Working as an autonomous practitioner as part of Medvivo’s multidisciplinary team you will operate from various Primary Care Centres, delivering face-to-face and telephone assessment and treatment of patients. You will respond to requests for home visiting with the support of a fully equipped medical car and driver. Support from remote or mobile doctors will be available.
You will provide out of hours (OOH) unscheduled care through the assessment, diagnosis, treatment and discharge or referral of patients with undifferentiated and undiagnosed injury/illness, or acute exacerbation of existing conditions. You will assist in the development of an integrated approach to the delivery of patient care across the ‘whole system’ of health and social care, working in partnership with all relevant stakeholders.
The postholder will provide clinical expertise in first contact care. You will work across traditional boundaries to produce effective local services providing comprehensive assessment to patients in a range of clinical settings.
Patients and carers; the public, acute and community hospitals, general practitioners, advanced nurse practitioners, Access to Care, community teams, social care staff, local hospices, palliative care teams, ambulance crews, community and in-patient mental health services, walk-in centre and minor injury unit staff.
Working within the multidisciplinary team at Medvivo, the postholder will be responsible for the following:
MANAGEMENT & LEADERSHIP
- To take clinical responsibility for themselves and to provide assistance and supervision to other health professionals as required.
- To assist in the maintenance of clinical standards and to share in the efficient running of the service.
- To share the responsibility for the security and care of equipment.
- To be aware of local, regional and national policies which affect the delivery of health and social care.
CLINICAL / JOB SKILLS
- To act as an autonomous practitioner providing clinical assessment, diagnosis (where possible), and treatment (where appropriate) for patients (Adults & Paediatrics) invited to attend Medvivo’s Primary Care Centres.
- Accurately triage & prioritise all patients demonstrating the use of a variety of techniques to elicit the history of an event / illness including past medical and drug history.
- Evaluate clinical information from examination & history taking and initiate appropriate treatment and referral or discharge.
- Refer patients to alternative care settings, where appropriate.
- Discharge or treat, as appropriate and within scope of practice.
- Prescribe, supply and / or administer medication and treatments according to agreed protocols, within scope of competence.
- To maintain accurate contemporaneous computerised clinical records of every contact, including history, examination, diagnosis, plan of care, advice given, treatment and recommended follow up. This includes documenting any adverse event, safeguarding child or vulnerable adult issue or other notifiable matter.
- To be aware of and work within the performance and quality framework for the OOH service: Care Quality Commission and the National Quality Requirements.
- To provide telephone assessment to patients and Health Care Professionals calling Medvivo, as necessary.
- To respond to requests for home visits and provide clinical expertise to patients by assessing and treating their medical condition.
- To refer to other health and social care professionals and providers, as appropriate.
- To be flexible and responsive both to the clinical needs of patients and operational needs of the service
- To empower service users to access the service through the most appropriate means and to encourage self-care where clinically appropriate.
- To liaise with clinical colleagues to provide the most appropriate package of care for each individual recognising his/her own scope of competence.
- To advise patients within the limits of his/her competence, recognising when to seek help. He/she will refuse any responsibility that falls outside of their scope of competence in line with regulatory body (NMC/HPC) requirements for fitness to practice.
- To provide clinical support to the multidisciplinary team at Medvivo.
- Continue to develop, expand and role model own personal clinical expertise as an autonomous / independent practitioner.
- In partnership with others, challenge and critically evaluate the boundaries of autonomous practice, such that patient access, choice and outcomes will improve.
- Help in the development and evaluation of clinical guidelines, and competency tools to support the clinical team in the delivery of best practice.
- Develop own areas of specific clinical expertise in order to link acute, primary, community and emergency care sectors in expanding clinical practice within Medvivo.
- Interpret National Guidance and Policy and advise Medvivo Directors of gaps, risks and financial implications within service delivery.
- Contribute to and implement initiatives relating to quality assurance and performance management
- You will take part in clinical audit of your activity according to policy; formal & informal feedback will be provided as part of performance management
- Monitor standards against NQR, the Care Quality Commission and Key Performance Indicators.
