Extended Scope Practitioner for the Enhanced Care Team in Hastings

Are you a dynamic, enthusiastic, forward-thinking Extended Scope Nurse or Paramedic in Frailty/Palliative Care looking for a new venture with a like-minded clinical team? If so, HRH are looking to employ a full-time Extended Scope Practitioner for the Enhanced Care Team who has a passion for high-quality, patient-led care and a desire to make a difference.

Access to Employee Assistance Program
Access to the NHS pension

You will be working in a close team providing Enhanced Care which includes Frailty, Palliative, Care Homes, Dementia, Learning Disabilities and Safeguarding. Also as part of a wider multi-disciplinary team which includes GP Partners, GPs, Advance Nurse Practitioners, Nurse Practitioners, Paramedic Practitioners, Clinical Pharmacists, Mental Health Nurse, Practice Nurses, Healthcare Assistants and Physiotherapists.

You will be responsible for home visits, face-to-face clinics and telephone consultations for patients with a wide range of medical and social concerns, urgent and same-day requests for treatment and chronic disease management, providing care for the presenting patient from initial history taking, clinical assessment, diagnosis, treatment and evaluation of care.

You will need to demonstrate safe, clinical decision-making and expert care, including physical assessment and diagnostic skills. You will need to triage the needs of patients accordingly making any referrals for investigations in the appropriate manner.

The role will include holistic assessment and coordination of care for Palliative and End of Life patients. The role will be involved in the care of frail and elderly patients including the responsibility of patients within care and nursing homes. This may include weekly ward rounds. Part of your responsibilities will include visiting patients in their home to assess their medical condition, frailty review and may include those with low-level mental health concerns.

Hastings & Rother Healthcare was formed in 2021 and consists of three GP practices within Hastings and St Leonards. We are an organisation that is rapidly growing and we currently cover the largest patient population in Hastings & St Leonards.

Joining our team means becoming part of a dedicated group of healthcare professionals who share a common vision and values. By putting our patients first and delivering high-quality care, you will contribute to our mission of improving the health and lives of the communities we serve. In return, we can offer excellent remuneration, career development and a supportive clinical working environment.

• Clinical leadership & specialist role
• Work closely with the Palliative and End of Life Care Team to support patients through the Gold Standards Framework.
• Completion, review, and audit of patient-centred RESPECT forms in partnership with patients and carers.
• Undertake home visits, face-to-face clinics, telephone consultations, care home ward rounds, and over-75s triage as part of the supported triage team.
• Specialist assessments & long-term condition management
• Manage MAS referrals and associated investigations and treatments relating to memory loss.
• Undertake Dementia and Learning Disability reviews in line with QOF requirements.
• Manage patients with complex co-morbidities commonly seen in frail and elderly populations e.g. cardiovascular disease, respiratory disease, dementia.
• Autonomous clinical practice
• Independently assess, diagnose, and manage patients using advanced clinical reasoning and physical assessment skills.
• To form accurate diagnoses, prognosis and care plans using a best current clinical and evidence-based practice to include a systematic formulation and advice on evidence-based therapeutic interventions.
• Independently decide on and carry out treatments, including the prescribing of medicines, within scope of practice and professional competence.
• Refer patients for investigations and specialist input as appropriate.
• Review test results such as bloods and X-Ray as clinically appropriate.
• Ensure continuity of care through follow-up consultations and review of outcomes.
• Be responsible for your own administration relevant to the role.

• Communicate effectively with patients, carers, and the multidisciplinary team to support shared decision-making.
• Promote self-management, health promotion, and healthy lifestyle strategies, adapting approaches to cognitive or motivational barriers.
• Signpost and coordinate care with internal and external services to ensure seamless transitions of care.
• Work effectively with outside agencies such as the District Nurse team, Hospice, Adult Social Care, SOAHMS etc.

• Deliver care in accordance with NICE guidance, NSF standards, GSF Framework, and evidence-based practice.
• Maintain accurate, timely clinical documentation and ensure appropriate coding and claims.
• Participate in audit, quality improvement, peer review, and governance processes.
• Recognise safeguarding responsibilities and act in accordance with statutory and professional requirements.

• Maintain professional registration and undertake required statutory, mandatory, and continuing professional development.
• Work within professional codes of conduct and recognise the limits of own competence.
• Manage workload effectively, prioritising care to maintain quality and safety.
• Contribute to team effectiveness, shared learning, and service improvement.
• Undertake other duties appropriate to the grade of the post.
• To provide an extended nursing or paramedic role and take a lead role in the care of the practice frail and palliative patients.
• To undertake training appropriate for the role namely, but not exclusively Level 7 physical assessment skills, Level 7 module in frailty and Non-Medical Prescribing.

• Full and unrestricted NMC (UK) or HCPC registration
• RGN or Paramedic (degree or equivalent)
• Evidence of Post-Graduate study with minimum of Mentorship module at Level 6 or 7
• Prescribing Qualification
• A qualification in Frailty Care
• Qualification in Physical Assessment skills

• Evidence of continuing professional development
• Experience of working with frail and palliative patients and those at the end of their life.
• Experience and knowledge in physically assessing patients
• Able to identify the acutely ill patient
• Experience of providing specialised advice in relation to care
• Evidence of clinical knowledge in caring for patients in relevant specialism
• To maintain own annual registration with the NMC and adhere to Code of Professional Conduct
• Two+ years proven record of working as an extended Nurse dealing with patients presenting with a wide range of medical issues
• In-depth knowledge of recent NHS legislation, recommendations for specialist area.
• Awareness of the national and local priorities and changing trends in specialist area.
• Experience of dealing with patients with undifferentiated and undiagnosed conditions
• Ability to work effectively within a small organisation and multi-disciplinary team
• Standard setting and audit
• Comprehensive knowledge and experience of clinical governance and training and an understanding of clinical governance in nursing
• Working across professional and organisational boundaries
• Previous Experience in General Practice

• Excellent prioritisation and organisational skills
• Excellent interpersonal, communication and presentation skills, both written and verbal
• Demonstrates leadership skills as well as the ability to be a good team member and assume leadership responsibilities
• Responsive, creative, resilient, able to adapt to change and work in challenging environments
• The ability to respond to appropriate requests for assistance, maintaining confidentiality whenever necessary
• Confident and effective communication skills, both verbally and in writing
• The ability to respond flexibly to the demands of the post
• The ability to work as a member of a team
• Show a capacity to work alone and the ability to keep calm under pressure
• Understand and have a commitment to the principles of equal opportunity and diversity
• Manage and prioritise multiple tasks
• Work confidently and accurately with data and information to present an accurate picture of analysis
• Able to effectively communicate and understand the needs of the patient
• Be able to work under pressure and have clear systems/strategies in order to prioritise workload
• Be proactive and able to use own initiative to complete tasks and projects.

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