Clinical Nurse Specialist (Prescriber)

The Clinical Nurse Specialist (Prescriber) is a key senior role within the Nursing team, acting as the clinical specialist lead and overseeing the community nursing service for a defined area on a rotation basis. Working with an integrated team of nurses, you will contribute to the overall care of patients and families referred to St Giles Hospice within the community setting. This role reports directly to the Clinical Lead for Community Services and promotes a positive, supportive working environment with emphasis on teamwork and cooperation. You will participate in a rota system providing a 7 day a week, face to face and telephone service for patients and families, with out-of-hours telephone advice and support (visits out of hours may occur in exceptional circumstances).

The work plan typically includes 80% clinical (clinical management), 10% service development, and 10% education and teaching. The role includes activities such as audit, quality and risk management initiatives. Nurses working at an advanced level will: practice autonomously, analyse complex situations, undertake comprehensive assessments (including physical examinations and diagnostic testing where appropriate), determine evidence-based therapeutic interventions (which may include prescribing and monitoring), participate in peer reviews of their own practice, define the boundaries of their practice, and support the implementation of local and national strategies and hospice core standards.

About Us: St Giles Hospice is a registered charity founded in 1983. We support patients and families living with a terminal illness, offering individually-tailored care free of charge, at the hospice or in patients’ homes across our communities. We spend close to £10 million a year on specialist services, with around 18% government funding; donations and local income generation fund the remainder.

The Role Entails But Is Not Limited To:

• Leadership and Managerial: Be an effective role model to the team and other primary healthcare colleagues. Provide leadership to the team, acting as a role model for best practice with honesty and integrity. Provide professional/clinical leadership to other Clinical Nurse Specialists and staff; act as a point of expertise, providing advice and support. Input into workforce planning and ensure efficient use of resources (rota and rotation of staff) supported by clinical administration. Participate in multi-professional meetings as a patient advocate and contribute to service delivery decisions. Attend appropriate patient-related and team meetings and participate in service development initiatives as required. Work with the Head of Clinical Services to develop St Giles Hospice policies and processes and ensure team compliance. Assure quality standards, clinical governance, standard setting and audit. Maintain high professional standards in accordance with Hospice policies and the NMC Code of Professional Conduct.
• Clinical: Coordinate the content and delivery of allocated patient care plans and ensure patients receive appropriate hospice services. Undertake patient clinical assessments and nurse prescribing. Collaborate with other CNSs and community team members to ensure high-quality nursing care for patients and families in the community. Promote palliative care principles and extend hospice services into the community; work across settings (home, care homes, community hospitals, telephone, outpatient reviews). Assess holistic needs (physical, psychological, social, cultural, spiritual) and collaborate with the team; participate in advance care planning discussions where appropriate. Provide bereavement support in collaboration with relevant teams and ensure documentation is up to date in the patient records. Work with GPs, DNs and external providers to ensure integrated care; participate in out-of-hours rota for telephone advice and occasional visits if indicated. Contribute to Gold Standard Framework, hospital and practice-based meetings; raise awareness of hospice services among community staff. Lead or participate in areas of allocated responsibility (e.g., outcomes audits, clinical governance, caseload reviews) as rotation requires.
• Education, Training and Development: Attend mandatory hospice training and in-house courses; participate in ongoing education and CPD opportunities. Maintain clinical competence per St Giles Hospice Competencies; identify training needs with the clinical education team; support orientation for new staff. Act as a mentor/supervisor and participate in research projects as required; engage in life-long learning and reflective practice.

Key Relationships: Director of Clinical Services; Head of Clinical Services; Clinical Lead for Community Services; Head of Clinical Quality and Safety Governance; Medical team; Inpatient Unit team; Education team; Governance team; Wider multi-disciplinary team; Family Support Worker Services.

Person Specification:

• Exhibits hospice values and behaviours
• Sound reflective and facilitation skills
• Expert communication, counselling and interpersonal skills
• Teaching skills — informal and formal; contributes to education program
• Leadership and management skills
• Ability to work independently and as part of a team
• Ability to make expert clinical decisions
• Emotional resilience; excellent time/deadline management; reflective practitioner

Experience:

• Community nursing experience
• Experience and evidence of clinical audit
• Published original work
• Proven experience within specialist palliative care
• Management experience
• Experience and evidence of effective change management
• Experience and evidence of research/evidence-based practice
• Experience and competence in managing complex palliative care cases
• Understanding of CNS role; development and implementation of quality and audit initiatives
• Knowledge of governance and research processes; diverse specialist palliative care knowledge

Qualifications:

• Registered Nurse (Degree/Master level); current NMC registration; recognised teaching qualification or equivalent
• Advanced Communication skills qualification; Independent Nurse Prescribing Level 6 minimum; Physical Health Assessment Level 6 minimum
• Willing to undertake additional study as required

Desirable:

• Degree in specialist practice related to palliative care; Community Nursing qualification; Leadership and Management courses

Disclosures: This post is subject to the Rehabilitation of Offenders Act and requires a DBS disclosure. UK Registration: Applicants must have current UK professional registration.