Required: Advanced Nurse Practitioner in General Practice Shifnal & Priorslee Medical Practice Shrewsbury Road Shifnal Shropshire TF11 8AJ Job Summary Salary: 35,000 to 45,000 Closing Date : 5 December 2014 An Advanced Nurse Practitioner at Shifnal and Priorslee Medical Practice will be an experienced Nurse who, acting within their professional boundaries, will provide care for patients presenting at the Practice from initial history taking, clinical assessment, diagnosis, treatment and evaluation of care. They will demonstrate safe, clinical decision-making and expert care, including assessment and diagnostic skills, for patients within the General Practice. The post holder will demonstrate critical thinking in the clinical decision-making process. They will work collaboratively with the General Practice team to meet the needs of patients, supporting the delivery of policy and procedures, providing leadership as required. Key Responsibilities Clinical Practice Assess patients presenting with acute illness or for review of chronic disease conditions. Undertake home visits for acute illness or chronic disease management. Diagnose, plan implement and evaluate treatment/interventions and care for patients presenting with an undifferentiated diagnosis. Clinically exam and assess patient needs from a physiological and psychological perspective, and plan clinical care accordingly. Assess diagnosis, plan, implement and evaluate interventions/treatments for patients with complex needs. Proactively identify, diagnose and manage treatment plans for patients at risk of developing a long-term condition (as appropriate). Diagnose and manage both acute and chronic conditions, integrating both drugs and non-drugbased treatment methods into a management plan. Prescribe and review medication for therapeutic effectiveness, appropriate to patient needs and in accordance with evidence-based practice and national and practice protocols and formularies. Work with patients and their carers in order to support compliance with and adherence to prescribing treatments. Provide information and advice on prescribing or over-the-counter medication on medication regimens, side-effects and interactions.
Prioritise health problems and intervene appropriately to assist the patient in complex, urgent or emergency situations, including initiation of effective emergency care. Support patients to adopt health promotion strategies that promote healthy lifestyles, and apply principles of self care. 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. Implement and participate in vaccination and immunisations programmes for both adults and children. Undertake minor surgery as appropriate to competence. Communication Utilise and demonstrate sensitive communication styles, to ensure patients are fully informed and consent to treatment. Communicate with and support patients who are receiving bad news Communicate effectively with patients and carers, recognizing the need for alternative methods of communication to overcome different levels of understanding, cultural background and preferred ways of communication. Anticipate barriers to communication and take action to improve communication Maintain effective communication within the Practice environment and with external stakeholders. Attend and contribute to practice and primary care team meetings. Delivering a Quality Service Recognise and work within own competence and professional cod of conduct as regulated by the NMC. Produce, organize and manage own workload in a manner that maintains and promotes quality. Deliver care accordingly to NSF,NICE guidelines and evidence-based care. Assess effectiveness of care delivery through self and peer review, benchmarking and formal evaluation. Initiate and participate in the maintenance of quality governance systems and processes across the organization and its activities. Utilise the audit cycle as a means of evaluating the quality of the work of self and team, implementing improvements where required. In partnership with other clinical teams, collaborate on improving the quality of health care responding to local and national policies and initiatives as appropriate. Evaluate patients response to health care provision and the effectiveness of care. Support and participate in shared learning across the practice and wider organization. Actively participate in the practice significant event procedures. Ensuring learning and actions from significant event reviews are implemented and reviewed. Assess the impact of policy implementation on care delivery. Understand and apply legal issues that support the identification of vulnerable and abused children and adults, and be aware of statutory child/vulnerable patients health procedures and local guidance.
Leadership Personal and People Development Take responsibility for own learning and performance including participating in clinical supervision and acting as a positive role mode. Support staff development in order to maximize potential. Actively promote the workplace as a learning environment, encouraging everyone to learn from each other and from external good practice. Support and contribute to the teaching of nursing staff/ medical students/gp registrars and administration staff as appropriate. Encourage others to make realistic self-assessment of their application of knowledge and skills, challenging any complacency or actions that are not in the interest of the public/or users of services. Critically evaluate and review innovations and developments that are relevant to the area of work. Enlist support and influence stakeholders and decision-makers in order to bring about new development in the provision of services. Take a lead role in planning and implementing changes within the area of care and responsibility. Work with practice Management to ensure sufficient staff of appropriate ability, quality and skillmix are available to meet current and future delivery that selection and recruitment processes are effective and that equality of treatment of the team incorporates quality HR principles and processes. Contribute to the development of local guidelines, protocols and standards. Maintain effective communication with those responsible for the overall commissioning and procurement process. Maintain active involvement in the planning and processing of practice-based commissioning or similar initiatives. Team Working Understand own role and scope and identify how this may develop over time. Work as an effective and responsible team member, supporting others and exploring the mechanisms to develop new ways of working. Delegate clearly and appropriately, adopting the principles of safe practice and assessment of competence. Create clear referral mechanisms to meet patient need. Prioritise workload and ensure effective time-management strategies are embedded with the culture of the team. Work effectively with others to clearly define values, direction and policies impacting upon care delivery. Discuss, highlight and work with the team to create opportunities to improve patient care. Manage and leaf on the delivery of specifically identified services or projects as agreed with the practice management team. Agree plans and outcomes by which to measure success.
