Advanced Clinical Practitioner

An exciting opportunity has arisen for an experienced Advanced Clinical Practitioner to join our Urgent Community Response, Virtual Ward and Reablement Team within Nottingham CityCare Partnership. The Advanced Clinical Practitioner plays a pivotal role in delivering rapid, high-quality clinical assessment and intervention for adults experiencing an acute health or functional crisis in the community. The ACP provides expert autonomous practice to prevent avoidable hospital admissions, support safe and timely discharge, and enable effective reablement, ensuring people can remain safely at home wherever possible.

The postholder leads clinical decision-making within a multidisciplinary team, provides advanced assessment and treatment planning, prescribes medication where appropriate, and contributes to service development, staff training, and integrated working across health and social care partners. The ACP carries clinical responsibility for a complex caseload, applying advanced investigative and analytical skills to lead safe, evidence-based practice, support timely discharge planning across community settings, and provide specialist advice to colleagues across the multidisciplinary team.

The post holder will have a Trust-wide responsibility to promote clinical excellence in the care of patients presenting to their area by providing clinical advice and support to nursing staff and other health care professionals.

The ACP is accountable for independent clinical assessment, diagnosis and treatment of patients with undiagnosed and undifferentiated conditions. They will practice at an advanced level demonstrating in depth knowledge and competence in all aspects of UCR/Virtual Wards, encompassing advanced clinical assessment, critical thinking and clinical management skills that are evidence based and deliver high quality patient centred care.

Within the role there will be a requirement to plan and direct the management of patients including accessing services within the multi-disciplinary team and wider health, social care, education, vocational and voluntary sector services as appropriate to the role. The postholder will lead on the strategic development of Trust-wide services in their specialist area, working with other strategic and clinical leads as appropriate. They will also lead and participate in education programmes designed to support other clinical staff skills within their speciality.

The postholder will provide peer support to clinical staff working with patients from the direct caseload or those involved in the management of patients. They will assist in the planning, co-ordinating and development of any newly implemented service plans as well as being responsible for ensuring that relevant legal and regulatory frameworks are acknowledged through local governance procedures.

We are a provider of NHS Community Health Services, CityCare exists to support the health and wellbeing of all local people, working alongside other health and care partners to achieve this. We are a value driven, people business with a passion for excellence. Our vision and social purpose is to make a difference every day to the health & wellbeing of our communities and our values of kindness, respect, trust and honesty lie at the heart of everything we do, guiding how we work together with partners and each other to consistently deliver high quality compassionate care.

CityCare values the benefits of a diverse and inclusive workforce. We encourage applications from candidates who identify as disabled, LGBT+ or from a Black, Asian or Minority Ethnic (BAME) background, as they are currently under-represented within our organisation. We are proud to be a forces-friendly organisation and are dedicated to supporting Veterans, Service Leavers, Reservists, and military spouses/partners. We value the unique skills and contributions you bring. CityCare is an equal opportunities employer. We are positive about employing people with disabilities.

The post holder will practice autonomously within the Advanced Practitioner level of competence working within the Integrated Reablement Team (IRT)/Virtual Ward (VW). They will assess, diagnose, treat or refer patients aged 18+, presenting with undifferentiated and undiagnosed problems. They will provide Clinical Leadership for the IRT/VW and support and mentorship to other primary care staff where appropriate.

The post holder will work alongside Clinicians, Assistant Practitioners and Health Care Support Workers, that make up the team of the day working collectively in the assessment of undifferentiated urgent care/VW patient presentations in the community. The post holder will work alongside management team to lead the way with innovation, testing out pilot services and bringing new business into CityCare.

The post holder will:

• Provide clinical assessment and deliver treatments to service users who have undifferentiated health care requirements in order to support the services delivered by the IRT/VW and prevent unnecessary acute hospital attendances and support early discharge.
• Utilise advanced clinical skills and competencies in clinical health assessment, medicines management, leadership and case management.
• Maximise patients' health and reduce risks that contribute to ill health, thereby reducing unnecessary admissions to acute services.
• Be an autonomous practitioner who is open to the flexibility required for the role.
• Participate in training opportunities for self and others within the Urgent Treatment Centre.
• Support and deliver training to IRT/VW, staff within CityCare and the wider healthcare community.
• Provide mentorship and support to IRT/VW staff, staff within CityCare and the wider healthcare community.
• Provider mentorship, support and training to students (including medical, nursing and allied health professionals).
• Able to take operational charge of a shift on a planned rota basis.
• Deputise for member of the management team when required to do so.
• To provide clinical line management to IRT staff members.

To work with the CityCare multidisciplinary team in provision of Urgent Care Services for Nottingham City. To represent Nottingham CityCare Partnership locally, regionally and nationally if required.

