Advanced Clinical Practitioner

Job description

Job responsibilities

Advanced clinical practice

Practise autonomously as an Advanced Clinical Practitioner, undertaking expert assessment, clinical examination, differential diagnosis, clinical decision-making, prescribing, care planning and management for people with complex and unstable palliative and end of life care needs.

Provide advanced clinical assessment and decision-making across community settings, including patients' homes, care homes, community clinics and other appropriate locations.

Work collaboratively with the three Palliative Medicine Consultants and other ACPs to provide senior clinical expertise across the three neighbourhood areas.

Provide senior clinical support to the approximately twenty five CNSs within the Community Specialist Palliative Care Service, enabling timely escalation and access to advanced clinical decision-making. Work closely with the Rapid Response Team to support urgent assessment and management of people with deteriorating or complex palliative care needs.

Contribute to a responsive same-day specialist palliative care service, providing timely assessment, advice and intervention for people with urgent or changing clinical needs.

Assess and manage people with complex symptoms and rapidly changing clinical conditions, using advanced clinical reasoning to determine appropriate management, escalation, referral or admission. Request relevant investigations and diagnostic tests where appropriate and within the agreed Scope of Practice.

Interpret assessment findings and investigation results to inform diagnosis, treatment and specialist palliative care management. Prescribe medicines safely and effectively within professional competence, legal frameworks and agreed LOROS policies.

Recognise and manage clinical risk, including situations requiring urgent escalation to medical, emergency or other specialist services. Make ethical, evidence-based decisions confidently and competently when faced with clinical complexity and uncertainty.

Support people with complex palliative care needs to remain in their preferred place of care wherever this is clinically appropriate and safe.

Contribute to reducing avoidable emergency department attendances and hospital admissions through timely specialist assessment, treatment, anticipatory planning and coordination of care.

Support timely and safe discharge from acute hospitals and other inpatient settings by providing specialist community palliative care input and ensuring appropriate follow-up and escalation arrangements.

Contribute to proactive identification of people who may benefit from specialist palliative care, working with neighbourhood teams and other professionals to facilitate earlier intervention where appropriate.

Support advance care planning, including appropriate documentation of goals of care, treatment escalation planning, ReSPECT and preferred place of care.

Communicate effectively with patients, carers and professionals regarding complex and sensitive clinical information, ensuring that agreed plans are clearly documented and accessible to relevant professionals. Ensure that care is coordinated across organisational boundaries and that patients and carers experience a coherent and responsive service.

Conduct appropriate follow-up, delegating and referring to other health and social care professionals and agencies when required. Make appropriate use of patient-reported outcome measures and other measures of clinical effectiveness to demonstrate patient outcomes and service impact. Collect and contribute to service data to support evaluation, quality improvement and evidence of effectiveness.

Work within appropriate legal frameworks, professional standards and LOROS policies. Maintain professional boundaries and comply with relevant NMC or HCPC requirements and standards for advanced clinical practice. Neighbourhood and integrated working

Contribute to the development of an integrated, neighbourhood-based model of specialist palliative care across three large geographical neighbourhood areas. Develop effective working relationships with GPs, community nursing teams, community services, care homes, acute hospitals, social care, voluntary organisations and other local partners.

Provide visible specialist palliative care leadership within the allocated neighbourhood while maintaining a whole-service perspective and contributing to cross-neighbourhood working. Work with neighbourhood partners to improve recognition of people approaching the end of life and facilitate timely access to appropriate specialist palliative care.

Support collaborative clinical decision-making across organisational boundaries, ensuring that care is provided by the right professional, at the right time and in the right place. Contribute to multidisciplinary discussions and case reviews involving people with complex needs.

Support effective communication and transfer of information between community, hospice and acute services.

Identify barriers to coordinated care and work collaboratively with partner organisations to resolve these. Promote the role of specialist palliative care within neighbourhood teams and support development of palliative care capability across the wider system. Contribute to service development and redesign to ensure that the community model remains responsive to population need and changing patterns of care.

Rapid response and same-day care Work collaboratively with the Rapid Response Team to provide timely specialist assessment and management of people with urgent or deteriorating palliative care needs.

Provide advanced clinical decision-making to support the Rapid Response Team when cases are complex or require senior clinical input.

