Job description

Job responsibilities

The post holder will proactively manage a caseload of patients requiring complex assessment including home oxygen (long term and ambulatory) therapy and case management in order to prevent unnecessary hospital admissions and improve patient health outcomes.

Working autonomously, the post holder will have continuing responsibility for proactively monitoring and managing, patients on the caseload. The post holder will be expected to possess skills in advanced clinical assessment, diagnostic reasoning and if applicable non-medical prescribing, using these skills will assist in the recognition of early symptoms of disease exacerbation.

The post holder will be expected to be a competent leader and case manager and critical thinker navigating the patient through the appropriate care pathway which spans across the primary, secondary care interface. Pivotal to the care pathway is the prevention of unnecessary admissions and facilitation of early supported discharge to reduce lengths of stay.To work closely with the rest of the team to reduce patients waiting times throughout their journey by reducing unnecessary consultant outpatient attendances.

The service provides assessment to patients diagnosed with chronic lung disease registered with a Bexley GP across various community settings and in their own homes.

Key Task and Responsibilities

The Respiratory Specialist Clinician will be expected to achieve the competencies set nationally by Skills for Health 2005 (www.skillsforhealth.org.uk). These can be summarised as follows;

Utilisation of advanced clinical skills and expert knowledge to plan, implement, monitor and review individualised patient-directed programmes of care to patients with chronic lung disease, home oxygen therapy management and health promotion interventions. To undertake goal centred interventions that are evidence-based, evaluating the effectiveness of these at regular intervals with a view to improving care continuously. Develop risk management plans that will enable individuals to remain safely within their homes Use expert knowledge and skills as a nonmedical prescriber to manage patient medication within own areas of competency, developing clinical management plans in partnership with GP colleagues where necessary. Anticipate individual care needs and develop appropriate care plans, involving carers and relatives To provide individuals and their carers with the necessary education that will enable them to plan for unavoidable disease progression and self manage as far as possible. To work collaboratively with members of the multi professional team to ensure that the patients needs are met, making appropriate referrals are made where necessary. Develop practices which promote patient choice and well-being Ensure that the needs of individuals who are vulnerable are highlighted and addressed in a timely manner To be a competent clinical leader demonstrating a willingness to work as an integral part of a multi professional team Be a highly skilled communicator, written and verbal, with a capability for communicating within a variety of professional groups, challenging attitudes where necessary To manage a caseload of patients with chronic lung disease To practice at an advanced level demonstrating an in-depth knowledge of all aspects of the management of chronic lung disease that is evidence-based To undertake advanced physical and social assessments and examinations, and initiate appropriate diagnostic activity and treatment To work with other health care professionals to ensure a consistency of approach to patient care and to support clinical supervision arrangements within the Trust To work collaboratively with other specialist and multidisciplinary teams, such as GPs, District Nurses, Consultants To support the and Expert Patient Programme and other self-management programmes To contribute towards reducing frequent admissions and bed days of patients with chronic lung disease To help improve the diagnostic rate of chronic lung disease in primary care with the delivery of an ARTP accredited quality assured spirometry clinic. To work alongside the clinical lead in the new/confirmed diagnosis of chronic lung disease in producing treatment plans including self-management and education at consultant lead MDT sessions. To be confident in the delivery of educational topics including pathophysiology of chronic lung disease, chronic lung disease medications, managing exacerbations, breathlessness, productive cough, anxiety and low mood and the importance of exercise and a balanced diet To participate in disease specific audit and data collection To act in accordance with the clinical governance framework within the Trust To share knowledge and skills with patients and families as a key therapeutic intervention and to enable self care and autonomy To identify the educational requirements of primary and social care colleagues in relation to the management of chronic lung disease and lead on meeting these needs To participate in clinical supervision, appraisal and personal development programme Ensure own professional development and clinical skills through attending courses, workshops and conferences and applying the knowledge gained in clinical practice To interface with primary and secondary care teams to enable the implementation of managed care pathways in line with local and national guidance To advise on and develop new initiatives and ways of working informed by local and national policy To be involved in the development of guidelines, policies and protocols within the Trust To promote effective collaborative working relationships with health and social care colleagues and those within support networks and the voluntary sector To act as a change agent and innovator, planning, instigating and evaluating changes To proactively demonstrate the positive impact of case management on the reduction of avoidable admissions and lengths of hospital stay Contribute to the service development within the Trust in line with national strategies for chronic lung disease To maintain accurate and legible and timely records To act as leader, mentor and preceptor to staff within the Trust.

PROFESSIONAL

The post holder will maintain registration with the NMC/HPC and apply the NMC or relevant professional clinical Code of Professional Practice at all times The post holder will keep knowledge and practice updated by study and attendance at appropriate conferences The post holder will work within their competencies at all times

GENERAL

All duties must be carried out in accordance with Bexley ACS policies and procedures The post holder will observe confidentiality of records and health information at all times and be aware of the practice and principles of the Data Protection Act 1998. Failure to comply with this may result in dismissal The post holder must be aware of the responsibilities placed upon them under the health and Safety Act 1974 to ensure that agreed procedures are carried out in a safe working environment is maintained for patients, visitors and employees. See the Trusts Policy Statements The post holder must adhere to the policys and procedures set out by Oxleas Foundation Trust

EFFORT AND ENVIRONMENT

Moderate physical effort is necessary for this post including regular periods of driving, frequent treatment and personal care and occasional movement of patients. The Mental effort required for this post includes in depth mental awareness to carry out interpretation of clinical assessment and decision making of complex clinical interventions. The emotional effort for this post involves frequent exposure to emotional circumstances, in particular care of patients and their carers at the end of life. Working conditions for this post include working in the patients own home with frequent exposure to body fluids and some exposure to containable hazards, eg need for personal alarms The mental effort required to interpret and react accordingly to patients who are acutely unwell.

On Call/Unsocial HoursThis post may required weekend working.

Person Specification

Education

Essential

• Degree level education
• Registered Nurse/AHP

Desirable

• NMP
• ARTP qualification
• Advanced clinical skills course or equvailant

Experience

Essential

• Minimum of 4 years post registration experience, 2 years at band 6
• Community Experience in respiratory
• Experience with the management of home oxygen therapy and review.

Desirable

• Knowledge and experience of treating patients with chronic lung disease
• Experience of delivering self management support in a group setting

Skills

Essential

• Advanced Physical Assessment Skills
• Experience of the management of people with long term conditions

Other

Essential

• Full UK Driving licence and access to a vehicle

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.

Certificate of Sponsorship

Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).

From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).

UK Registration

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

Employer details

Employer name

Oxleas NHS Foundation Trust

Address

151 Lodge Hill, Goldie Leigh

Abbey Wood

SE2 0AY

United Kingdom

Employer's website

http://oxleas.nhs.uk/ (Opens in a new tab)