Advanced Clinical Practitioner

Job Summary
At One Health Lewisham (OHL), we're transforming the way healthcare is delivered across South East London. As an integrated community provider, we work closely with GP practices, Primary Care Networks (PCNs), and system partners to deliver innovative, patient-centred services that improve outcomes for some of the borough's most complex populations.

We're looking for an experienced and motivated Advanced Clinical Practitioner (ACP) to join our growing clinical team. This is an exciting opportunity to work autonomously while contributing to service innovation and the delivery of high-quality, evidence-based care across Lewisham.

Main duties of the job
As an Advanced Clinical Practitioner, you will provide expert assessment, diagnosis, treatment and management of patients with acute, chronic and complex conditions. Working independently and collaboratively within a multidisciplinary team, you will deliver safe, effective and compassionate care while helping to develop and improve services across primary care.

This is a varied role offering the opportunity to work across a range of innovative services, including:

• Home Visiting Service
• Care Home Services
• Special Allocation Service
• NHS Health Checks
• Population Health Programmes
• Long COVID Service
• Weight Management (including Tirzepatide/Mounjaro pilot)
• High Intensity User Service
• Digital Transformation initiatives

What You'll Be Doing

• Independently assess, diagnose and manage patients with complex and undifferentiated conditions.
• Develop evidence-based treatment and management plans.
• Request and interpret appropriate investigations.
• Prescribe medications (where qualified as an Independent Prescriber).
• Deliver holistic, patient-centred care across community settings.
• Work collaboratively with GPs and multidisciplinary colleagues.
• Provide clinical leadership, mentorship and support to colleagues.
• Contribute to service development, quality improvement, audit and clinical governance.
• Promote innovation and continuous improvement across our services.

About us
One Health Lewisham (OHL) is the integrated community provider working across SEL, delivering a variety of innovative services for patients supporting practices and PCNs. We are a forward-thinking innovation partner, striving to develop streamlined and transformative pathways which support the wider integrated care system. We are passionate about our mission to provide the best possible care for our patients, and we work hard to support and develop our team to strive for excellence.

We are a fast-growing organisation, providing a range of services which are fully integrated into primary care. We hold an APMS contract providing care for some of the most complex patients in the system through our Special Allocation Service and Care Home services.

• NHS Health Checks Programme;
• Home Visiting Service, led by our experienced team of ANPs;
• High Intensity User Service;
• Digital Transformation (Change Management and embedding digital technologies and pathways across our services);
• Population Health improvement services, e.g., Vaccination uptake, LTC reviews, HIV screening etc.;
• Long Covid Service - we are a local pioneer in developing this service in the community for our local populations;
• Weight loss - Tirzepatide pilot (Mounjaro weight loss injection).

Job responsibilities
Job Summary:
The Advanced Clinical Practitioner works as an autonomous, highly skilled clinician, providing expert assessment, diagnosis, treatment, and evaluation for patients presenting with acute, chronic, and complex conditions. The ACP independently manages a varied caseload, makes safe clinical decisions, and delivers highquality, patientcentred care while working collaboratively with the wider multidisciplinary team.

The post holder will be a registered healthcare professional and hold an MSc in Advanced Clinical Practice or equivalent at MSc level. If relevant to the post, they will be an independent Non-Medical Prescriber registered with their relevant professional body. They will practice at an advanced level demonstrating in depth knowledge and competence in all aspects of primary care, medicine, encompassing enhanced assessment, critical thinking and clinical management skills that are evidence based and deliver high quality patient centred care.

Key Responsibilities
Clinical responsibilities
Use highly developed clinical knowledge to independently assess, diagnose, plan, implement and evaluate treatments and interventions for patients presenting, frequently with complex undifferentiated or undefined presentations. Uses highly developed clinical knowledge to independently assess, diagnose, plan, implement and evaluate treatments and interventions for patients presenting to the practice with complex undifferentiated or undefined presentations.

Undertakes physical examination as indicated by the patients condition; autonomously analysing complex clinical signs and investigation results to consider differential diagnoses and diagnose conditions, initiating treatment as required.

Performs clinical procedures appropriate to the history and physical examination of patients, including further invasive testing and treatments requiring highly developed skills and precision, including (but not limited to) catheterisation, cannulation, peripheral arterial blood gas sampling.

Requests investigations such as blood, urine and other laboratory tests, electrocardiographs (ECGs), ultrasound scans, X-Rays and computed tomography (CT) scans in accordance with IR(ME)R regulations and as local policy allows.

Analyses multiple sources of data including patient history, physical examination and investigation findings when making diagnoses, clinical judgements and evaluating care provided; presenting this information to specialty/senior medical staff for advice when scope of practice is exceeded.

Autonomously formulates appropriate management plans for patients, formulates clinical decisions and often complex treatment plans to manage acute illness and acute episodes of chronic illness including referral, admission, or discharge from service.

Continuously revaluates findings and clinical response to treatment and establishes an appropriate ongoing management plan accordingly.

Prioritises health problems and intervenes appropriately in complex, urgent and emergency situations, including initiation and leadership of resuscitation.

Manages clinical events involving patients, often requiring unpredictable and high levels of mental and/or physical effort according to the patients dependency and clinical need.

