We are looking for enthusiastic, innovative and engaging individuals, who have a passion for the delivery of high quality patient care within the community. The candidates will have to be able to prioritise their own workload without supervision, have an excellent patient focussed approach and be able to use their initiative as well as work as part of a multidisciplinary team.
The post supports delivery of a 2hr Urgent care response - Community Rapid Intervention Service as part of admission avoidance alongside our General Acute Medicine and Frailty Virtual Ward is a new and innovative Service, that has an agreed admission criteria and works in partnership with supporting care services to deliver acute care in the patient’s own home. The aim of a virtual ward is to reduce length of acute hospital stay and/or avoid hospital admission; this leads to quicker recovery and reduces disruption to patients’, and their carers’ lives. This means we can proactively manage people living with frailty at home, and for those that have a sub-acute episode we can improve a patient’s experience and outcomes. In addition, this means we have more space in our hospitals for acutely unwell patients and reduces the pressure on urgent care.
Role Summary
The post holder will be a Registered Healthcare Professional and hold an MSc in Advanced Clinical Practice. They will be an independent Non-Medical Prescriber. They will practice at an advanced level demonstrating in depth knowledge and competence in all aspects of acute care within the patient’s home setting & environment, encompassing enhanced assessment, critical thinking and clinical management skills that are evidence based and deliver high quality patient centred care.
The post holder will have both UHNM and MPFT responsibility to promote clinical excellence in the care of patients referred to or managed by the Virtual Ward by providing clinical advice and support to nursing staff and other health care professionals. They will provide expert professional and independent clinical care which enables the coordination of a multi professional seamless service for all patients referred through the CRIS and Virtual Ward service.
The role will include developing audit and research projects within their sphere/ area of practice, and participating in up-dating and implementing departmental policies, protocols and guidelines, in line with national guidance and contemporary evidence
This post is part of the Acute Care at Home service which is responsible for a Community Rapid Intervention Service (CRIS) and the Community Virtual Ward Service (CVWS)
Key Areas/Tasks
The ACP will provide an alternative medical workforce within a new service providing acute care to patients in their own home / place of residence. The ACP will work as an autonomous expert within the patient’s home environment providing acute assessment, Intervention and medical management plan for that patient.
A list of main tasks and duties are outlined below but are not exhaustive due to the evolving nature of this role and service.
Use highly developed clinical knowledge to independently assess, diagnose, plan, implement and evaluate treatments and interventions for patients presenting with an undifferentiated diagnosis referred by external agencies in to the Virtual Ward Service
Undertake physical examination as indicated by the patient’s condition; autonomously analysing complex clinical signs and investigation results to consider differential diagnoses and diagnose conditions, initiating treatment as required.
Perform clinical procedures appropriate to the history and physical examination of the patient, including further invasive testing and treatments requiring highly developed skills and precision, including (but not limited to) catheterisation, cannulation, peripheral arterial blood gas sampling as relevant within the patient’s own home setting.
Request investigations such as blood, urine and other laboratory tests, electrocardiographs (ECGs), ultrasound scans, X-Rays and computed tomography (CT) scans in accordance with IR(ME)R regulations and as local policy allows.
Autonomously formulate appropriate management plans for patients, formulate clinical decisions and often complex treatment plans to manage acute illness and acute episodes of chronic illness including referral, admission or discharge.
Continuously revaluate findings and clinical response to treatment and establish an appropriate ongoing management plan accordingly.
Prioritise health problems and intervene appropriately in complex, urgent and emergency situations, including initiation and leadership of resuscitation.
Manage regularly clinical events involving patients often requiring unpredictable and high levels of physical effort according to the patient’s dependency and clinical need.
Prescribe and review medication (as an independent prescriber) for therapeutic effectiveness appropriate to patient need and in accordance with best/evidence based practice and national and local protocols and within the role’s scope of practice and legal framework.
Integrate both pharmacological and non-pharmacological treatment in patient care/management plans.
Assess patients with mental health needs using local policy and guidelines and refer to appropriate services.
