The General Practice Bank

Advanced Clinical Practitioner

 

Role Summary:

  • The post holder will demonstrate courageous and critical thinking and is a caring, compassionate and committed experienced nurse who, acting within their professional boundaries, will provide care for the presenting patient from initial history taking, clinical assessment, diagnosis, treatment and evaluation of care. They will demonstrate safe, competent clinical decision-making and expert care, including assessment and diagnostic skills, for patients within the general practice.
  • The post holder will commit to demonstrating critical thinking in the safe clinical decision-making process. They will communicate and work collaboratively with the general practice team to meet the needs of patients, supporting the delivery of policy and procedures, and providing nurse leadership as required.

 

Primary Responsibilities:

Clinical Practice:

  • Assess, diagnose, plan, implement and evaluate treatment/interventions and care for patients presenting with an undifferentiated diagnosis
  • Clinically examine 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 drug- and non-drug-based
  • 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 within scope of practice
  • Work with patients in order to support compliance with and adherence to prescribed treatments
  • Provide information and advice on prescribed 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, cervical cytology 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 immunisation programmes for both adults and children
  • Advise, support, and administer vaccinations for patients travelling abroad, where appropriate
  • Promote and deliver evidence-based care for patients presenting with aural conditions
  • Meet the needs of patients presenting for opportunistic wound care
  • 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, recognising the need for alternative methods of communication to overcome different levels of understanding, cultural background and preferred ways of communicating

 

Delivering a quality service:

  • Recognise and work within own competence and professional code of conduct as regulated by the NMC
  • Produce accurate, contemporaneous, and complete records of patient consultation, consistent with legislation, policies, and procedures
  • Deliver care according to NSF, NICE guidelines, and evidence-based care
  • Assess effectiveness of care delivery through self and peer review, benchmarking, and formal evaluation
  • Evaluate patients’ response to health care provision and the effectiveness of care
  • Support and participate in shared learning across the practice and wider organisation
  • Use a structured framework (e.g. root-cause analysis) to manage, review and identify learning from patient complaints, clinical incidents, and near-miss events
  • Working with the practice management monitor and develop the performance of the GPN team in accordance with local policies

 

Leadership – personal and people development:

  • Act as a clinical leader in the delivery of practice nursing services ensuring that the needs of the patient are a priority
  • Take responsibility for own learning and performance including participating in clinical supervision and acting as a positive role model
  • Support staff development in order to maximise potential
  • Work with practice management to ensure sufficient staff of appropriate ability, quality and skill-mix are available to meet current and future service 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

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

 

Management of Risk:

  • Manage and assess risk within the areas of responsibility, ensuring adequate measures are in place to protect staff and patients
  • Monitor work areas and practices to ensure they are safe and free from hazards and conform to health, safety and security legislation, policies, procedures and guidelines
  • Ensure appropriate supervision of safe storage, rotation and disposal of vaccines and drugs. Oversee the monitoring, stock control and documentation of controlled drug usage according to legal requirements where appropriate

 

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 and accurate information retrieval for monitoring and audit processes
  • Understand responsibility of self and others to the practice and primary care trust regarding the Freedom of Information Act

 

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 developments (e.g. courses and conferences)
  • Assess own learning needs and undertake learning as appropriate
  • Provide an educational role to patients, carers, families and colleagues in an environment that facilitates learning

 

Secondary Responsibilities:

Delivering a quality service:

  • Initiate and participate in the maintenance of quality governance systems and processes across the organisation and its activities
  • Utilise the audit cycle as a means of evaluating the quality of the work of self and the 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
  • Assess the impact of policy implementation on care delivery
  • Contribute to the appraisal of the performance of the team, providing feedback as appropriate
  • 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

Working with practice management to ensure the whole team have skills and knowledge regarding domestic violence, vulnerable adults, substance abuse and addictive behaviour. Provide guidance and support to ensure appropriate

 

Leadership – personal and people development:

  • Actively promote the workplace as a learning environment, encouraging everyone to learn from each other and from external good practice
  • 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 and/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 developments in the provision of services
  • Maintain effective communication with those responsible for the overall commissioning and procurement process
  • Maintain active involvement in the planning and processes of practice-based commissioning or similar initiatives
  • Promote the role of the advanced nurse practitioner in general practice

 

Team working:

  • Prioritise own workload and ensure effective time-management strategies are embedded within 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 lead on the delivery of specifically identified services or projects as agreed with the practice management team
  • Agree plans and outcomes

 

Management of Risk:

  • Working with the practice management, ensure the nursing team has access to and undertakes mandatory and statutory training requirements
  • Apply infection-control measures within the practice according to local and national guidelines
  • Advocate for policies that reduce environmental health risks, are culturally sensitive and increase access to health care for all
  • Interpret national strategies and policies into local implementation strategies that are aligned to the values and culture of general practice

 

Managing Information:

