Senior Clinical Practitioner Band 7 to 8a Progression Post | Bolton NHS Foundation Trust

We are pleased to offer an exciting opportunity for an experienced and highly motivated clinician to join our Specialist Palliative Care Service in a Band 7 to Band 8a progression post. This role has a clear and sustained focus on preventing avoidable hospital admissions by delivering proactive, responsive, and highly skilled specialist palliative care assessments within the hospital and community, enabling patients to reduce their length of stay in hospital or to remain safely in their own homes for as long as possible.

The post holder will be appointed at Band 7 initially, with progression to Band 8a subject to the achievement of defined competencies and service expectations. The role combines elements of advanced practice with leadership and service development, with a strong emphasis on early discharge, admission avoidance and reducing reliance on acute hospital services. Preventing unnecessary hospital admissions and supporting more people to die at home is a core function of this post.

The Senior Clinical Practitioner will identify patients at risk of deterioration, intervene early and coordinate care across the services to manage complex symptoms and psychosocial needs in the community. Through robust anticipatory planning and clinical decision-making, the post holder will prevent crisis-driven admissions to hospital and support timely appropriate care escalation when clinically necessary.

Bolton NHS Foundation Trust is an integrated provider of acute, intermediate and community health care serving the population of Bolton. This provides us with an opportunity for our services to work closely with our partners in primary care and the local authority to ensure a seamless service for our patients.

The post holder will be responsible for working within the Integrated Community Services Division (ICSD); using advanced skills to identify, assess, diagnose, treat and manage patients with complex palliative care needs. The post holder will be expected to work within the patient’s own home, care home settings and hospital. The post holder will work as part of a multi-disciplinary team and will be highly visible and accessible within the division.

They should be an exemplary role model for health care professionals, leading by example, empowering staff to deliver improved patient safety and enhance the patient experience. They will adhere to professional standards of care and promote a professional image of health care that inspires confidence in service users, family members and carers and the healthcare community as a whole.

The post holder will lead and participate in the delivery and organisation of formal and informal teaching, working with colleagues both across the community and within the hospital to improve palliative care knowledge and enhance support for generalist staff. They will also have a key role in providing and supporting advance care planning and education.

In conjunction with other team members, provide clinical decisions, seven days per week in line with NICE guidance, National End of Life Care Strategy (2008), National care of the Dying (2016), the Specialist Palliative Care Commissioners Report (2016) and CQC requirements. The post holder will work closely with the Matron for Specialist Palliative care, Accident and Emergency Department Nurse Practitioners, Consultants in palliative medicine and medical staff, nursing staff, Allied Healthcare Professionals and all applicable support staff, with the aim of preventing attendance at the Emergency Department and unnecessary admissions to hospital for patients in the last 90 days of life.

In addition, the post holder will proactively support in identifying dying patients earlier in order to improve symptom management and discourage unnecessary investigations and treatment thus improving the patient and carer experience.

• Clinical Responsibilities:
• Responsible and accountable for clinical decision-making in the management of patients with palliative care needs and to influence practice within the MDT.
• Work on own initiative to undertake a wide range of duties relating to palliative and end of life care, backed up by professional skills and knowledge, including being able to respond to urgent symptom control issues.
• Be highly skilled and competent in the comprehensive holistic assessment of patients using theoretical knowledge and a wide range of experience to assess needs and optimise symptom management and support.
• Devise individualised plans for symptom management and end of life care taking into account the wishes of the patient and those important to them.
• Co-ordinate interventions which may include other disciplines through case management, multidisciplinary team meetings and integrated teams within the hospital and in the community settings.
• Respond appropriately to requests for advice by triaging calls and offering assistance to patients, carers and healthcare professionals.
• Ensure the use of a clinical governance framework and resources to guide practice, participating in supervision and reflection on clinical practice.
• Bring excellent clinical judgemental skills to the analysis and interpretation of a range of clinical options regarding patient care.
• Work with colleagues in ED/assessment areas to facilitate timely discharge of patients who do not require hospital admission in order to reduce avoidable admissions of patients at the end of life.
• Provide timely input for patients on inpatient and critical care wards.
• Provide a proactive presence across the Trust in order to identify dying patients earlier, reducing the burden of unnecessary investigations and treatment and facilitating advance care planning.
• Ensure good symptom control, psychological and social support for patients who are at the end of life.
• Liaise with the Hospice to facilitate weekend admissions.
• Lead on joint working with other specialities e.g. acute medicine, heart failure, COPD, liver failure and encourage the discussion and documentation of appropriate care plans when not in place.
• Interprets data relevant to the patient’s condition and progress.

• Management and Leadership:
• Support staff with work planning and evaluation, training, development and guidance.
• Contribute to service development, delivery, quality improvement and business planning with the Departmental Leads.
• Lead and attend departmental meetings and/or multi-disciplinary meetings as indicated.
• Plan, manage and prioritise a complex workload, delegating to the team and reorganising work as necessary.
• Maintain appropriate patient/service records and monitor the standards of those of the team.
• To be responsible for the maintenance of accurate and evaluative professional documentation, including initial holistic assessment and plans of care.
• Adhere to all local standard operating procedures and policies.
• Contributes to the induction and development of team members.
• Submit and interpret accurate and timely statistical data and information as required.
• Contribute to developing a service based on national policy and guidance and ensure that these standards are monitored and adhered to by all members of the team.
• Contribute and assist in implementation and evaluation of changes in practice to promote the continuous development of services within the Palliative and End of Life Care Department.

• Research and Audit:
• Responsible for identifying research priorities for area of practice.
• Responsible for initiating, participating in and evaluating audit within the Palliative and End of Life Care setting.
• Demonstrate commitment to develop own research/audit skills.
• Responsibility for ensuring his/her practice is based on evidence-based guidance.
• Lead or participates as appropriate in research or audit projects and programmes.

Please refer to full role specific job description and person specification.