Job Description

WORCESTERSHIRE ACUTE HOSPITALS NHS TRUST JOB DESCRIPTION Post Title: Senior Advanced Neonatal Nurse Practitioner Pay Band: 8b Hours: Full time 37.5 hours per week Contract: Permanent Location / Department: Neonatal Services, Paediatric Directorate Worcestershire Royal Hospital Accountable to: Divisional Director of Nursing (Professionally) Reports to: Neonatal Consultant Lead Ref: Key Working Relationships: Chief Nurse/Deputy Chief Nurses/Divisional Director/Divisional Director of Operations/Divisional Director of Nursing/Director of Midwifery/Deputy Divisional Directors/ Directorate Manager/Clinical Leads of Service/Matrons/Ward Managers/Consultants/Medical Staff/ All Nurses/AHPs and support workers/Clinical Governance team/Parents and families, Neonatal ODN and any other relevant external Agencies. Risk Assessment: Works with display screen equipment Manual handling activities and exposure to body fluids and chemicals Individual may be exposed to violence and aggression. Job Purpose: The postholder is an experienced Advanced Neonatal Nurse Practitioner (ANNP) and an integrated member of the neonatal multidisciplinary team. They will practise with a high degree of professional and personal autonomy, working independently with an agreed scope of practice, with clinical supervision from a Consultant Neonatologist, when required.



Care delivery will be evidence-based, underpinned by advanced clinical skills and sound clinical reasoning. The postholder will work on the Tier 2 (middle grade) medical rota, holding the neonatal registrar bleep and will work to an agreed job plan. Key responsibilities: Exercise independent judgement to assess, investigate, diagnose, plan, implement and evaluate the care of premature, sick newborns. Make judgements involving complex information, using analysis and interpretation to ensure safe, effective, and family centred care.



Manage and coordinate care in complex clinical situations when a neonatal consultant is not immediately available, escalating appropriately when required. Act as an independent non-medical prescriber in line with NMC and professional standards. Provide supervision, teaching, and educational support to members of the neonatal team within the clinical environment. Participate in relevant research activity to inform and improve clinical care.

Key Duties:

The post holder will: Provide continuity of care by sharing patient and family information effectively with the rotating neonatal services team. Coordinate discharge planning including arranging medical follow up for complex and/or long-term neonatal patients. Provides day-to-day clinical leadership, guidance, and mentorship to junior doctors and junior ANNPs on the Tier 1 rota under the supervision of the Neonatal Consultants. Support the supervision and professional development of junior ANNPs in clinical practice, including participation in annual personal development reviews in collaboration with the neonatal lead consultant.



Undertake medical reviews of babies in the Neonatal Unit (NNU), Delivery Suite, Transitional Care Unit, Postnatal ward, and Meadow Birth Centre. Work collaboratively with the multidisciplinary team including paediatrics, nursing, midwifery, obstetrics, and allied healthcare professionals to deliver high quality, family integrated care within neonatal services. Practices within neonatal guidelines, exercising advanced clinical judgement to assess, diagnose, plan, implement and evaluate the care of premature and sick babies and their families. Demonstrates expertise in advanced neonatal skills and knowledge in clinical practice.



Supports the education and skills development of medical, nursing, and allied health professional staff within the neonatal service. Contributes to neonatal service improvement by engaging in audit, quality improvement and guideline development activities. Asses the medical need for admission and transfer, including stabilisation for transport, of preterm or critically ill neonate. Maintains Nursing and Midwifery Council (NMC) registration and revalidation requirements.



Works in line with the British Association of Perinatal Medicine (BAPM) ANNP Capabilities Framework at Senior/Expert level (2021). Holds non-medical prescribing qualification and practise within NMC and Royal Pharmaceutical Society standards for prescribers. Main Duties and Responsibilities Local Delegated Clinical Responsibilities Undertakes daily responsibilities of a registrar on tier 2 medical rota, including holding registrar bleep. Participates in daily neonatal ward rounds, engaging with parents/caregivers, medical and nursing team members to provide holistic assessment, formulate differential diagnosis, plan care and evaluate outcomes.



Provide timely senior review for junior medical staff, ANNPs on the Tier 1 rota, nursing/midwifery staff as required. Attend high-risk deliveries and emergency calls to leading the immediate management of sick or premature infants in line with local protocols. Use advanced knowledge and skills to manage emergency situations within neonatal clinical areas, escalating to the consultant as appropriate. Apply clinical reasoning underpinned by a comprehensive understanding of neonatal physiology and pathophysiology to plan and manage care episodes from birth to discharge.



Assess the health status of through physical examination, medical history, and social assessment to establish differential diagnosis. Plan, implement and evaluate care in accordance with best evidence, national guidance, and local protocols. Provide senior clinical advice regarding admission, transfer, and discharge from neonatal services to optimise patient safety, acuity management and cot capacity. Request and interpret clinical investigations, acting on results appropriately within scope of practice.



Refer to specialist healthcare professionals and centres, seeking guidance from the neonatal consultant when required. Liaise with medical and transport teams for neonates requiring transfer to other neonatal or childrens hospitals. Coordinate the stabilisation of sick and/or extremely preterm neonates for urgent transfer to tertiary centres in collaboration with the local consultant and tertiary / transport teams. Work with families, neonatal consultants, the multidisciplinary team, community outreach services and relevant community organisations to facilitate safe and effective discharge planning.



Lead discharge planning for complex and/or long-term neonatal patients in partnership with the neonatal community outreach service and neonatal consultants. Identify and document the psychosocial needs of each family and baby in collaboration with the multidisciplinary team. Promote family centred care through regular communication with parents about their babys progress and by encouraging active involvement in care planning and delivery. Ensure all aspects of care and communication are documented accurately and contemporaneously in both written and electronic records.



Practical Procedures The senior ANNP will perform advanced practical and diagnostic procedures, seeking advice and support from a consultant as required and in accordance with local and national clinical guidelines. Procedures will include, but are not limited to: Initiation and ongoing management of neonates receiving mechanical ventilation, including intubation and insertion of alternative airway devices. Application of ventilation strategies appropriate to clinical conditions, adjustment of ventilation settings and extubation. Administration of surfactant via endotracheal tube (ETT) or alternative less invasive techniques.



Investigation and management of suspected pneumothorax, including needle aspiration, chest drain placement and removal. Initiation and prescribing of treatment, intravenous fluids, and parenteral nutrition within local and national guidance. Advanced resuscitation including emergency drug administration in line with local neonatal guidelines. Blood sampling via capillary, venous, arterial, and indwelling arterial/venous catheters.



Insertion and removal of intravenous cannulas and longlines (percutaneous central venous lines). Insertion and removal of peripheral arterial line, umbilical venous lines, and umbilical arterial lines. Lumbar puncture with interpretation and action of results. Insertion and removal of urinary catheters and suprapubic aspiration of the bladder when clinically indicated.



Clinical examination and assessment including examination of the newborn. Ordering, interpretation and acting upon laboratory tests, radiological imaging, and other investigations. Diagnosis pathophysiology conditions and undertaking dilution and/or exchange transfusion as appropriate. Performance and interpretation of cranial ultrasound.



Electrocardiogram (ECG) and cerebral function monitoring (CFM) recording and interpretation.