Advanced Practitioner (ACP/ANP) Persistent Pain

The Advanced Clinical Practitioner (ACP) / Advanced Nurse Practitioner (ANP) is a senior autonomous clinician within the East Sussex Community Persistent Pain Service, providing expert assessment, clinical decision-making and personalised care for adults living with persistent musculoskeletal pain.

Working across community settings, the post holder will deliver advanced clinical practice through holistic What Matters to You (WMTY) conversations, recognising each person as an expert in their own life and supporting them to develop the knowledge, confidence and skills to live well with persistent pain. The role combines advanced clinical reasoning with health coaching, behaviour change and psychologically informed practice to ensure care is tailored to the individual's goals, strengths and circumstances.

The ACP / ANP will provide clinical leadership within the multidisciplinary team, managing complex presentations, leading advanced triage, contributing to multidisciplinary decision-making and supporting colleagues across primary care, community services and the voluntary sector.

They will work collaboratively with Pain Practitioners, Clinical Psychologists, Pharmacists, Pain Navigators, Health Builders, GPs and other partners to deliver coordinated, evidence-based care aligned with NICE guidance and the East Sussex Integrated Care Strategy. Alongside expert clinical practice, the ACP will contribute to service development, quality improvement, education, research and workforce development.

As a senior clinician, the post holder will act as a role model for compassionate, trauma-informed and strengths-based practice, helping to shape an innovative community pain service that delivers excellent clinical outcomes while improving people's confidence, independence and quality of life.

Main duties and responsibilities

Advance Clinical Practice

• Work as an autonomous advanced practitioner, accountable for their own professional decisions and actions within their professional scope of practice.

• Work in accordance with relevant legislation, professional standards, organisational policies, clinical governance arrangements and evidence-based guidance.

• Provide expert assessment, clinical reasoning and decision-making for adults with persistent musculoskeletal pain.

• Manage a complex caseload, including individuals with co-morbid physical, psychological and social needs.

• Undertake advanced triage and determine the most appropriate care pathway.

• Identify and respond appropriately to red flags, safeguarding concerns and clinical risks, taking appropriate action where required. Examples include but are not limited to: serious pathology; new or progressive neurological symptoms; inflammatory or systemic presentations; significant deterioration or unexplained change; medication-related harm; severe psychological distress; risk of self-harm or suicide; safeguarding concerns; substance dependence or harmful medication use; and social circumstances that may prevent safe or equitable access to care.

• Identify potential serious, progressive or treatable pathology and arrange appropriate escalation, investigation or onward referral.

• Request, interpret and act upon investigations where professionally authorised, clinically indicated and consistent with the service pathway.

• Create emotionally and psychologically safe consultations.

• Use trauma-informed principles of safety, trust, choice, collaboration, empowerment and cultural sensitivity.

• Recognise the boundaries between psychologically informed practice and specialist psychological therapy.

• Discuss the benefits, limitations and risks of medicines used for persistent pain.

• Prescribe independently where the post holder holds an appropriate prescribing qualification, has organisational authorisation and is competent to prescribe within the relevant area of practice. Where not an independent prescriber, work within agreed medicines-management arrangements and refer to an appropriate prescriber.

• Together with the patient, develop and review personalised care plans using a person-centred, biopsychosocial approach.

• Maintain accurate, timely and legally compliant clinical records.

Supporting Self-Management and Behaviour Change

• Undertake comprehensive, proportionate and person-centred clinical consultations based on the person’s needs and the purpose of the contact.

• Use a “What Matters to You?” approach to understand their story, experience of pain, concerns and expectations and understanding.

• Enable people to better understand persistent pain and its impact on everyday life.

• Use health coaching, shared decision-making and behaviour change approaches to support meaningful, sustainable change.

• Support people to develop persistent pain management strategies, e.g.: pacing and flexible activity management; flareup management; reducing fear and avoidance; improving confidence in movement; sleep and fatigue management etc.

• Help people identify realistic goals relating to movement, activity, sleep, emotional wellbeing, relationships, work, education, participation and quality of life

• Plan, deliver and evaluate group education, group consultation and supported self-management programmes with the MDT.

• Facilitate groups in ways that promotes participation, psychological safety and mutual support.

