Advanced Clinical Practitioner - Urgent Care

Job overview

We are looking for a highly motivated, experienced and capable Advanced Clinical Practitioner (ACP) to provide expert high quality clinical care and share leadership responsibilities across our 2 Urgent Care/Treatment Centres

Main duties of the job

After an induction period, the ACP will work across the 4 pillars of practice with an emphasis on autonomous advanced level clinical practice managing patients presenting with minor injury and illness. They will work closely with the other UCC ACPs , the Consultant Nurse and Head of Nursing in leading the UCC/UTC on both the Guys and St Thomas' site. This will involve line management of Emergency Practitioner workforce, roster management, recruitment and HR activities.

They will have a key role in teaching on the internal minor injuries course and other educational requirements across the department/Trust and wider, as well as an important role in providing supervision to internal and external learners.

They will also have an important role in quality improvement, service development, audit, as well as opportunities for involvement in research activities

Working for our organisation

Guys and St Thomas' NHS Trust has 2 UCC/UTCs including a stand alone UCC based at Guys Hospital staffed by Emergency Practitioners, GPs and RNs open 08:00 - 20:00 7/7 and a UCC at St Thomas which is co-located with the Emergency Department staffed by Emergency Practitioners, Emergency Medicine Doctors, ACPs, RNs and Senior Nursing Assistants open 24/7

Our current staffing across both units includes; a Consultant Nurse, a ACP/Lead (UCC), a ACP/Physiotherapist, 25 Emergency Practitioners, 7 trainee Emergency Practitioners, 7 assessment/triage nurses, 4 Senior Nursing Assistants (people in post, not FTE)

The UCC team provides a supportive and nurturing environment to new , experienced and trainee staff. We seek to provide the high standards of evidenced based care and aim to continually improve, and expand our service to meet changing healthcare and service demands. Moreover, the Urgent Care team sits within the bigger Urgent and Emergency Care team where it contributes to education, QI, clinical governance, service improvement initiatives as well as a significant role in overall performance. 

This role forms part of our workforce development plan as we develop and progress clinical career pathways 

We value every single member of our team

Detailed job description and main responsibilities

Clinical:

·The ACP will be expected to work autonomously and manage their own caseload of patients. This role involves working as part of the multi-disciplinary team, ensuring continuity and a high standard of assessment, diagnosis and treatment of patients presenting to the Urgent Care/Treatment Centres on either the Guys or St Thomas' site

·This role will include the prescribing of medicines.

·The ACP should have experience working within the field of urgent care, with the capability to demonstrate advanced clinical reasoning and diagnostic skills when caring for patients’ presenting with undifferentiated health problems of varying acuity and severity.

·The ACP should have the ability to initiate and interpret investigations including: skeletal X-ray, standard blood tests and other diagnostic imaging reports. 

·They should be competent in clinical skills such as: Wound closure with sutures; reduction of dislocations and fracture manipulation; nerve blocks and plaster/cast application.

·Practise in accordance with the respective code of professional conduct and within designated scope of practice, responsible and accountable for own decisions, actions and omissions at this level of practice.

·Demonstrate a critical understanding and adhere to the defined boundaries of advanced practice in this role.

·Be a source of expert opinion for other staff across professional boundaries.

·Have interpersonal skills that encourage patients and carers active participation in their care. Have advanced verbal and non-verbal communication skills. . Be able to receive and disseminate complex clinical information sensitively in all professional contexts, adapting to cultural and socioeconomic complexity. 

·Use expertise and decision-making skills to inform clinical reasoning approaches when dealing with differentiated and undifferentiated individual presentations and complex situations, synthesising information from multiple sources to make appropriate evidence informed judgements and diagnoses. 

·To act as a clinical role model / advocate for developing and delivering care that is responsive to changing requirements.

·To be responsible for ordering investigations as appropriate and provide treatment and care both individually, as part of a team, and through referral to other agencies.

·Will have the authority to admit or discharge patients from their caseload and refer patients to other health care providers as appropriate if this is within the scope of practice.

·To evidence the underpinning subject-specific competencies to demonstrate capabilities that are appropriate to the individual, role setting and scope.

· Undertake complaint investigations relating to patient care, leading the development of action plans to address area(s) of concern, identify learning and propose change to practice.

·To have the knowledge and capability to appropriately apply national guidelines and legislation relating to health and social care to local service provision

Leadership and Management

·To contribute to the Trust’s, Directorates and Teams Clinical Governance and Quality assurance programmes, setting and monitoring practice standards, jointly developing guidelines, protocols and innovative solutions with the service and in liaison with interdisciplinary colleagues.

·To lead and manage staff within the service, providing effective guidance, supervision, mentorship and performance management at an advanced level.

·Work with the clinical lead and Human Resources Department in the recruitment, selection, appointment and retention of staff.

·To work in close partnership with the appropriate Clinical Leads and Service Managers to ensure relevant national initiatives and targets in relation to speciality are met.

·To inform the service of changes in clinical practice which may influence service delivery, business planning and strategic reviews to support the delivery of meeting agreed objectives.

·To influence clinical reasoning and decision making to enhance quality, reduce unwarranted variation and promote the sharing and adoption of best practice.

·To pro-actively initiate and develop effective relationships, fostering clarity of roles within teams across the Trust and wider health economy to encourage effective and efficient services.

·To evaluate own practice and participate in multi-professional team and service evaluation, demonstrating the impact of advanced practice on service function, effectiveness and quality, outcomes, experience and safety.

·To actively engage in peer review to inform own and other’s practice. The practitioner will have the capability to be able to, formulate and implement strategies to act on learning and make improvements.

