Job Description

Main Duties and Responsibilities of Post To be competent and confident in managing people with long term health conditions To ensure practice guidelines relating to Asthma, COPD, Diabetes and CVD are up to date, discuss any changes and implement in collaboration with Clinical Leads. To audit each disease area is moving toward target, highlight and action any problem areas discuss any issues with Clinical Leads. To proactively identify, diagnose and manage treatment plans for patients at risk of developing a long term condition. To diagnose and manage long term conditions, integrating both drug-and nondrug-based treatment methods into a management plan (as appropriate).



To review and re-authorise medication for therapeutic effectiveness, appropriate to patient needs and in accordance with evidence-based practice and national and practice protocols, and within scope of practice. To work with patients to support compliance with, and adherence to, prescribed treatments, promoting self-management. To provide information and advice on prescribed or over-the-counter medication, medication regimes, side-effects and interactions to long term conditions. To provide assessment, screening, treatment, monitoring and health education advice to long term conditions.



To utilise and demonstrate sensitive communication styles, to ensure patients are fully informed and consent to treatment. To prioritise own workload and ensure effective time-management strategies are implemented. To produce accurate, contemporaneous and complete records of patient consultations and treatments, consistent with legislation, policies and procedures. To undertake home visits, as appropriate.



To attend and participate in Practice meetings. To recognise and work within own competence and professional code of conduct as regulated by the NMC. To deliver care according to NICE guidelines and other relevant evidence-based care. Any other delegated duties appropriate to the post