  • Manage information searches using the internet and local library databases
  • Collate, analyse, and present clinical data and information to the team
  • Communicate essential financial restraints with the team and discuss with them ideas for effective and efficient working within these constraints
  • Manage, if agreed, the nursing budget within financial principles

 

Equity and Diversity:

  • Identify patterns of discrimination and take action to overcome this and promote diversity and equality of opportunity
  • Enable others to promote equality and diversity in a non-discriminatory culture
  • Support people who need assistance in exercising their rights
  • Monitor and evaluate adherence to local chaperoning 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
  • Assist patients from marginalised groups to access quality care

 

Secondary Responsibilities:

Qualifications

Essential

Desirable

Registered first level nurse

✅

 

MSc in a nursing related subject

✅

 

Mentor/teaching qualification

✅

 

Clinical supervision training and experience

✅

 

Non-Medical Prescriber

✅

 

Level 3 Extended brief interventions (NICE guidelines)

 

✅

NMC’s 'Academic Assessors', 'Practice Supervisors', and 'Practice Assessors accreditations

 

✅

Experience

Essential

Desirable

5 years’ post registration experience including 6 months experience in a GP practice/ Walk in Centre/ Urgent Care Centre

✅

 

Nurse-led management of minor illness, minor ailments, and injuries

✅

 

Nurse-led triage

✅

 

Compiling protocols and clinical guidelines

✅

 

Clinical Leadership

✅

 

Audit

✅

 

Research

✅

 

Nurse prescribing

✅

 

Experience of chronic disease management

✅

 

Project management

 

✅

Working with community development initiatives

 

✅

Health-needs assessment

 

✅

Clinical Knowledge & Skills

Essential

Desirable

Immunisations (routine, childhood, B12, travel)

✅

 

Wound Care / Treatment of advanced injuries / Removal of sutures & staples

✅

 

Women’s health (Cervical cytology, contraception, etc.)

✅

 

Dressings

✅

 

Diabetes review

✅

 

Hypertension

✅

 

Cardiovascular disease – primary prevention

✅

 

Coronary Heart Disease

✅

 

Blood pressure

✅

 

Travel medicine

✅

 

Mental Health

✅

 

ECGs

✅

 

Asthma

✅

 

Ability to work within own scope of practice and understanding when to refer to GPs

✅

 

Advanced clinical practice skills Management of patients with long-term conditions

✅

 

Management of patients with complex needs and chronic diseases

✅

 

Clinical examination skills

✅

 

Ability to record accurate clinical notes

✅

 

Clinical governance issues in primary care

✅

 

Patient group directions and associated policy

✅

 

Understands the importance of evidence-based practice

✅

 

Understanding of Extended brief interventions (NICE guidelines)

✅

 

Cytology certificates

✅

 

Local and national health policy

 

✅

Venepuncture

 

✅

New patient medicals

 

✅

Chaperone procedure

 

✅

Requesting pathology tests and processing the results, advising patients accordingly

 

✅
   

✅

Knowledge of public health issues in the local area

 

✅

Able to identify determinants on health in the area

 

✅

Awareness of issues within the wider health arena

 

✅

General Skills

Essential

Desirable

Excellent communication skills (written and oral)

✅

 

Clinical leadership skills

✅

  
 

✅

 

Negotiation and conflict management skills

✅

 

Change management

 

✅

Teaching and mentorship clinical setting

 

✅

Resource management

 

✅

Strong IT skills

✅

 

Clear, polite telephone manner

✅

 

Competent in the use of Office and Outlook

✅

 

Competent in the use of patient record management systems: EMIS / SystmOne

✅

 

Competent in Document Management systems: Docman

✅

 

Competent in other portals: Open Exeter, Coordinate my Care

✅

 

Effective time management (Planning & Organising)

✅

 

Ability to work as a team member and autonomously

✅

 

Good interpersonal skills

✅

 

Problem solving & analytical skills

✅

 

Ability to follow clinical policy and procedure

✅

 

Experience with audit and able to lead audit programmes

✅

 

Experience with clinical risk management

✅

 

Facilitation of Learning for patients, carers, other staff and students

 

✅

Leadership and management skills, as part of a general practice nursing team with delegated accountability and responsibility for patient care

 

✅

Evidence, research and development - has an enquiring approach to practice to ensure best quality care is offered within any constraints of the service

 

✅

Personal Qualities

Essential

Desirable

Polite and confident

✅

 

Flexible and cooperative

✅

 

Motivated, forward thinker

✅

 

Problem solver with the ability to process information accurately and effectively, interpreting data as required

✅

 

High levels of integrity and loyalty

✅

 

Sensitive and empathetic in distressing situations

✅

 

Ability to work under pressure / in stressful situations

✅

 

Effectively able to communicate and understand the needs of the patient

✅

 

Commitment to ongoing professional development

✅

 

Effectively utilises resources

✅

 

Punctual and committed to supporting the team effort

✅

 

 

This job description outlines the roles, duties, and responsibilities of the post. It is not intended to detail all specific tasks.