Support rapid assessment and management of symptoms including pain, breathlessness, agitation, nausea, vomiting and other complex end of life symptoms. Contribute to decisions regarding treatment escalation, admission, discharge, hospice admission or continued management in the community. Support the development of clear escalation pathways between the Rapid Response Team, CNSs, ACPs, Consultants, GPs, community services and acute hospitals. 6. Contribute to reviewing urgent referrals and determining the most appropriate response from the Community Specialist Palliative Care Service.

Promote a culture of responsive, clinically appropriate intervention while ensuring that rapid response is integrated with proactive and planned specialist palliative care.

Clinical leadership and management

Provide visible clinical leadership across the Community Specialist Palliative Care Service, neighbourhood teams and partner organisations.

Work collaboratively with the three Consultants and two other ACPs to provide consistent senior clinical leadership and appropriate cross-cover across the three neighbourhoods. Support the CNS workforce through accessible senior clinical advice, case discussion, supervision and escalation.

Provide clinical leadership that promotes safe, coordinated and person-centred care. Act as a clinical role model, demonstrating high standards of professional behaviour, communication and decision-making.

Participate in clinical supervision and provide clinical supervision to colleagues within the Community Specialist Palliative Care Service as appropriate to experience and competence. Contribute to peer review and reflective practice for own practice and that of others. Identify gaps, risks and opportunities within community specialist palliative care provision and work with service leads and colleagues to develop and implement improvements.

Contribute to the development and implementation of local guidelines, protocols, pathways and standards. Support implementation of national policy and evidence relevant to specialist palliative and end of life care. Contribute to clinical governance, including incident reporting and investigation, complaints, risk management, clinical audit and learning from adverse events.

Promote effective use of LOROS resources and contribute to the development of cost-effective models of specialist palliative care. Promote the role and contribution of Advanced Clinical Practice within specialist palliative care and support the development of advanced clinical career pathways.

Contribute to workforce planning and service development as the neighbourhood model evolves. Support the development of a culture in which the whole community team works collaboratively across professional and organisational boundaries. Maintain professional registration and undertake continuing professional development appropriate to the role.

Maintain personal standards of conduct and behaviour consistent with LOROS Values & Behaviours and relevant professional guidance. Education and development.

Contribute to the development and delivery of specialist palliative care education for LOROS staff, community teams, primary care colleagues, care home staff and other professionals.

Job responsibilities

Advanced clinical practice

Practise autonomously as an Advanced Clinical Practitioner, undertaking expert assessment, clinical examination, differential diagnosis, clinical decision-making, prescribing, care planning and management for people with complex and unstable palliative and end of life care needs.

Provide advanced clinical assessment and decision-making across community settings, including patients' homes, care homes, community clinics and other appropriate locations.

Work collaboratively with the three Palliative Medicine Consultants and other ACPs to provide senior clinical expertise across the three neighbourhood areas.

Provide senior clinical support to the approximately twenty five CNSs within the Community Specialist Palliative Care Service, enabling timely escalation and access to advanced clinical decision-making. Work closely with the Rapid Response Team to support urgent assessment and management of people with deteriorating or complex palliative care needs.

Contribute to a responsive same-day specialist palliative care service, providing timely assessment, advice and intervention for people with urgent or changing clinical needs.

Assess and manage people with complex symptoms and rapidly changing clinical conditions, using advanced clinical reasoning to determine appropriate management, escalation, referral or admission. Request relevant investigations and diagnostic tests where appropriate and within the agreed Scope of Practice.

Interpret assessment findings and investigation results to inform diagnosis, treatment and specialist palliative care management. Prescribe medicines safely and effectively within professional competence, legal frameworks and agreed LOROS policies.

Recognise and manage clinical risk, including situations requiring urgent escalation to medical, emergency or other specialist services. Make ethical, evidence-based decisions confidently and competently when faced with clinical complexity and uncertainty.

Support people with complex palliative care needs to remain in their preferred place of care wherever this is clinically appropriate and safe.

Contribute to reducing avoidable emergency department attendances and hospital admissions through timely specialist assessment, treatment, anticipatory planning and coordination of care.

Support timely and safe discharge from acute hospitals and other inpatient settings by providing specialist community palliative care input and ensuring appropriate follow-up and escalation arrangements.

Contribute to proactive identification of people who may benefit from specialist palliative care, working with neighbourhood teams and other professionals to facilitate earlier intervention where appropriate.

Support advance care planning, including appropriate documentation of goals of care, treatment escalation planning, ReSPECT and preferred place of care.