- You will report on clinical incidents, compliments and complaints in line with the Adverse Incident Reporting, Investigation and Learning Policy, escalating high risk incidents without delay.
- Undertake risk assessment of all levels of clinical service reporting to senior management
- Be aware of responsibilities under the Data Protection Act.
- To attend team meetings as required.
- Ensure effective communication takes place within and across teams using face to face, electronic and written communication.
- Utilise complex communications skills to negotiate (using translation services if language barriers are present), and provide support to patients who may be non-compliant, emotive, hostile or antagonistic with recommended outcomes.
- Utilise advanced listening skills, probing and facilitative skills across a diverse range of interactions, some of which will be highly challenging.
- Remain up-to-date with organisational policies, procedures, news etc. through frequent access of the Medvivo intranet.
- Support and actively promote the integration of the OOH urgent care service within Wiltshire.
PERSONAL AND PEOPLE DEVELOPMENT
- Take part in the annual appraisal process, agreeing and setting own professional and performance objectives.
- Receive and deliver clinical supervision in accordance with Medvivo clinical supervision policy.
- Identify own professional development needs to maintain professional registration with the NMC.
- Facilitate the learning and development of people and teams in accordance with the Medvivo Learning and Development Plan.
- Proactively manage own performance management cycle in accordance with the Performance Management and Personal Development Policy.
- Actively participate in service development plans.
- Act as project lead when directed by Quality Committee or as part of a project team to undertake service exploration and development.
RESEARCH / AUDIT
- For clinical governance and training purposes, regular call monitoring is a requirement of this job. A random sample of the Adastra notes written by every clinician is audited monthly against a set of criteria. These criteria include clarity and accuracy of documentation as well as standards of good clinical practice.
- To participate in the clinical audit of the Out of Hours Service with particular emphasis upon the provision of a non-medical practitioner led minor illness service.
- To contribute to the development and evaluation of both current and future urgent care services.
As an evolving organisation, it is envisaged that the role will continue to develop and will be the subject of ongoing review between the post holder and line manager.
This job description is not an exhaustive statement of the responsibilities of the post.
The post holder will be required to undertake such other duties which may, from time to time, be required as a result of the nature of the organisation and subsequent review of impact on service delivery. The range of duties may be changed following consultation with the post holder.
EQUALITY AND DIVERSITY
Medvivo aims to be a modern and equitable employer. We recognise and encourage the potential of a diverse workforce, positively welcome all applicants and appoint on merit. We provide flexible working options.
“Medvivo is committed to valuing diversity and promoting equality. As an organisation we seek to provide fair, accessible services for all and equality of opportunity for our staff. We aim to maximise the potential of all employees and build a workforce that is valued and reflects the communities we serve. We will equip our staff with the knowledge and understanding to promote equality of opportunity in employment and service delivery, and view individual and institutional diversity positively.
The impact on equality of all relevant policies and services will be assessed in order to ensure that barriers to access are identified and removed, culturally competent services are delivered, service outcomes are equitable and that no person is treated less favourably on the grounds of their race, ethnic group, religion, language, disability, impairment, age, gender, qualification, education, sexual orientation or mental health status”.
HEALTH AND SAFETY
All employees are responsible for complying with safe working procedures in accordance with Medvivo Health and Safety Policy and the Health and Safety at Work etc Act 1974. All employees have a duty to:
- Take reasonable care of themselves and for others at work.
- Co-operate with the organisation, as far as is necessary, to enable them to carry out their legal duty.
- Not to intentionally or recklessly interfere with anything provided (including personal protective equipment) for health and safety or welfare at work.
Medvivo is committed to reducing the risk of healthcare associated infections. All employees involved directly or indirectly in the provision of health or social care have a duty to cooperate with all organisational Infection Prevention and Control associated policies and procedures to reduce the risk of healthcare associated infections for customers, patient’s staff and the public.
You will be expected to cooperate with colleagues, contractors and other healthcare providers also involved in customer/patient care directly or indirectly so far as is necessary to enable Medvivo to meet its obligations under the Health and Social Care Act 2008.