Clinical Responsibilities:

• Comprehensively assess, review and evaluate the needs of service users with undifferentiated healthcare needs to improve their physical, psychological and mental health wellbeing to promote self-care and reduce the need for hospitalisation.
• Accurately prioritise patients within the service, undertaking clinical assessment and providing the necessary treatment including the use of Non-Medical Prescribing and/or Patient Group Directions in line with local/national policies, procedures and guidelines as appropriate.
• Request diagnostic tests only where clinically indicated in line with organisational, local and national guidelines and appropriate to the community setting.
• Develop plan of care in conjunction with the service user through; application of clinical knowledge and, analysis of symptoms and data, identification of risk factors associated with those conditions, recognition of early signs of acute illness, involving the patients and the carers in the care plan and ensuring it is understood, documenting safety netting plans and processes.
• To utilise effective communication to aid onward referrals to specialists as appropriate. Facilitating a coordinated primary healthcare response to service users' needs.
• To work in an autonomous manner without direct supervision whilst recognising limitation of the practitioner role.
• To carry out enhanced clinical skills as required.
• To keep accurate and immediate records of all interventions fully utilising software systems in place.
• To encourage clients to carry out self-care as appropriate through effective communication of health care using written information as appropriate.
• To advise client on the most appropriate use of Primary, Secondary and Emergency services.
• To maintain patient confidentiality as per CityCare's clinical guidelines.

• To work within the AHP/NMC Code of Professional Conduct.
• To act in accordance with and promote CityCare's values at all times.
• To act as an ambassador for CityCare and the IRT at all times building professional relationships with primary care partners, voluntary organisations and other outside agencies.
• To be committed to working flexibly within a dynamic environment, responding positively to the changing needs of the service.
• To promote and facilitate evidence-based practice.
• To be committed to providing a high level of customer service and patient experience.
• Maintain professional awareness and attend appropriate training as necessary.
• To participate in the appraisal process and development of own Personal Development Plan to include clinical supervision and Revalidation.
• To develop a culture within the IRT of continuing professional development, supporting nursing staff in meeting the requirements for Post registration Education and Training.
• To provide clinical support and mentorship to other nurses, primary care assistants to meet the requirements of their own personal/professional development plans. This may include, where appropriate, mentoring nurses through work-based learning programmes.
• To support/facilitate the provision of Clinical Supervision in accordance with organisational policy.
• To liaise with other Agencies as appropriate to ensure comprehensive and collaborative care for service users.

• To maintain current professional registration and to ensure that all personal responsibilities in relation to this and to the revalidation process are met, including maintenance of a professional portfolio, evidence of practice hours, professional development planning and reflective writing.
• To meet the organisational requirements for mandatory training appropriate to the role.
• To recognise his/her own professional limitations, practising accordingly, seeking advice and support as appropriate.
• To take an active role in the organisational appraisal process and develop an appropriate and relevant personal development plan and work-based objectives.
• To have awareness of the relevant organisational and professional Safeguarding policies and guidance and to act in accordance with their direction, attending update training as required.

• To clinically lead a team consisting of Clinical Practitioners, Health Care Support workers and non-clinical support staff.
• To participate and assist in evaluation, audit and research as required.
• To participate in the investigation of any complaints, incidents and accidents.
• To participate in the training and induction of new members of staff to the Care Centre Team.
• To participate in the mentorship, support and training of visiting nurses on recognised training programmes such as Student Nurses and Practice Nurses.

• Registered healthcare professional, e.g. Nurse, part 1 of current NMC register, ECP, Clinical Pharmacist, Physiotherapist.
• Recognised full Masters level qualification in Advanced Clinical Practice. Digital badge or equivalent competencies.
• Independent Non-medical Prescriber (V300).
• Evidence of ability to apply theory to practice.
• Recognised teaching/mentorship/Supervision Qualification.
• Clinical Leadership experience/qualification.
• Experience/qualification in a specialist area e.g. mental health, Emergency/respiratory/acute medicine, primary care or mental health.
• Evidence of formal teaching.
• Participation in research.

• In depth knowledge of contemporary clinical issues, legislation relating to healthcare and clinical practice, and relevant Standards and Codes (e.g. NMC/HCPC).
• Understanding of the principles and practice of clinical governance.
• IT skills, including use of MS Word and Excel.
• Demonstrates effective communication and interpersonal skills.
• Negotiating and influencing skills.
• Use of a range of communication techniques.
• Demonstrable/proven leadership skills.
• Able to use internet as an information resource, including searching clinical and academic databases.
• Familiarity with accredited clinical systems for recording patient data e.g. SystmOne.

• All appointments are subject to satisfactory medical clearance and the ability to cope with the demands of the role.
• Proof of vaccination & immunisation status in accordance to Department of Health guidelines.
• Ability to be flexible over hours worked within contracted hours to meet the needs of the service.
• Ability to work in a 7 day service from 8am to 10 pm on a rota basis.
• Confident and self-aware.
• Openness to leading and testing innovative projects in a variety of primary care settings with multi-agency participation.
• Able to fulfil physical demands of post, this may involve moving and handling, fine motor skills are required for clinical activities such as suturing.
• Full driving licence with business insurance and the ability to travel.

• Experience of working at an Advanced Practice level with patients presenting with undifferentiated illness some of which should be in community or Primary Care.
• Knowledge and experience of multi-agency working.
• Experience of leading and working with an MDT with the ability to motivate others.
• Evidence of leading innovation and change in a clinical environment.
• Experience of policy development and implementation.
• Management experience and skills.
• Experience of working in a Mental Health environment.

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.