Communicate effectively with patients, carers and professionals regarding complex and sensitive clinical information, ensuring that agreed plans are clearly documented and accessible to relevant professionals. Ensure that care is coordinated across organisational boundaries and that patients and carers experience a coherent and responsive service.

Conduct appropriate follow-up, delegating and referring to other health and social care professionals and agencies when required. Make appropriate use of patient-reported outcome measures and other measures of clinical effectiveness to demonstrate patient outcomes and service impact. Collect and contribute to service data to support evaluation, quality improvement and evidence of effectiveness.

Work within appropriate legal frameworks, professional standards and LOROS policies. Maintain professional boundaries and comply with relevant NMC or HCPC requirements and standards for advanced clinical practice. Neighbourhood and integrated working

Contribute to the development of an integrated, neighbourhood-based model of specialist palliative care across three large geographical neighbourhood areas. Develop effective working relationships with GPs, community nursing teams, community services, care homes, acute hospitals, social care, voluntary organisations and other local partners.

Provide visible specialist palliative care leadership within the allocated neighbourhood while maintaining a whole-service perspective and contributing to cross-neighbourhood working. Work with neighbourhood partners to improve recognition of people approaching the end of life and facilitate timely access to appropriate specialist palliative care.

Support collaborative clinical decision-making across organisational boundaries, ensuring that care is provided by the right professional, at the right time and in the right place. Contribute to multidisciplinary discussions and case reviews involving people with complex needs.

Support effective communication and transfer of information between community, hospice and acute services.

Identify barriers to coordinated care and work collaboratively with partner organisations to resolve these. Promote the role of specialist palliative care within neighbourhood teams and support development of palliative care capability across the wider system. Contribute to service development and redesign to ensure that the community model remains responsive to population need and changing patterns of care.

Rapid response and same-day care Work collaboratively with the Rapid Response Team to provide timely specialist assessment and management of people with urgent or deteriorating palliative care needs.

Provide advanced clinical decision-making to support the Rapid Response Team when cases are complex or require senior clinical input.

Support rapid assessment and management of symptoms including pain, breathlessness, agitation, nausea, vomiting and other complex end of life symptoms. Contribute to decisions regarding treatment escalation, admission, discharge, hospice admission or continued management in the community. Support the development of clear escalation pathways between the Rapid Response Team, CNSs, ACPs, Consultants, GPs, community services and acute hospitals. 6. Contribute to reviewing urgent referrals and determining the most appropriate response from the Community Specialist Palliative Care Service.

Promote a culture of responsive, clinically appropriate intervention while ensuring that rapid response is integrated with proactive and planned specialist palliative care.

Clinical leadership and management

Provide visible clinical leadership across the Community Specialist Palliative Care Service, neighbourhood teams and partner organisations.

Work collaboratively with the three Consultants and two other ACPs to provide consistent senior clinical leadership and appropriate cross-cover across the three neighbourhoods. Support the CNS workforce through accessible senior clinical advice, case discussion, supervision and escalation.

Provide clinical leadership that promotes safe, coordinated and person-centred care. Act as a clinical role model, demonstrating high standards of professional behaviour, communication and decision-making.

Participate in clinical supervision and provide clinical supervision to colleagues within the Community Specialist Palliative Care Service as appropriate to experience and competence. Contribute to peer review and reflective practice for own practice and that of others. Identify gaps, risks and opportunities within community specialist palliative care provision and work with service leads and colleagues to develop and implement improvements.

Contribute to the development and implementation of local guidelines, protocols, pathways and standards. Support implementation of national policy and evidence relevant to specialist palliative and end of life care. Contribute to clinical governance, including incident reporting and investigation, complaints, risk management, clinical audit and learning from adverse events.

Promote effective use of LOROS resources and contribute to the development of cost-effective models of specialist palliative care. Promote the role and contribution of Advanced Clinical Practice within specialist palliative care and support the development of advanced clinical career pathways.

Contribute to workforce planning and service development as the neighbourhood model evolves. Support the development of a culture in which the whole community team works collaboratively across professional and organisational boundaries. Maintain professional registration and undertake continuing professional development appropriate to the role.

Maintain personal standards of conduct and behaviour consistent with LOROS Values & Behaviours and relevant professional guidance. Education and development.

Contribute to the development and delivery of specialist palliative care education for LOROS staff, community teams, primary care colleagues, care home staff and other professionals.