Communicate effectively with patients, carers, colleagues and others using appropriate communication styles. Anticipate barriers to communication and ensure patients and significant others are kept fully informed and consent to treatment.
Work in partnership with the existing senior multi-disciplinary teams, driving service development and change.
Manage conflicting views and liaise between groups where there may be conflict.
Highlight and address areas of witnessed poor practice and manage the situation appropriately.
Manage staff performance, training and supervision of trainee ACPs including annual appraisals.
Support staff development in order to maximise potential, encouraging everyone to learn from each other and from external good practice.
Support patients, carers, relative’s and staff during difficult situations arising in the clinical area e.g. breaking bad news or following an unexpected event
Produce accurate and complete documentation and patient records consistent with legislation, policies and procedures.
Possess excellent time management and personal organisation skills.
To be an available knowledge resource in how to initiate and manage the impact of change
Develop and contribute local guidelines, interpreting and adapting national protocols and standards to enhance patient care and safety.
To be aware of budgetary constraints within the department and manage resources appropriately and encourage others to do likewise.
Ensure appropriate representation and participation in departmental meetings as appropriate for role.
To actively contribute and provide leadership with service development plans within the directorate.
Take responsibility for own learning and performance including participating in clinical supervision and maintaining awareness of relevant research evidence.
Develop health promotion and education in conjunction with other health care professionals ensuring that all patient care within the multi-disciplinary team is based on research and best practice.
Act as a constant source of clinical and theoretical knowledge for all grades and disciplines of staff as well as patients and their significant others, providing support and clinical advice in specialist areas, based on evidenced based research.
Possess proficient typing, IT and computer skills. Use audio/visual equipment to record and impart information and research.
Prepare and deliver presentations and participate in workshops on a local, regional and national level, to ensure the communication of good practice.
Work with the MDT to further develop appropriate clinical pathways and care approaches. To disseminate learning and good practice gained to other team members.
Design, coordinate and undertake collaborative audit, research and development into Oncology and related practices.
Planning, delivering and implementing programmes of education and training for trainee ACP’s, nurses, medical and other disciplines and continue to be involved in their ongoing support.
Undertake/ participate in research/ audit and publish findings.
Support Trust research and development plans
Recognise and work within own competence and professional code of conduct
Ensure that own practice is kept updated, using an acceptable model of clinical supervision.
Take every opportunity to expand own practice in line with the Professional codes for the discipline. Identify personal career development pathway as part of formal appraisal system.
Through supervision and mentorship identify personal learning needs, participate in personal continuing education and other activities to promote own personal growth.
Develop clinical knowledge and professional skills through relevant training.
Adhere to occupational health guidelines at all times.
Be able to work on own initiative – independently and as a team.
Be able to read and interpret extensive policy documentation; sometimes of a clinical nature requiring periods of intense concentration.
Communicate with enthusiasm and conviction; motivating, inspiring and encouraging.
Utilise and demonstrate sensitive communication styles to ensure patients are fully informed and consent to treatment.
Anticipate barriers to communication.
Communicate effectively often about complex, sensitive and potentially distressing information with patients with carers.
Create a trusting partnership with patients and/or relatives in order to communicate and explain complex medical issues including new diagnoses and agree a management /treatment plan.
Ensure awareness of sources of support and guidance such as PALS and provide information in an acceptable format to all patients recognising and referring any difficulties and referring where appropriate.
Be responsible for the delivery of a detailed, accurate and potentially complex clinical handover to other specialities and General Practitioner’s. To produce detailed and accurate written information within the medical notes or medical IT system regarding all clinical assessments, investigations completed and requested and treatments administered
Maintain confidentiality as required by professional, local and national policy, but acknowledge situations where there can be a breach of confidentiality.
Be able to recognise and defuse potentially aggressive and violent individuals/situations in line with local policy and legal frameworks
Interpret national and local policy regarding virtual wards and make recommendations regarding the way in which this should be applied to the service
Role involves a mixture of driving, assessments in the patient’s home, sitting at a computer to update patients records, managing emails
