Practice Nurse - Chronic Disease Management and Minor Illness

Job summary
King Edward Road Surgery is looking for an experienced and enthusiastic Practice Nurse to join our friendly and supportive team for approximately 21 hours per week.

The role will focus particularly on diabetes and chronic disease management. We welcome applicants with strong general practice nursing experience and recognise that candidates may bring different combinations of chronic disease skills. Relevant training and development can be discussed with suitable candidates.

The successful candidate will work autonomously within their competence and as part of our multidisciplinary team, delivering safe, evidence-based and person-centred care. The role will also include health promotion and agreed core practice nursing duties according to experience, competence and practice need.

Main duties of the job
The successful candidate will undertake diabetes checks and structured nurse-led diabetes reviews, assessing symptoms, lifestyle, self-management, medicines adherence and relevant risk factors. They will undertake or arrange appropriate monitoring, including blood pressure, weight or BMI, foot screening, urinalysis and review of relevant blood and urine results. They will provide patient education, lifestyle advice, personalised care planning and support for self-management, recognising abnormal findings, deterioration or complications and referring or escalating appropriately.

The role will also include structured reviews and ongoing monitoring for other long-term conditions, according to competence, including asthma, COPD, hypertension and cardiovascular disease. The post-holder will contribute to QOF, prevention, screening, recall systems, clinical audit and quality improvement.

Other duties may include immunisations, injections, wound care, cervical screening, venepuncture, ECGs and spirometry, according to competence and service need. The post-holder will maintain accurate electronic patient records, use appropriate clinical coding, work autonomously within agreed protocols and collaborate with the wider primary care team.

About us
King Edward Road Surgery is a busy town practice in Northampton, caring for approximately 12,000 patients. We are a friendly and supportive training practice, committed to high-quality patient care and a positive environment for colleagues and learners. We value teamwork, professional development and continuous improvement.

Job responsibilities
Job purpose
To provide safe, effective and person-centred general practice nursing care, with a particular focus on diabetes and chronic disease management.

The post-holder will undertake structured reviews, support patients to manage their health and contribute to agreed core practice nursing services. The post-holder will work autonomously within professional competence, practice policies and agreed clinical pathways, while collaborating with the wider primary care team.

Diabetes care and reviews

• Undertake diabetes checks, interim monitoring and structured nurse-led diabetes reviews in accordance with current guidance, practice protocols and individual competence.
• Take a relevant clinical history and assess symptoms, lifestyle, self-management, medicines adherence and risk factors.
• Undertake or arrange appropriate monitoring, including blood pressure, weight or BMI, foot screening, urinalysis and review of relevant blood and urine results.
• Provide patient education, lifestyle advice, personalised care planning and support for self-management.
• Recognise abnormal findings, deterioration or potential complications and refer or escalate appropriately.
• Maintain accurate records and clinical coding.
• Contribute to diabetes recall systems, QOF, clinical audit and quality improvement.

Wider chronic disease management

• Undertake structured reviews and ongoing monitoring for other long-term conditions according to competence, including asthma, COPD, hypertension and cardiovascular disease.
• Assess treatment effectiveness, medicines adherence, relevant observations and investigation results.
• Agree personalised management plans, promote shared decision-making and support patients to manage their conditions.
• Identify patients requiring follow-up, additional investigation, referral or medical review.
• Contribute to prevention, screening, recall systems, QOF and work to reduce health inequalities.

Core practice nursing and prevention

• Provide evidence-based health promotion and lifestyle advice, including smoking cessation, diet, physical activity and cardiovascular risk reduction.
• Undertake agreed practice nursing duties according to competence and service need.
• Duties may include immunisations, injections, wound assessment and care, cervical screening, venepuncture, ECGs, spirometry and physiological observations.
• Use patient group directions and other authorised medicines processes safely and within professional and organisational requirements.
• Recognise findings that require urgent review and obtain appropriate clinical support.

Clinical governance and patient safety

• Practise in accordance with the NMC Code, relevant legislation, evidence-based guidance, practice policies and professional scope of practice.
• Maintain accurate, complete and contemporaneous electronic patient records.
• Use appropriate clinical coding and templates.
• Comply with safeguarding, infection prevention and control, confidentiality, information governance, medicines and vaccine management, cold-chain and health and safety requirements.
• Report incidents, significant events, risks, complaints and equipment concerns promptly.
• Participate in learning from incidents and quality-improvement activity.
• Recognise personal limitations, seek advice when required and work within demonstrated competence.

Teamwork and service development

• Work collaboratively with GPs, nurses, healthcare assistants, pharmacists, administrative colleagues, Primary Care Network staff and other health and care professionals.
• Communicate sensitively and effectively with patients, carers and colleagues, adapting communication where required.
• Contribute to clinical meetings, audit, protocol development, service review and quality-improvement activity.
• Support colleagues and learners appropriately, including delegation and supervision within competence.
• Use appointments, equipment, clinical supplies and other practice resources responsibly.

Professional development

• Maintain NMC registration, revalidation and an up-to-date professional portfolio.
• Participate in appraisal, mandatory training, clinical supervision and continuing professional development relevant to the role.
• Maintain and develop competence in diabetes, chronic disease management and agreed core practice nursing duties.
• Reflect on practice and use feedback, audit and learning events to improve patient care.

Working relationships
The post-holder will work with GP Partners, salaried GPs, the Lead Practice Nurse, Practice Manager, practice nurses, healthcare assistants, clinical pharmacists, administrative and reception colleagues, Primary Care Network staff, community and secondary care services, patients and carers.

General
This job description describes the main responsibilities of the post and is not exhaustive. It may be reviewed with the post-holder to reflect service development, provided that any changes remain appropriate to the role, contracted hours and the post-holders demonstrated competence.

Person Specification
Qualifications
Essential

• Registered Nurse with current NMC registration
• Recognised training or assessed competence in chronic disease management

Desirable

• Recognised minor illness qualification or assessed competence
• Independent prescribing qualification

Experience
Essential

• Recent primary care or general practice experience
• Experience of working autonomously
• Competence in chronic disease management
• Competence in diabetes checks and nurse-led diabetes reviews
• Experience of asthma and/or COPD management
• Experience of assessing and managing minor illness
• Ability to recognise red flags and refer or escalate appropriately
• Effective communication and consultation skills
• Good organisational and time-management skills
• Accurate electronic record keeping and computer literacy
• Ability to work independently and as part of a multidisciplinary team
• Knowledge of clinical governance, safeguarding and infection control
• Commitment to ongoing training and professional development

Desirable

• Independent prescribing qualification
• Formal qualification in diabetes, respiratory disease or minor illness
• Cervical screening qualification
• Experience of immunisations, wound care, ECGs or spirometry
• Experience of QOF and clinical audit
• Experience of SystmOne

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.
Applicants must have current UK professional registration.