Advanced Nurse Practitioner

Undertake advanced, autonomous work and health assessments for patients referred into the pilot, employing an extended scope of practice including advanced consultation, history taking and, where within the post holders assessed competence, physical assessment.

Assess undifferentiated presentations in the context of work, applying systematic clinical reasoning to distinguish between patients whose needs can be met by a Workability Plan, those requiring parallel clinical management, and those requiring urgent escalation.

Formulate and co-produce personalised Workability Plans focused on functional capability, phased return, adjustments and the practical support required to sustain work.

Exercise independent judgement in determining whether a period away from work is clinically appropriate, and articulate that judgement in terms that withstand challenge from patients, employers, referring clinicians and, potentially, an employment tribunal.

Recognise deteriorating or high risk presentations, including physical deterioration, mental health crisis, safeguarding concern and undisclosed serious pathology, and escalate without delay through agreed routes.

Issue fit notes for patients

Request, review and interpret investigations where clinically indicated and within agreed pilot scope, communicating and acting on findings appropriately.

Post: Advanced Nurse Practitioner or Advanced Clinical

Practitioner with relevant experience

Service: MBPCC Enable Service

Accountable to: Service & Clinical Lead

Responsible to: Service

Lead

Hours: 37.5 per week

Salary: £52,000 £65,000 (30% enhanced hourly rate for

Saturday working)

Contract Type Fixed term 12 months.

Secondment applications welcome.

Base: Hybrid and

flexible with home working occasional Barrow and Mid

Furness PCN sites

MAIN DUTIES AND RESPONSIBILITIES

Clinical practice

Advanced assessment

and clinical decision making

Undertake advanced, autonomous work and health

assessments for patients referred into the pilot, employing an extended scope

of practice including advanced consultation, history taking and, where within

the post holders assessed competence, physical assessment.

Assess undifferentiated presentations in the context

of work, applying systematic clinical reasoning to distinguish between patients

whose needs can be met by a Workability Plan, those requiring parallel clinical

management, and those requiring urgent escalation.

Formulate and co-produce personalised Workability

Plans focused on functional capability, phased return, adjustments and the

practical support required to sustain work.

Exercise independent judgement in determining whether

a period away from work is clinically appropriate and articulate that judgement

in terms that withstand challenge from patients, employers, referring

clinicians and, potentially, an employment tribunal.

Recognise deteriorating or high risk presentations,

including physical deterioration, mental health crisis, safeguarding concern

and undisclosed serious pathology, and escalate without delay through agreed

routes.

Issue fit notes for patients

Request, review and interpret investigations where

clinically indicated and within agreed pilot scope, communicating and acting on

findings appropriately.

Complex casework and

clinical consultancy

Hold the most clinically complex, contested and high

risk cases within the service, including multiple comorbidity, mental health

presentations, contested employer relationships and cases with potential legal

exposure.

Act as the definitive clinical point of reference for

colleagues, providing case advice, joint assessment and decision support, and

taking clinical handover of cases beyond their scope.

Provide specialist advice on reasonable adjustments,

graduated return, workplace modification, redeployment and ill health

capability, informed by the Equality Act 2010 and relevant health and safety

legislation.

Assess mental capacity where relevant, obtain and

record valid informed consent, and work within the applicable legal framework.

Acknowledge the limits of personal competence and of

the pilot service, and accept responsibility only for activity where competence

can be assured.

Leadership and management

Provide senior clinical leadership to the assessment

function, setting and modelling the standard of practice for the service.

Own, develop and maintain the clinical assessment

protocols, triage criteria, escalation thresholds, business rules, assessment

templates and standard operating procedures, ensuring they are version

controlled and approved through the agreed governance route in collaboration

with other team members.

Exercise professional judgement to create precedent

and resolve ambiguous or novel clinical problems where no protocol exists, and

ensure those decisions are subsequently reflected in protocol.

Provide clinical supervision to clinical staff within

the service, and clinical oversight to non-clinical work and health coaches,

ensuring they operate within safe boundaries and escalate appropriately.

Deputise for the Clinical Lead in their absence on

clinical matters, escalating to the Clinical Lead where a decision falls

outside delegated authority.

Lead the clinical governance arrangements for the

assessment function, including clinical audit, incident and complaint

investigation, and the clinical risk register.

Advise on the clinical implications of proposed

operational changes, including capacity, appointment length, skill mix and

caseload distribution, and contribute to the workforce model for any successor

service.

Contribute to recruitment, induction, competency

assessment and development planning for clinical members of the team, and

identify and address unwarranted variation in practice.

Support the wellbeing of the clinical team in a

service dealing with distressed patients and emotionally demanding material.

Education

Act as the clinical educational resource for the

service, building capability in workability assessment across clinical and

non-clinical colleagues.

Design and deliver training, briefings and awareness

sessions for primary care colleagues, work and health coaches, employers and

partner organisations.

Provide mentorship, coaching and reflective

supervision, and support the development of any trainee or developmental posts

within the service.

Build constructive relationships with referring GPs,

providing feedback that improves referral quality and sustains clinical

confidence in the pilot model.

Take responsibility for personal continuing

professional development, maintain registration and revalidation requirements,

and arrange personal clinical and professional supervision.

Contribute to the wider dissemination of learning from

the pilot, including written outputs, case studies, presentations and

contributions to professional networks.

Research and evaluation

Design and lead clinical audit and case note review,

report findings and ensure recommendations are implemented and re-audited.

Lead clinical test-and-learn cycles, proposing,

testing and evaluating changes to the assessment model during the pilot period.

Act as a clinical point

of contact for the national evaluation, including interviews, case note review

and data queries, within the limits of patient confidentiality

5. FREEDOM TO ACT

The post holder practises competently and autonomously

without direct clinical supervision, in accordance with the NMC Code and local

policy.

The post holder assumes clinical accountability for

patients referred into a non-medically led pathway.

The post holder exercises professional judgement and

expertise to create precedent and deal with ambiguous or novel problems,

applying evidence-based practice and rigorous analytical judgement in the

absence of specific guidance.

The post holder holds delegated authority to determine

clinical assessment practice within the service, subject to ratification by the

Clinical Lead

Matters with implications for patient safety, service

scope, contractual obligation or the national pilot design are escalated to the

Clinical Lead

WORKING ARRANGEMENTS

This is a fixed term post for 12 months, funded

through the national pilot. Continuation beyond the pilot period cannot be

guaranteed and is subject to national decisions on the future of the model.

A flexible and agile approach to working is expected.

The service operates a blended model of face to face clinics, remote

consultation and home working, and the balance between these will vary with

service demand and patient need.

Home working is supported for remote assessment,

report writing, supervision and administrative activity, subject to a suitable,

confidential home working environment and compliance with information

governance requirements. Home working is an operational arrangement, not a

contractual entitlement, and does not remove the requirement to attend sites.

The leadership, supervisory and educational elements

of the role require a regular on-site presence sufficient to maintain

visibility, support the team and sustain relationships with referring

practices.

Morecambe Bay Primary Care Collaborative is the largest employer of Primary Care colleagues in South Cumbria, we are a not-for-profit Community Interest Company, and work to support, guide and underpin primary medical care across Lancashire and South Cumbria.

We deeply value education and learning, hosting the Lancashire and South Cumbria Training Hub. We have a great team on our board that guide our organisation, and you will be supported to excel in your role.

Experience

Qualifications

Knowledge and skills