SAFEGUARDING CHILDREN AND VULNERABLE ADULTS
In accordance with Section 11 of the Children Act (2004) and Department of Heath guidance 'No secrets' (2000): Medvivo is committed to safeguarding and promoting the welfare of Children, Young People and Vulnerable Adults. All staff working with these groups are expected to share a commitment to this. You will be expected to promptly report any concerns relating to the safeguarding of children, young people and / or vulnerable adults in accordance with agreed procedures. If your own conduct in relation to the safeguarding of children, young people or vulnerable adults gives cause for concern, Medvivo’s internal processes for protecting the public will be followed, alongside implementation of the Disciplinary Procedure where appropriate.
Confidentiality must be maintained at all time, in accordance with Medvivo policies and the Data Protection Act 1998. Breaches of confidentiality are subject to disciplinary action.
DISCLOSURE AND BARRING SERVICE
The post is subject to an Enhanced Disclosure through the Disclosure and Barring Service (DBS). Further details about DBS disclosure can be found at www.homeoffice.gov.uk/dbs
Note: No Smoking Policy
Medvivo adopts a policy of encouraging all staff not to smoke for the benefit of their health.
Smokers are welcome to apply for posts and their applications will be treated on the same basis as those of non-smokers.
Smoking is not permitted at the work place and applicants are advised to discuss this at interview if they are smokers.
QUALIFICATIONS & TRAINING
Registered Level 1 Nurse with current NMC registration.
Evidence of on-going learning
MSc in Advanced Practice or evidence of accumulation of relevant experience / knowledge.
Physical assessment and clinical reasoning including paediatrics
Evidence of level 3 /MSc Advanced practice
EXPERIENCE & KNOWLEDGE
Minimum of 5 years post registration experience.
At least 1 years’ experience as an Advanced Nurse Practitioner.
Experience of working autonomously diagnosing and treating patients.
Evidence of wide knowledge base and competency in clinical practice.
Evidence of excellent oral and written communication.
Experience of working in a multidisciplinary environment with a wide range of individuals at different levels.
Experience of working across organisational boundaries within health and social care.
High level of current clinical knowledge.
Experience of providing urgent care
Experience in mental health assessment.
Understanding of legal and ethical issues / responsibilities relating to professional practice especially with regard to autonomous practice and telephone triage.
EXPERIENCE & KNOWLEDGE CONTINUED
An understanding of the emergency care pathway.
Recent evidence and experience of prescribing.
Knowledge of primary health care issues affecting a diverse local population.
Understanding of equality and diversity and its significance for health and social care.
Knowledge in the delivery of Health Care Advice and Health Promotion.
Understanding of end of life pathways
Knowledge of Clinical Governance issues and ability to establish systems in practice.
Knowledge of the National Agenda with regards to the provision of Out of Hours care.
SKILLS / ABILITIES
To be patient-focused.
Evidence of ability to maintain effective working relationships with peers, colleagues, patients, and their families.
Effective team player.
Excellent clinical judgement and decision making skills.
Evidence of ability to prioritise and manage time effectively.
Ability to empathise with and reassure patient, relatives and carers in crisis situation
Teaching and assessing skills and experience in clinical practice.
SKILLS / ABILITIES
Ability to empathise with and reassure patient, relatives and carers in crisis situations
Ability to work under pressure and to deal with emergency situations and/or difficult clients and stressful situations professionally.
Evidence of ability to influence practice through the use of evidenced based research.
Ability to assess, minimise and manage risk.
Ability to remain calm and professional under pressure.
Familiarity in the use of IT systems, e.g. MS Office applications.
Ability to be flexible and adaptable.
Ability to be motivated and forward thinking.
Extremely effective communicator, able to manage staff in a high pressure environment.
Demonstrate energy and determination to deliver on commitments in an ever changing environment.
Ability to remain calm, adaptable and cheerful when working under pressure.
Ability to cope with crisis / conflict and untoward events
Full Clean Driving Licence
Competent and confident driving skills.