Prescribes and reviews medication (as an independent prescriber, if relevant) for therapeutic effectiveness appropriate to patient need and in accordance with best/evidence-based practice and national and local protocols and within the roles scope of practice and legal framework. Integrates both pharmacological and non-pharmacological treatment in patient care/management plans

Assesses patients with mental health needs using local policy and guidelines and refers to the appropriate services.

Communicates effectively with patients, carers, colleagues, and others using appropriate communication styles. Anticipates barriers to communication and ensures patients and significant others are kept fully informed and consent to treatment.

Acts as a resource for staff, advising on local, national, and organisational policy, procedures and guidelines ensuring patient safety and clinical governance.

Leadership/ Management
Works in partnership with the existing senior medical, nursing and AHP teams in driving development and change.

Manages conflicting views and liaises between groups where there may be conflict.

Highlights and addresses areas of witnessed poor practice and manages the situation appropriately.

Manages staff performance, training, and supervision of other staff including annual appraisals

Supports staff development to maximise potential, encouraging everyone to learn from each other and from external good practice.

Supports patients, carers and staff during difficult situations that arise e.g. breaking bad news or following an unexpected event.

Produces accurate and complete documentation and patient records consistent with legislation, policies, and procedures.

Possesses excellent time management and personal organisation skills.

Acts as a knowledge resource in how to initiate and manage the impact of change.

Develops and contributes to local guidelines, interpreting and adapting national protocols and standards to enhance patient care and safety.

Maintains awareness of budgetary constraints within the organisation, manages resources appropriately and encourages others to do likewise.

Ensures appropriate representation and participation in organisational meetings as appropriate for the role.

Actively contributes and provides leadership with service development plans within the PCN practices.

Education Training and Development:
Takes responsibility for their own learning and performance including the participation in clinical supervision and maintaining an awareness of relevant research evidence.

Develops health promotion and education in conjunction with other health care professionals ensuring that all patient care within the multi-professional team is based on research and best practice.

Acts as a constant source of clinical and theoretical knowledge for all grades and disciplines of staff as well as patients and their significant others, providing support and clinical advice in specialist areas, based on evidenced based research.

Possesses proficient typing, IT and computer skills. Uses audio/visual equipment to record and impart information and research.

Prepares and delivers presentations and participates in workshops on a local, regional and national level, to ensure the communication of good practice.

Works with the multi-professional team to further develop appropriate clinical pathways and care approaches. Disseminates their own learning and good practice to other team members.

Designs, coordinates, and undertakes collaborative audit, research, and development into the practice and related practices.

Plans, delivers, and implements programmes of education and training for trainee ACPs, nurses, medical and other disciplines and continues to be involved in their ongoing support.

Supports organisational and system research and development plans.

Personal & professional development
Annual reviews:
Participate in own annual NHS appraisal, annual OHL appraisal, the revalidation process as required by the NMC and support others as required.

Development of others:
Be an effective role model and resource for other members of the multi-disciplinary team

To maintain clinical excellence within the department and provide education and training both formerly and informally for colleagues.

Key Practice Issues and Responsibilities
Facilitate pro-active links and relationships between the Team & the wider community giving advice & guidance to fellow professionals, carers, voluntary organisations & the public.

Foster collaborative working relationships with the whole system.

Ensure appropriate and timely transfer of care between services.

Ensure that all practitioners maintain accurate databases.

Facilitate regular review of caseloads, providing guidance and support to ensure all care is of a high quality and is evidence based.

Person Specification
Experience
Essential

• Experience 1+ years working in general practice.
• Worked with the EMIS Clinical System.
• Experience of providing leadership to a project.
• Experience of informing and leading quality improvements to improve outcomes for patients.

Desirable

• Work in an organisation that has impacted on care delivery in Lewisham.
• Experience of previously working with a Lewisham health provider in a quality improvement capacity.
• Minimum of 3 years in general practice.
• Previous experience of working in a collective decision-making group.
• Experience in leading a service or clinical team.
• Have worked with digital technology.
• Carried out clinical audit and quality improvement projects showing significant changes within healthcare services.

Knowledge and Skills
Essential

• Able to use computers for recording clinical data, data analysis, administrative purposes and communication.
• Ability to take the lead clinically.
• Take part in and react positively to changes in practice and the work environment.
• Understanding of EMIS systems.
• A general understanding of health and an appreciation of the broad social, political, and economic trends influencing it.
• The ability to recognise key influencers and the skills in engaging them in order to implement quality improvements.
• Able to engage effectively with a wide range of stakeholders, ensuring effective two-way communication with the member practices.
• Able to facilitate and encourage active engagement.
• Ability to communicate effectively across Primary Care services.
• Ability to identify barriers and find solutions to support best-practice across all local practices.

Desirable

• Understanding of digital health systems outside of NHS.

Qualities and Attributes
Essential

• Good verbal and written communication skills.
• Ability to motivate self and others.
• Ability to lead and work within a team.
• Excellent interpersonal and relationship skills.
• Ensures professional values and ethics are upheld.
• Enquiring, critical approach to work.

Qualifications
Essential

• Full registration with the NMC.
• Appropriate qualification to practice in the UK.
• Not suspended or disqualified from practice or on any conditional inclusion list with any CCG.

Disclosure and Barring Service Check
This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

UK Registration
Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).

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