Advanced Clinical Practitioner - Frailty

Key Result Areas:

Expertise & Excellence in Clinical Practice

Deliver evidence-based personalised and compassionate care which places quality at the heart of specialist practice. Care will be responsive to individual patient needs and reflect current local protocols and national guidelines.

Utilise high levels of autonomy and advocacy, using analytical and judgemental skills in undertaking differential diagnosis to ensure the delivery of an expert level of care, developing their own and others knowledge within the speciality.                       

Manage their own caseload of patients including comprehensive review of patients, requesting diagnostics, reviewing results and creating and implementing management plans within the speciality and prioritise workload to meet patient and service need.

Independent and supplementary prescribing including discharge of patients, within current legislative and local frameworks. 

Support development and implementation of personalised care pathways for the speciality through holistic needs assessment, planning and evaluation of care and all care interventions.

Implement pathways of care, adapting to patients’ emerging needs by ensuring a planned and co-ordinated approach to care, supporting enhanced recovery and reducing inappropriate admissions to improve patient experience and safety.

Refer directly to other health care professionals and specialist departments as necessary, to ensure optimal efficiency and quality of care.

Act as a patient advocate to facilitate the process of shared decision-making in respect to health, choice of treatment and care. Use interpersonal and communication skills where there may be significant barriers in order to build confidence. Ensure that patients’ individual needs are expressed and valued and individual management plans are understood.

Advise on diagnosis and symptom management for patients within the speciality. Evaluate response to interventions and advise on the adaptation of management and discharge plans.

Empower patients to self-manage their condition, undertaking risk stratification to determine those who can self-manage following education, those who will need guided support to self-manage and those who will need ongoing face-to-face support.

Work autonomously in the development and delivery of practitioner led or parallel clinics within AEC in line with National guidance and local service need.

Provide clinical advice and input to commissioning in relation to Acute Medical services as required.

Act as a resource, providing clinical expertise, specialist advice and support across service boundaries to ensure optimum liaison and co-ordination of care.

Undertake clinical competencies relevant to this specialist service to develop autonomous expertise in an advanced role. Actively integrate theory and practice.

Management & LeadershiP

Provide clinical advice and leadership to others across the organisation, acting as a role-model and demonstrating high standards of holistic care.

Support trainee practitioners including responsibility for annual appraisal where applicable.

Contribute to budget planning and management as required.

Contribute to annual improvement plans and continuously review their own performance against these plans, taking action or escalating where appropriate.

Promote an ethos of continual service improvement and lead delegated projects, monitoring progress in terms of milestones and key measures of performance.

Strive to motivate and involve others in developments in the speciality.

Contribute to the clinical governance agenda.

Attend Trust senior team meetings and contribute to the agenda and the strategic vision as required.

Communication

Take personal responsibility for ensuring effective communication between all service providers.

Demonstrate advanced empathetic interpersonal and communication skills in supporting, informing and advising patients and carers through diagnosis, treatment, disease progression, prognosis and supportive and palliative care where applicable.  This may involve imparting significant news or supporting patients and carers during and following such consultations.

Effectively and sensitively communicate highly complex and sensitive information to emotionally distressed patients and family/carers at key points along the care pathway on a frequent basis.

Refer to other health professionals and outside agencies to ensure optimum care and ongoing support for individual patients/carers, and to ensure the seamless transition between primary and secondary care appropriate to patients’ individual needs and circumstance.

Develop and maintain links with local and national organisations which support the care of patients within this speciality.

Network both locally across the sector and nationally to ensure that services within the Trust are at the leading edge of development in Acute Medical care.

Create, manage and maintain robust links with inpatient specialities and community services to ensure patients are identified and moved swiftly into optimal care pathways to improve flow and patient outcomes.

Education

Support the development of trainee ACPs involved in the care of acute medical patients.

Identify and use educational strategies to deliver complex information to patients and carers.

Contribute to the development of patient training to support self-management and health promotion activities.

Influence the development of other professionals by leading or contributing to Trust-wide specialist education and training.

Deliver formal and informal teaching initiatives as part of the Trust’s education strategy as agreed with the appropriate senior staff to ensure practice development, staff empowerment and improved care for patients.

Act as a mentor/clinical supervisor as appropriate.

Take personal responsibility for life-long learning and personal development through clinical supervision and appraisal.  Actively engage with learning and development opportunities needed to work as an ACP and take appropriate action to ensure these needs are met.

Contribute to Trust-wide advanced practice education agenda.

Utilise a professional portfolio to develop enhanced clinical skills to deliver advanced service within speciality. 

Develop and monitor skills using best available evidence to support development.