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Job Description CNS Clinical Lead POST: BASE: ACCOUNTABLE TO: REPORTS TO: RESPONSIBLE FOR: CNS Clinical Lead St John s Hospice Head of Nursing and Quality Head of Nursing and Quality Community Clinical Nurse Specialists Admin Support (part time) JOB PURPOSE To manage and lead the specialist palliative community nurse team across the Hospice footprint. With a mix of direct patient contact and managerial responsibility as part of the Hospice s leadership team, the post holder will champion Hospice services throughout the dynamic and emerging integrated care pathways locally. KEY WORKING RELATIONSHIPS St Johns Hospice Services Clinical Nurse Specialist hospital based teams (RLI/RPI & BVH) Patients, family & carers. Voluntary organisations. GP practices Community nurse and AHP team. HR Coordinator Data Analyst Relevant strategic health & social care professionals MAIN DUTIES Service Development and Strategic Work Develop the service so the hospice s operational objectives and strategic vision for reaching more people are achieved. Work in partnership with a range of health and social care professionals in the planning and development of the service, promoting the involvement of service users. Work closely with Consultants in Palliative Medicine, NHS Leads, GP s District Nursing Teams all other relevant professionals and colleagues within St John s Hospice to sustain and further develop

effective partnerships and shared programmes delivering innovative integrated End of Life Care initiatives within primary and secondary care. Ensure up to date knowledge of local and national standards of care and be able to lead and inspire on the development of national agenda and strategies within our locality. Ensure that services are continually reviewed and adjusted to meet patients need and choice ensuring a culture of patient involvement and engagement through surveys and other mediums. Actively participate in relevant Peer Review and End of Life Care Quality Standards. Meet regularly with the Head of Nursing & Quality and Medical Director to report on and discuss service developments. Ensure effective relationships and communications with the Primary and Acute healthcare teams and Trusts and other professionals. Participate in local and national committees/steering groups and working parties as appropriate. Chair team meetings and encourage staff to actively and positively contribute to service development. As a member of the Clinical and Hospice Management Teams, participate in the development and implementation of the Hospice Strategy, vision and values. Leadership and departmental management Be an active member of St John s Hospice Management Team Have overall responsibility for the department, its services, staff and staffing levels. Lead and manage the team ensuring the right skills and capabilities are in place to deliver the strategic goals shared with partners. Build strong relationships and shared goals/work programmes with the Palliative Care Consultant, clinical leads in the community and hospital trusts. Ensure team members adhere to the NMC Code of Professional Conduct in the performance of nursing duties and are professionally accountable for their actions whilst on duty. Ensure the delivery of defined and agreed nursing standards within the department in line with national and required hospice specialist palliative care standards. Ensure that the team is up to date in evidence based specialist palliative care. Be responsible for the recruitment, selection and management of staff within the department. Monitor the workload of staff ensuring work is fairly allocated, forecasting demand for the service and ensuring sufficient resources are in place, to deliver high quality care within the departmental budget. Conduct regular team meetings to provide support and information, and foster two-way communication between all members of the team. Ensure all activities within the department are consistent with the Hospice s Policies & Procedures. Ensure the team work in accordance with NMC standards, community policies and SJH Policy for the management and administration of medications in the community. Act as a resource for patients, carers, staff and non-specialist groups of staff. Act as a change agent, developing clinically effective practice through the utilisation and integration of evidence. Facilitate the personal and professional development of individual team members to produce a cohesive and effective working team. Ensure the collection of accurate data for service activity and evaluation. Act as a visible leader within the team. Provide leadership that enables professional decision making and effective team working. Empower and enable staff to contribute to the delivery of high quality person-centred care.

