ACP/ ECP in Derby

We are seeking a motivated Advanced or Enhanced Clinical Practitioner for our Home Visiting Service at Belper PCN. This team provides holistic care for housebound, frail, elderly, and complex patients at home or care homes. Working with a multi-skilled team and partners, the service aims to deliver safe, effective care, develop new clinical pathways, and meet local and national standards.

The successful candidate will deliver expert clinical care to housebound patients within the PCN, using advanced skills and independent judgement for assessment, diagnosis, treatment, and management. They will enhance care quality through audits, evidence-based practice, supervision, teaching, colleague support, and professional leadership. They will apply clinical guidelines and contribute to the development of research and audit.

The successful candidate will lead the development of non-medical-led models of care within primary and community care settings, in collaboration with multi-professional colleagues, and will play a crucial role in improving the proactive management of patient care through timely assessment, referral, responsive intervention, and anticipatory care planning.

This is a full-time role, or a part-time shared role for the right candidate. We would welcome informal visits or discussions for anyone wanting to know more about the role and the opportunities at the PCN.

Main duties of the job:

• Provide expert care to housebound patients with various medical conditions through comprehensive clinical assessments and an extended scope of practice. This includes conducting referrals, interpreting investigations, and independent prescribing.
• Be instrumental in developing our Local Navigation Hub and alongside the clinical and management team participate in regular MDT meetings to ensure a no wrong door approach and preventative care.
• Utilise a systematic approach to develop differential diagnoses and treatment plans while engaging patients, families, and caregivers in health priorities.
• Communicate sensitive information with empathy and refer patients to other practitioners as necessary.
• Evaluate therapeutic interventions and adapt management plans accordingly.
• Assume a leadership role in complex cases and maintain a strong clinical presence to enhance patient care outcomes.
• Offer guidance on therapeutic interventions, advance care planning, and decision-making for patients lacking capacity.
• Recognise patient deterioration and implement timely interventions.
• Provide advice and education to relatives, caregivers, and professionals, applying expertise in palliative care.
• Demonstrate analytical thinking and professionalism to ensure a high-quality patient experience, integrating contemporary research and evidence-based practices in clinical pathways.
• Maintain accurate patient records in compliance with relevant standards.

Belper PCN consists of 4 local GP practices working both together and with the broader health, social care, housing and voluntary organisations to improve the health and wellbeing of our local people. The vision for Team Up is to create one team across Health and Social Care that sees all housebound patients in a neighbourhood. Our team cover urgent, planned, and anticipatory care for our patients, working with a complete integration of local services. The team deliver care to those patients who are elderly, frail, and housebound.

The ACP or ECP areas of responsibility include:

• Providing same-day urgent response to housebound patients.
• Collaborating with the clinical team to ensure care home residents receive coordinated medical care, including proactive care planning and consistent support from a multidisciplinary team.
• Participating in multi-disciplinary team meetings.
• Recognising opportunities for anticipatory care of suitable patients through treatment plans.
• Working with registered practices to ensure seamless care.
• Leading and coordinating across organisations.
• Delivering high-quality, methodical, and well-informed patient diagnoses and care plans.
• Developing expertise within the community to improve the lives and care of the elderly.
• Promoting the use of supportive, non-statutory services to support self-care and social prescribing agendas.
• Maximising the quality of care in patients' care homes to reduce the need for hospital admissions.

This job description is an outline of the tasks, responsibilities and outcomes required of the role. The job holder will carry out any other duties as may reasonably be required by the Clinical Lead.