet varying literacy levels and patient needs. Promote inclusion within the team and uphold the organisation's equality and diversity policies.

12. Health, Safety, and Infection Control

Follow infection prevention and control procedures at all times, both in clinics and home visits. Maintain safe disposal of sharps and clinical waste according to policy. Conduct dynamic risk assessments for patient interactions and report safety concerns promptly. Ensure personal safety through adherence to lone working and incident reporting procedures.

13. Person specification

Criteria

Essential

Qualifications

Registered Nurse (NMC), Registered Pharmacist (GPhC),

or experienced HCA with NVQ Level 3 or equivalent in Health and Social Care.

Experience

Experience in clinical or patient-facing roles within primary or community care.

Skills

Excellent communication, IT literacy, accuracy, ability to follow clinical protocols.

Knowledge

Understanding of anticoagulant therapy, medicines management, and patient safety principles.

Personal Attributes

Compassionate, organised, proactive, flexible, and team-oriented.

Desirable:

Additional anticoagulation qualification (e.g. BSH competency certificate, INRstar accreditation).

Direct experience in anticoagulation management or chronic disease monitoring.

Competence in interpreting INR results and making dose adjustments within protocol.

Knowledge of NICE and BSH guidelines, and local anticoagulation pathways.

Car driver with access to own transport (for home-visiting roles).

Job Type: Zero hours contract

Pay: 26.77-49.00 per hour

Licence/Certification:

NMC (preferred)
Work Location: In person