Job Description

Specialist Long Term Condition Nurse (Diabetes essential) Job Title: Specialist Long Term Condition Nurse Responsible to: Lead Nurse / Practice Manager Working Hours: 2 days per week Wednesday and Friday preferred (negotiable) Salary: Negotiable depending on qualifications and experience Job Summary: To deliver high-quality, evidence-based care for patients with long-term conditions (LTCs) in a GP Practice setting. The post holder will take a lead role in the clinical management of conditions such as diabetes (essential), COPD, asthma, hypertension, and cardiovascular disease. They will provide patient education, medication management, and lifestyle support while working closely with GPs and the wider multidisciplinary team. Key Responsibilities: Clinical Care Undertake holistic assessments, reviews, and ongoing management for patients with LTCs.



Lead disease-specific clinics (e.g., diabetes, respiratory, cardiovascular). Interpret results and take appropriate actions including medication changes within scope of practice. Use evidence-based guidelines to ensure best practice and continuity of care. Provide support and education to patients to self-manage their conditions effectively.



Prescribing & Medication Management If a qualified prescriber, initiate and manage medication changes. If not qualified, work under Patient Group Directions or alongside prescribers. May be supported to undertake Prescribing Qualification (subject to funding and suitability). Team Working Work collaboratively with GPs, nurses, healthcare assistants, pharmacists, and administrative teams.



Contribute to MDT discussions and case management of complex patients. Participate in audits, QOF, and service improvement initiatives. Professional Development Maintain registration and compliance with NMC Code of Conduct. Attend regular training and updates, including relevant CPD.



Reflect on practice and participate in clinical supervision and annual appraisal. Desirable Clinics/Skills (not essential): Insulin initiation or titration General Responsibilities: Maintain patient confidentiality and adhere to data protection regulations. Follow practice protocols and procedures to ensure compliance and efficiency. Promote a safe working environment by adhering to health and safety regulations.



Support equality and diversity in the workplace. Participate in ongoing professional development and mandatory training. Communicate effectively with colleagues, patients, and external healthcare providers. Contribute to practice improvements and participate in audits.

Confidentiality:

In the course of seeking treatment, patients entrust us with, or allow us to gather, sensitive information in relation to their health and other matters. They do so in confidence and have the right to expect that staff will respect their privacy and act appropriately In the performance of the duties outlined in this , the post-holder may have access to confidential information relating to patients and their carers, Practice staff and other healthcare workers. They may also have access to information relating to the Practice as a business organisation. All such information from any source is to be regarded as strictly confidential Information relating to patients, carers, colleagues, other healthcare workers or the business of the Practice may only be divulged to authorised persons in accordance with the Practice policies and procedures relating to confidentiality and the protection of personal and sensitive data Practice Protocols: The practice has Protocols in place for Clinical and Administrative tasks, staff are required to adhere to all Practice Protocols, it is essential that all staff keep up to date with protocols and advise of any changes needed.



All protocols are stored on the Practice Intranet. Health & Safety: The post-holder will assist in promoting and maintaining their own and others health, safety and security as defined in the practice Health & Safety Policy, the practice Health & Safety Manual, and the practice Infection Control policy and published procedures. This will include: Using personal security systems within the workplace according to Practice guidelines Identifying the risks involved in work activities and undertaking such activities in a way that manages those risks Making effective use of training to update knowledge and skills Using appropriate infection control procedures, maintaining work areas in a tidy and safe way and free from hazards Actively reporting of health and safety hazards and infection hazards immediately when recognised Keeping own work areas and general / patient areas generally clean, assisting in the maintenance of general standards of cleanliness consistent with the scope of the job holders role Undertaking periodic infection control training (minimum annually) Reporting potential risks identified Equality and Diversity: The post-holder will support the equality, diversity and rights of patients, carers and colleagues, to include: Acting in a way that recognizes the importance of peoples rights, interpreting them in a way that is consistent with Practice procedures and policies, and current legislation Respecting the privacy, dignity, needs and beliefs of patients, carers and colleagues Behaving in a manner which is welcoming to and of the individual, is non-judgmental and respects their circumstances, feelings priorities and rights. Personal/Professional Development: The post-holder will participate in any training programme implemented by the Practice as part of this employment, such training to include: Participation in an annual individual performance review, including taking responsibility for maintaining a record of own personal and/or professional development Taking responsibility for own development, learning and performance and demonstrating skills and activities to others who are undertaking similar work Attend compulsory training, such as Fire Awareness and infection control, and any other training the practice feels is necessary for the safe running of the practice.

Quality:

The post-holder will strive to maintain quality within the Practice, and will: Alert other team members to issues of quality and risk Assess own performance and take accountability for own actions, either directly or under supervision Contribute to the effectiveness of the team by reflecting on own and team activities and making suggestions on ways to improve and enhance the teams performance Work effectively with individuals in other agencies to meet patients needs Effectively manage own time, workload and resources Communication: The post-holder should recognise the importance of effective communication within the team and will strive to: Communicate effectively with other team members Communicate effectively with patients and carers Recognise peoples needs for alternative methods of communication and respond accordingly Contribution to the Implementation of Services: The post-holder will: Apply Practice policies, protocols, standards and guidance Discuss with other members of the team how the policies, protocols, standards and guidelines will affect own work Participate in audits where appropriate