Advanced Nurse Practitioner in London

The Advanced Clinical Practitioner is an experienced clinician (nurse, paramedic, pharmacist) who has undertaken, or is willing to work towards, Masters level education covering the four pillars of advanced practice: clinical practice, leadership and education, research, and teaching. The autonomous practitioner must also be an independent prescriber.

They will undertake clinical assessment including history taking and physical examination, form a diagnosis, and provide a treatment plan, which may include prescribing. The Advanced Clinical Practitioner demonstrates safe clinical decision‑making and expert care, treating all ages from children to the elderly with undifferentiated presenting complaints, including mental health, paediatric illness, and palliative care. Top‑up training can be provided in any identified development areas.

Main duties of the job

• Work autonomously within a health‑care team consisting of Team Leaders, Advanced Clinical Practitioners, Duty Doctors, Drivers, Call Handlers, and Receptionists.
• Team composition varies by shift; must communicate effectively and professionally with all staff members.
• Deal with calls of diverse nature covering all clinical aspects and issues, acknowledging cultural, social, and emotional diversity during consultations.
• Use a multi‑skilled approach, employing technology, effective listening, and communication skills to make clinical decisions, create records, and refer to clinical literature.
• Retrieve and use information regarding healthcare provision in the patient’s locality to access appropriate care as necessary.

Clinical

• Assess, diagnose, plan, implement, and evaluate treatment/interventions and care for patients presenting with an undifferentiated diagnosis.
• Manage both acute and chronic conditions, integrating 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, national and practice protocols, and within scope of practice.
• Support patients to achieve compliance with prescribed treatments.
• Provide information and advice on prescribed or over‑the‑counter medication, including 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.
• Assess, identify, and refer patients presenting with mental health needs in accordance with the NSF for Mental Health.
• Provide face‑to‑face and telephone clinical assessment, treatment, and management plans to patients.
• Help develop and evaluate clinical guidelines and competency tools to support practitioners in expanding their roles.
• Conduct consultations with patients, taking a comprehensive history, performing physical examinations, and using expert clinical judgement to identify potential diagnoses.
• Refer patients for investigations when necessary or appropriate.
• Make a final diagnosis, decide on and carry out treatment, including prescribing medication or referring to primary or secondary care specialist services within local agreed pathways and protocols as appropriate.
• Ensure all treatments and care provided are based on best practice and evidence‑based care.
• Assess and evaluate, with the patient, the effectiveness of the treatment and care provided and make changes as needed.
• Use independent prescribing skills for the benefit of patient care.
• Identify and take appropriate actions to address risk to the patient, including: Identification of emergency care needs requiring dispatch of a 999 ambulance. Safeguarding children and protection of vulnerable adult issues requiring referral to other agencies in line with local policies.
• Work independently and, at the same time, contribute to the work of the whole team to ensure delivery of a consistently high level of service.
• Taking responsibility and being accountable for managing own workload, risk assessment, and management, acting within professional codes and seeking advice and support from the clinical team leader when appropriate.
• Act as a clinical resource for non‑clinical staff who may require advice and support.

Communication

• 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.
• Anticipate barriers to communication and take action to improve communication.
• Be aware of responsibilities under the Data Protection Act.
• Attend regular team meetings.
• Provide a professional, courteous, and efficient service consistent with organisational standards for patients seeking assistance from the service, maintaining a professional and reassuring manner at all times.
• Utilise advanced listening, probing, and facilitative skills across a diverse range of cases, some of which may be highly challenging due to emotive circumstances, communication difficulties, and patient anxiety.
• Utilise complex communication skills to negotiate and provide support to patients who may be non‑compliant with the recommended outcomes.
• Utilise interpreter services, communication aids, and other resources to address barriers to communication and understanding.
• Effectively use a range of communication methods (e.g. telephone, email, fax, letter, and report writing) to facilitate communication at all levels within and external to the organisation.

Audit

• For clinical governance and training purposes, regular monitoring is a requirement of this job.

Education, Training and Development

• Contribute to the achievement of service standards and performance requirements by participating in regular quality monitoring and individual performance reviews.
• Attend and contribute to meetings, workshops and other groups to support the ongoing development of the service.
• Participate in audit, customer satisfaction programmes, research and other quality improvement activities.
• Participate in the investigation of incidents, complaints and other issues as required.
• Manage and maintain clinical records as required.
• Maintain active NMC registration.
• Carry out other duties commensurate with the grade as directed.

Person Specification

• Live registration with professional body.
• Qualification that entitles basic registrations.
• Masters level study in advanced practices covering all 4 pillars of advanced practice (clinical practice, leadership & education, research, education).
• Independent/Supplementary prescriber.

Experience

• Experience of working as a practitioner in a GP surgery, primary care environment, emergency department, urgent care centre, MAU/EAU or other first contact setting, evidence of excellent assessment skills.
• Experience of telephone triage/assessment environment.
• Experience of working autonomously diagnosing and treating patients.
• Experience in mental health assessment.
• Experience in paediatric assessment.
• Knowledge of equal opportunities and its significance in health care.
• Awareness of mental health, child protection and safeguarding vulnerable adults issues.
• Experience of having participated in service improvement activities including audit and research.
• Experience in verification of death.
• Knowledge of national agendas in General Practice.
• Knowledge of service improvement activities including audit, research, reflective practice.

Skills

• Advance clinical assessment skills including history taking/clinical examination.
• Use of expert knowledge and clinical judgement to identify potential diagnosis.
• Excellent communication, listening and interpersonal skills.
• Demonstrates advanced problem solving and decision making skills supported by evidence‑based and/or best practice.
• Ability to assimilate large quantities of information quickly and accurately and communicate it clearly.
• Able to work autonomously and as part of a team.
• Excellent written and verbal communication skills.
• Excellent interpersonal skills.
• Ability to maintain accurate records.
• Able to listen carefully to order to understand the needs of others.
• Able to use information, technology and communication equipment efficiently.
• Able to work under pressure whilst maintaining a high level of accuracy and attention to detail.
• Self‑motivated with the ability to support and enthuse.
• Good organisational and prioritisation skills.
• Tactful and diplomatic.
• Able to maintain professionalism.
• Able to manage sensitive and emotive situations.

Personal Qualities

• Polite and confident.
• Flexible and cooperative.
• Motivated and a 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/stressful situations.
• Effectively able to communicate and understand the needs of the patient.
• Commitment to ongoing professional development.
• Punctual and committed to supporting the team effort.

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and, as such, a submission for Disclosure to the Disclosure and Barring Service (formerly known as CRB) will be required to check for any previous criminal convictions.