·To lead new practice and service redesign solutions within a quality improvement (QI) framework in response to feedback, evaluation, need and current evidence, working across boundaries.

·To actively seek feedback, involvement and engagement with patients, carers, their families, service users and colleagues in the co-production of service improvements.

·To demonstrate team leadership, resilience and determination, managing situations that are unfamiliar, complex or unpredictable.

·To constructively challenge others, escalating concerns that may affect patients, carers, and colleague’s safety and well-being.

·To actively participate, plan or lead working groups proposing policy changes which may have when appropriate, a broad application across other departments and disciplines as an integral part of the job.

·To line manage members of the team where appropriate ensuring regular mentorship, supervision and effective performance reviews are conducted. To have and demonstrate a knowledge of budget management.

·To utilise advanced communication skills acting as a prime educator of other staff on own area of clinical expertise and on the role and scope of the service.

Education

·To critically assess and address own learning needs, developing a personal development plan that reflects the breadth of ongoing professional development across the four pillars of advanced clinical practice.

·To engage in own supervision, mentorship and performance review to continually demonstrate learning and development in the advanced role.

·To engage in self-directed learning at an advanced level, critically reflecting to maximise clinical skills and knowledge as well as own potential to lead and develop care and services.

·To advocate for and contribute to a culture of organisational learning to inspire future and existing staff.

·To support the team to build capacity and capability through work based learning and inter-professional learning.

·To act as a role model, educator, supervisor, coach and mentor seeking to instil and develop confidence and capability in others.

·To teach / deliver core or specialist training to the multi-professional workforce.

Research and Quality Improvement (QI )

·To clinically engage in research/ QI activity, adhering to good research/ QI practice guidance, so that evidenced based strategies are developed and implemented to enhance quality, safety, productivity and efficiency.

·To evaluate and audit own and other’s clinical practice.

·To critically appraise and synthesise the outcome of relevant research and QI evaluations using the results to underpin own practice and to inform that of others.

·To adopt a critical approach to identify gaps in the evidence base, alerting appropriate individuals and organisations to these and how they might be addressed.

·To identify potential need for further research/ QI to strengthen evidence base.

·To develop and implement robust governance systems and systematic documentation processes.

·To disseminate best practice research findings and quality improvement projects through appropriate media, presentations, peer review, publications.

·To facilitate links between clinical practice and research through proactive engagement and networking.

Professional Accountability:

·To comply with all Trust policies and procedures.

·To demonstrate and role model Trust Values and Behaviours at all times.

·To act in accordance with the Nursing and Midwifery Council (NMC) or Health and Care Professions Council (HCPC) or General Pharmaceutical Council (GPhC) code of professional conduct and other Trust, professional and statutory guidance, policies and rules.

·To make professionally autonomous decisions, for which they are accountable.

·Responsible for own professional development and clinical/managerial update.

·To undertake any other duties commensurate with the grade as directed.

·The practitioner is responsible for the safe use of expensive or highly complex equipment, where appropriate to the role. For example; Endoscopes, Ultrasound, Mechanical Ventilation Devices.

·The post holder is required to follow Trust policies and procedures which are regularly updated.

Person specification

Professional registration

Essential criteria

Registered Nurse or AHP

Qualifications

Essential criteria

Post Graduate Diploma (PgDip) or Masters (MSc) qualification in Advanced Clinical Practice or equivalent

Evidence of completing a recognised Minor Injury/Minor Illness course (of at least 3 months duration)

Independent prescribing qualification.

Mentorship, supervision and assessment qualification or equivalent.

Evidence of recent academic study (last 5 years).

Evidence of excellent knowledge base and competency sign off in the assessment, diagnosis and treatment of patients who present with undefined minor injury and/or illness

Desirable criteria

Leadership qualification

Certificated speciality courses ALS, ETC or ATLS

Completed spotting the Sick Child course

Completed NIHR Good Clinical Practice course

Previous experience

Essential criteria

A minimum of 2 years working at an enhanced and advanced level autonomous practice in emergency/urgent care or urgent unscheduled primary care

Evidence of broad clinical experience relevant to the post, including specialist skills.

A proven track record of staff management at a senior level, including line management.

Evidence of providing education; including formal and informal teaching, mentorship, supervision and assessment of clinical practice of staff.

Evidence of research, quality improvement, stakeholder engagement and influencing the development and improvement of practice, patient care, patient safety and service delivery.

Desirable criteria

Evidence of financial management

Experience in effective and efficient staff roster management

Skills/Knowledge/Ability

Essential criteria

Evidence of advanced theoretical and practical knowledge of speciality with a wide range of approaches to the management of patients.

Clinical skills, including the ability to: Interpret plain extremity and facial X-rays

Clinical skills, including the ability to: Interpret blood and other pathology test results

Clinical skills, including the ability to: Close wounds with sutures

Clinical skills, including the ability to: Apply splints & plaster casts

Clinical skills, including the ability to: Reduce dislocations & manipulate fractures

Clinical skills, including the ability to: Perform digital/haematoma blocks

Clinical skills, including the ability to: Venepuncture and cannulation

Evidence of leadership in multi-professional working

Guy’s and St Thomas’ celebrates, respects and values the diversity of its staff and patients. We review our policies, procedures and practices to ensure that all employees, patients and carers are treated equitable according to their needs. We are actively committed to ensuring that no one who applies for a job, works or study’s at the Trust, or accesses our services is discriminated against on the grounds of race, ethnicity, nationality, disability, religion or belief, age, gender identity , gender reassignment, sexual orientation, pregnancy and maternity/paternity, or marital/civil partnership.