Managing Information Use technology and appropriate software as an aid to management in planning, implementation and monitoring of care, presenting and communicating information. Review and process data using accurate Read codes in order to ensure easy accurate information retrieval for monitoring and audit processes. Manage information searches using the internet and local library databases. Understand responsibility of self and others to the practice regarding the Freedom of Information Act. Collate analyse and present clinical data and information to the team. Learning and Development Undertake mentorship for more junior staff, assessing competence against set standards. Disseminate learning and information gained to other team members in order to share good practice and inform others about current and future development (eg courses and conferences). Assess own learning needs and undertake learning as appropriate. Equality Identify patterns of discrimination and take action to overcome this and promote diversity and equality or opportunity. Enable others to promote equality and diversity in a non-discriminative culture. Support people who need assurance in exercising their rights. Monitor and evaluate adherence to local chaperone policies. Act as a role model in the observance of equality and diversity good practice. Accept the rights of individuals to choose their care providers, participate in care and refuse care.
Personal Specification Knowledge Essential Advanced clinical practice skills Management of patients with long-term conditions Desirable Knowledge of public health issues Able to identify determinants on health in the area Management of patients with complex needs Knowledge of public health issues on the area Clinic examination skills Accountability of own role and other roles in a nurse-led service Local and national health policy Wider health economy Clinical governance issues in primary care Patient group directions and associated policy Skills Clinical leadership skills Communication shills, both written and verbal Experience Communication of different messages to patients and families Negotiation and conflict management skills change management Teaching and mentorship clinical setting Resource management Minimum 5 years post registration experience At least 2 years recent primary can community nursing experience Nurse-led management of minor illness, minor ailments and injuries Nurse-led triage including telephone triage Compiling protocols and clinical guidelines Leadership in quality initiatives such as clinical benchmarking Audit Extended and supplementary nurse prescribing Project management Working with community development initiatives Health-needs assessment Home visit assessment of patients Sexual health including fitting/removal of IUCD and Nexplanon Minor surgery Child health surveillance 5
Qualifications Registered first level nurse MSc or equivalent Relevant nursing/health degree Mentor/teaching qualification Clinical supervision training and experience Extended/independent nurse Community nursing specialist Other Full driving Licence Self-directed practitioner Highly motivated Flexibility Enthusiasm Team player Ability to work across boundaries 6
Shifnal & Priorslee Medical Practice Candidate Briefing Pack For the post of: Advanced Nurse Practitioner 37.5 hours per week 1. Background information Shifnal & Priorslee Medical Practice Shifnal Medical Practice was established in the late 50 s, located in Idsall House in the market town of Shifnal. In the early 70 s it moved to the current premises, which has been extended twice. The Practice has a patient population of approximately 9,800 and is still growing. We expect this growth to continue for some time due to the extensive ongoing development in both Shifnal and Priorslee. It has very close to the motorway network, with easy access to Wales and the West Midlands. In 2000 The Practice changed its name to Shifnal and Priorslee Medical Practice when it opened a large branch surgery in Priorslee, which is just 3 miles from the main surgery. Practice population The Practice population is varied with an older population in Shifnal and a younger population in the Priorslee area. We serve both urban and rural areas with little deprivation. There is currently one Residential Home within our Practice area. The Practice has a well established Patient Group. Contract & Enhanced Services We hold a GMS Contract, which provides the usual range of Services. The Practice has opted out of Out of Hours provision and this Service is covered by the local OOH coop;shropdoc. There is, however, the option to join the coop should you wish. We participate in offering extended hours providing early morning surgeries between 7-8AM in addition to our normal hours. All Partners/GP s take their fair share in providing this additional service. The Practice provides a full range of enhanced services including minor surgery, reversible contraception, near patient testing, initial DVT assessment, minor injuries and childhood immunisations. We also participate in the Patient Participation Group DES, provide a Vasectomy and Shared Care Drug Misuse Clinic. Research The Practice is involved in clinical research and currently we are engaged with the Primary Care Research Network and are undertaking the following Studies: HEAT Study ~ a trial on the benefit of treating H. Pylori in patients on Aspirin CONTACT Study ~ a trial on low dose colchicine or an oral NSAID in acute gout Barack D ~ a trial on the benefit of Aldosterone for Chronic Kidney Disease Management We have recently reorganised the management structure to make it more robust and efficient in today s challenging NHS. The Team currently consists of Maxine Maguire (Managing Partner), Richard Shore (Clinical Manager) the remaining Partners (areas of specific responsibility), Susan Sousa (Nurse Manager), Caroline Beale and Bev Gordon (Office Managers ). The Clinical Manager works with the Managing Partner overseeing QOF and clinical services to ensure maximum effectiveness and profitability. We achieve high QOF points. Work Force At present we have 3 GP Partners working full-time (minimum 8 sessions). The 4th Partner has recently retired and with the growing population it was felt necessary to not only replace him but to increase the total number of Partners/GP s in the Practice. It is expected as the Practice population 7
grows we will recruit more clinicians. Most importantly is that we find the right people who will be the right fit for our team. Motivated, flexible, and empathetic. The Practice Nursing Team comprises a Nurse Practitioner/Prescriber, 3 Nurses and 2 Health Care Assistants. All Nurses carry out triage as well as practice nurse duties. The Practice is well supported by administration and reception staff on both sites, mainly part-time. Membership Shropshire Clinical Commissioning Group Shropshire Federation PCRN CQC inspection We recently had a CQC inspection and were congratulated on how well the Practice was organised. We successfully fulfilled all requirements of the inspection. Patient feedback was very positive. Patient Involvement We have had a PPG for some years and are currently encouraging our patients to join our Virtual Patient Participation Group to broaden our patient demographics, as we realize there are certain patient groups we do not hear from. Computer Systems We use Emis Web and Docman and are paper light. Patients are encouraged to use an online service and can book appointments, order repeat prescriptions and change personal details. We currently subscribe to Blue Stream Academy for online training which covers health and safety, clinical governance, safeguarding etc. 8