Assist staff in identifying their own educational and development needs to support the work and development of the department, including mandatory training. Ensure all of the team achieve compliance with mandatory, statutory and professional education and training requirements. Create and maintain professional supportive relationships with all members of staff and with other professionals and agencies to enhance palliative care. Promote the health and wellbeing of staff and observe for any signs of ill health or stress, taking appropriate action in line with SJH policies, and HR advice. Ensure staff who are not working to their potential are supported through the performance management process, ensuring staff are aware of their responsibilities and requirements in their role. Participate in the Hospice s annual appraisal programme undertaking these with team members and assisting them to formulate their personal objectives in line with the Hospice objectives, as well as ensuring appropriate reviews of all team members. Ensure all staff are able to attend regular reflective practice sessions, encouraging resilience and team building. Undertake management of short term persistent or long term sickness absence, with the support of the HR Coordinator, reporting any issues to the Head of Nursing and Quality. Ensure an accurate record of annual leave entitlement; leave booked and taken is maintained via Cascade (HR Management System). Clinical Adhere to Hospice policies and procedures. Demonstrate expert knowledge by being visible and accessible. Maintain and develop own clinical skills by holding own patient case load to ensure regular direct clinical input. Adhere to NMC Code of Professional Conduct in the performance of nursing duties and to be professionally accountable for all actions while on duty. Hold clinical responsibility for the development and maintenance of a problem-solving approach to the assessment, planning, implementation and evaluation of care for all community patients. Demonstrate clinical competence and expertise in specialist and complex palliative care and display sound knowledge and excellent skills both face to face and when providing telephone advice. Demonstrate knowledge of the grief and bereavement process, recognising the need for referral and appropriate follow-up. Promote a multi-disciplinary approach to care by contributing to good inter-disciplinary communication and co-operation, both internally and with external colleagues. Assume responsibility for ensuring: liaison with the MDTM; assessment of patient needs and treatment plans; that nursing is holistic and patient-led; that nursing is evaluated within the framework of the hospice quality cycle; liaison with community services regarding patient care. Participate in the weekly Hospice MDT meetings, ensuring effective patient management including timely discharge. Appoint a deputy from the team in your absence. Be a role model and resource of specialist palliative care expertise for all MDT colleagues, applying highly developed evidence-based knowledge to influence the provision of complex symptom management. Work effectively with internal and external healthcare professionals, support services and other palliative care teams ensuring effective communication between all service providers. Co-ordinate referrals to the service ensuring effective and efficient acceptance of patients, liaising with referrers and the hospice MDT

Ensure that an agreed specialist palliative care plan of care is available for each patient and that patient participation is encouraged, whenever possible. Ensure effective record keeping and documentation so that data is accurate and supportive for present and future needs of the hospice services. Ensure an approach in palliative care that minimises risk and maximises clinical effectiveness. Be responsible for ensuring Infection Control guidelines are maintained within the department. Ensure all incidents are reported via the online Incident Reporting system. Additionally, high level incidents to be reported direct to Head of Nursing & Quality. Ensure all incidents are reviewed, actions carried out and lessons learned disseminated. Ensure safeguarding processes are followed when there are any such concerns for patients and families. Ensure that all communication is within the boundaries of client confidentiality, and to seek guidance when unsure. Ensure the principles of MCA and DoLS are followed by the team as appropriate. Ensure all staff work to their potential, giving person-centred care at all times to the patient and their family, supporting equality and diversity. Observe, report and record changes in the patient s physical and psychological wellbeing and ensure timely escalation to appropriate members of the multi-professional teams, where this is required. Undertake and document complex holistic nursing care assessments where these are indicated using specialist palliative care skills. Work in collaboration with patients as experts in their own care, promoting the principles of choice and individualised patient care, including Advanced Care Planning, to value and empower them as service users. Foster and maintain effective communications and promote collaborative working relationships with other professionals and formal carers providing relevant information about patients needs, clinical knowledge and shared goals to improve EOL care and provision in North Lancashire. Facilitate a team of critical and reflective thinkers whose goal is the expert delivery of complex quality care. Respond to questions or concerns from service users, carers, and staff in a timely and professional manner. Clinical Governance Be responsible for the development, implementation and maintenance of agreed clinical policies and procedures, ensuring that review and regular update is undertaken in line with the changing and developing service. Promote the development of clinical policies and procedures to facilitate practice developments, and benchmarking where possible, to ensure that the Hospice adheres to best practice and makes optimum use of resources to achieve the highest standards of care and service. Maintain a sound working knowledge of the legislation, policy and guidance necessary to care effectively for people with palliative care needs and their family. Be responsible for implementing relevant changes in the Hospice, in discussion with the Medical Director and Head of Nursing & Quality. Attend relevant clinical meetings and disseminate information to staff in the department. Arrange for a deputy from the team to attend in your absence.