• Manage difficult, distressed or challenging group dynamics sensitively and confidently.

• Support the involvement and development of peer facilitators and people with lived experience within clear governance and role boundaries.

• Work collaboratively with families and carers where appropriate.

Multidisciplinary and Partnership Working

• Work collaboratively within the multidisciplinary team to deliver coordinated care.

• Present and discuss complex cases within multidisciplinary meetings.

• Provide specialist advice and support to colleagues, referrers and partner organisations.

• Develop effective relationships with primary care, community services, secondary care providers and the voluntary sector.

• Participate in multidisciplinary meetings and contribute to complex case discussions.

• Support effective transitions between services and reduce unnecessary duplication of care.

• Present and discuss complex cases within multidisciplinary meetings.

Clinical Governance and Quality

• Practise in accordance with professional, legal and organisational requirements.

• Maintain high standards of patient safety, safeguarding and risk management.

• Participate in clinical audit, service evaluation, quality improvement and research activities.

• Contribute to incident reviews, learning events and continuous service improvement.

• Promote equality, inclusion and equitable access to services.

Leadership and Professional Development

• Provide visible clinical leadership and act as a role model for person-centred practice.

• Support the development, supervision and learning of colleagues and students where appropriate.

• Contribute to the development of clinical pathways, policies and service innovation.

• Maintain professional registration, revalidation and continuing professional development requirements.

• Participate in appraisal, supervision and mandatory training

Professional Responsibilities

• Maintain current registration with the NMC, HCPC, GOsC or other approved statutory professional regulator relevant to the appointment.

• Work within their professional scope of practice and level of competence.

• Maintain an advanced level of clinical knowledge and competence in persistent pain and relevant MSK practice.

• Participate in annual appraisal and review of advanced-practice capability.

• Disclose any limitations, investigation or condition affecting safe professional practice.

• Adhere to organisational policies relating to confidentiality , safeguarding, health and safety, information governance and equality and diversity.

PERSON SPECIFICATION

Qualifications

Professionally Registered- eg NMC, HCPC or other appropriate professional regulator - E

Evidence of continuing professional development with recognised post-registration course in pain management and/or extensive experience in working with people with persistent pain at Band 7 or above - E

Evidence of MSc Advanced Practice - E

Have experience of teaching and mentoring at an advanced level - E

Undertaken or working towards appropriate leadership training with an aptitude to lead change and lead new ways of working - E

Non-Medical Prescribing - D

Personal Qualities

Expert practitioner and role model - E

Successful leadership and management skills - E

Demonstrates compassionate, person-centred and strengths-based practice - E

Committed to personalised care and What Matters to You conversations - E

Demonstrates resilience, curiosity, innovation and reflective practice - E

Experience & Job Related Knowledge

Significant experience working autonomously at an advanced level within MSK, Persistent pain or long-term conditions - E

Experience of managing highly complex clinical presentations - E

Experience of advanced clinical assessment, differential diagnosis and clinical decision-making - E

Experience of identifying red flags and appropriate escalation - E

Experience of multidisciplinary working - E

Experience of student/staff supervision, mentoring and training - E

Excellent understanding of persistent pain, pain neuroscience and biopsychosocial models of care - E

Knowledge of NICE guidance relating to persistent pain - E

Understanding of supported self-management, behaviour change and personalised care - E

Understanding of trauma-informed practice and psychologically informed approaches - E

Evidence of participating in research, audit and evaluation - E

Skills

Advanced clinical reasoning and autonomous decision making - E

Ability to undertake complex triage and prioritisation - E

Excellent consultation skills with ability to undertake a holistic assessment considering physical, psychological and social factors - E

Ability to formulate personalised care plans - E

Excellent understanding of, and demonstratable ability to apply, health coaching, motivational interviewing, personalised care and trauma-informed approaches to support behaviour change, shared-decision making and supported self-management - E

The ability to work with complexity, uncertainty and ambiguity - E

Community Working

Commitment to delivering care in community settings - E

Ability to travel across East Sussex to meet the requirements of the role - E

Experience of working flexibly across multiple sites - E

Understanding of barriers to accessing healthcare including rurality, transport, digital exclusion and deprivation - E