Play a key role in the SJH Governance Programme, participating in, and supporting research and audit both within the Hospice, regionally and nationally. Contribute to Clinical Governance and the fundamentals of care within St John s Hospice via service improvement initiatives to improve standards of specialist care by developing practice to ensure that patients and carers have a quality experience, and to reduce risk and increase safety for staff and patients. Update the department s risk assessments twice yearly and make sure the actions to reduce risk are implemented at all times. Take an active role in quality assurance initiatives, including the setting and auditing of standards, and implementing resulting action plans. Be aware of the requirements of the Data Protection Act 1998 and follow codes of practice to ensure safeguarding of confidential information. Take a lead role in ensuring that the service is compliant with CQC requirements. Lead the team in ensuring that risk assessments and care plans for all patients are completed effectively and reviewed on a regular basis involving patients and carers wherever possible and appropriate. In co-operation with the Hospice service user policy develop systems to support user feedback. Ensure safe and effective use of equipment. Ensure near misses, incidents, accidents and faulty devices are reported to the relevant departments, investigated if needed, and learning disseminated. Manage and investigate service complaints, reporting findings and any formal action required or taken. Professional Development, Education & Audit Promote a culture of research and evidence-based practice within the team, to enhance personcentred care. Create an environment that supports life-long learning. Promote an environment conducive to the development needs of staff and volunteers, and participate in the teaching of staff including clinical staff, student placements, visiting students and volunteers. Promote a culture of continuous quality improvement through the use of audit, patient and carer feedback, and reflection on practice by self and other members of the team. Participate in the induction and orientation of new members of the team, ensuring clear aims, objectives and competencies are put in place, reviewed and met. Maintain and extend personal knowledge and expertise in all aspects of palliative care by identifying personal learning and development needs. Keep up to date with current issues in nursing and changes in clinical practice (both internally and externally) and to ensure ongoing personal development in line with NMC requirements. Attend reflective practice, as provided by the Hospice. Complete mandatory and statutory training as required by the role and the Hospice. Be prepared to represent the Hospice at meetings and events, to promote public awareness of the role of SJH. Provide and support a positive learning environment, and one that provides supervision and mentorship to both qualified and unqualified staff including students. Encourage all staff to be involved in the Hospice s education programme, leading and facilitating formal education as required. Support all registered nurses to meet their revalidation requirements, utilising their given study leave time to meet these.

STANDARD/ENHANCED DISCLOSURE REQUIREMENT Enhanced Disclosure + Barring Check required DUTIES AND RESPONSIBILITIES TO ST. JOHN S HOSPICE 1. Confidentiality Each member of the Hospice staff is responsible for ensuring the confidentiality of any information relating to patients, personal information relating to staff, volunteers, supporters, visitors or contractors, financial information, commercial information, and for complying with all the requirements of the Data Protection Act and Caldicot Guidelines whilst carrying out the duties of the post. Any breaches in Hospice confidentiality will be dealt with by St. John s Hospice Disciplinary Procedure and may result in dismissal. 2. Health and Safety Each member of the St Johns Hospice staff is responsible for ensuring that they carry out the duties of their post in accordance with all appropriate Health and Safety legislation, guidance and procedures and they do not, by any act or omission on their part, create a threat to the Health and Safety of any other person. 3. External Interests Each member of the St Johns Hospice staff is responsible for ensuring that any external interest they have do not conflict with the duties of their posts and they must disclose the external interest if this is likely to occur, or if they are in doubt about a possible conflict with their work. Each member of staff is reminded to refer to their employment contract in relation to any other secondary work that they may do alongside working for St John s Hospice and their obligations under the Working Time Directive. 4. Statutory Training Each member of the St Johns Hospice staff has a statutory obligation to attend mandatory training. It is the responsibility of each member of staff to ensure that they comply with this legal requirement. 5. Flexibility This job description is intended to act as a flexible guide to the duties of the post and therefore will require revision in consultation with the post holder to reflect the changing requirements of the post, to enable the St John s Hospice to achieve its corporate goals and objectives. 6. Safeguarding Each member of St John s Hospice staff is responsible for understanding their responsibilities for Safeguarding Children and Vulnerable Adults in accordance with their job role and any requirements they are obliged to follow as members of their profession. Staff should seek guidance from their immediate supervisor if in doubt.

7. Disclosure and Barring Each member of staff is required to disclose any caution, fine, penalty or criminal conviction that may occur during the course of employment. This should include any motoring convictions as this may affect the staff member s ability to use Hospice vehicles. Any change in circumstance must be reported immediately to the staff member s supervisor so that any impact on ability to work in post can be assessed. 8. Equality and Inclusion Each member of staff is required to undertake their duties with due regard for the provisions of the Equality Act 2010 i.e. not to discriminate against members of staff, patients, patient family members, volunteers, supporters, contractors and any visitors to the Hospice. 9. Volunteers The role of volunteers is integral with the work of St John s Hospice and paid staff are required to underpin this in their attitude and actions.