Job responsibilities

The Practice Nurse will work as part of the primary care team providing a wide range of nursing care to a mixed population. This will require a specialist set of skills and knowledge which the successful candidate will be required to maintain and update to practice safely.

Please see the attached job description and person specification documents for further information and ensure you meet this criteria.

Qualifications

Essential

• NMC Adult or General Registered Nurse (RN / RGN - not Nursing Associate)
• Evidence of continuing professional development
• Willingness to gain qualifications and skills where the applicant does not yet hold all of skills listed if there is a practice need.

Desirable

• General Practice Nurse Qualification
• Non-medical prescribing qualification
• Spirometry qualified (ideally ARTP registered but not essential)
• Diplomas or evidence of suitable training in long term conditions such as diabetes, asthma and COPD.
• Mentoring / teaching qualification
• Clinical supervision experience
• Child and adult immunisation training and experience
• Cervical Screening qualification and experience
• Wound care knowledge and training
• Travel Health training and experience
• Wound care knowledge and training
• Mentoring / teaching experience
• Spirometry assessment, procedure and interpretation
• Contraception and HRT reviews and initiation
• INR / anti-coagulation training and experience
• Venepuncture
• LARC qualification and experience

Wider Knowledge

Essential

• Knowledge and understanding of accountability of own role and within the context of the wider team
• Knowledge and understanding of relevant legal issues e.g GDPR, confidentiality, health and safety, safeguarding, domestic violence/vulnerable adults
• Knowledge of local and national health policy.
• Knowledge of wider health economy within primary care and NHS.
• Understanding measures that are required to provide appropriate, accessible and sensitive primary health care services

Desirable

• Understanding of QOF (Quality Outcomes Framework)
• Knowledge of national public health issues and local patient population
• Able to identify determinants on health in the area
• Clinical governance issues in primary care
• Knowledge of patient group directions, patient specific directions and associated policy
• Willing to do home visits for our housebound patients when required. This may be on foot to suitable locations if required and do not have access to a car or a driving licence so that this is shared.
• Clean driving license and car access

Experience

Essential

• Experience as a General Practice Nurse
• Able to work well within a team and a knowledge of team dynamics
• Some experience in the management of patients with chronic diseases such as but not restricted to; diabetes, COPD, asthma, CKD, CVD.
• Recent general practice and /or relevant nursing experience.
• Ability to work across in different settings related to this role as and when required, this may be in a clinic, care home or patients home.
• Highly motivated and enthusiastic
• Team player
• Flexibility in relation to working hours, sites and duties

Desirable

• Developing protocols and clinical guidelines
• Auditing experience
• Specialist interest in diabetes, COPD or asthma.

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).

Job responsibilities

1. Patient-facing / Remote Medicines Support

Deliver patient-facing medication review clinics, stratifying need across the full spectrum of review types from technical, medicines adherence reviews (including polypharmacy reviews) through to focal long-term condition reviews (see section 3) and holistic SMRs. Provide accessible support for patients with questions, queries, and concerns about their medicines.

2. Medicines-Related Clinical Support for Care Homes

Deliver clinical medication reviews in collaboration with patients, care home staff, and the Ageing Well team, producing clear and evidencebased recommendations for the multidisciplinary team to support medicines optimisation, prescribing, and monitoring. Work collaboratively with care home staff and the Ageing Well team to optimise medicines management and promote safe, effective, and appropriate use of medicines, including updating medication at transfer of care and investigating and responding to requests for medication not on, or as on, repeat. This workstream is coordinated by the PCN's Pharmacy Hub for Assessment Services (PHASe), integrated within The Ageing Well Team, but practice-based pharmacists will need to liaise with the hub, communicating effectively, to ensure an efficienct and seamless care delivery service.

3. Long-Term Condition Clinics

Deliver reviews to patients with single or multiple medical problems where medicine optimisation is required (e.g., respiratory, cardiovascular-reno-metabolic). Review the on-going need for each medicine, monitoring needs and support patients in getting the best use of their medicines (i.e. medicines optimisation). Make appropriate recommendations to Senior Pharmacists or GPs for medicine improvement. Contribute to QOF achievement and IIF targets related to long-term condition management.

4. Patient facing Domiciliary Medication Reviews

Deliver medication reviews to patients in care home or domiciliary settings, working within the PCN's Pharmacy Hub for Assessment Services (PHASe), integrated within The Ageing Well Team. For care home patients, medicines reconciliation and medication review is coordinated through the centralised pharmacy hub. The post holder will work within this hub structure, contributing to and drawing on hub-led clinical oversight, supervision, and workflow support, and producing recommendations for the multidisciplinary team on prescribing, deprescribing, and monitoring. In some practices, medication reviews for care home patients may be delivered outside of the central hub, and some reviews for care home or housebound patients may require home visits.

5. Risk stratification

Identify cohorts of patients at increased risk of harm from medicines using agreed, preprepared practice clinical system searches, including prescribing and clinical decision support software such as Eclipse Live Radar 500 searches. Risks may be patientrelated, medicinerelated, or a combination of both.

Where appropriate, pharmacy technicians will be accountable for reviewing and acting on the outcomes of these searches within their scope of competence, in accordance with agreed protocols. Clinical pharmacists will provide supervision and support where the management of highrisk patients falls outside the pharmacy technicians competence, and will assume responsibility during periods of leave or in exceptional circumstances.

6. Unplanned hospital admissions

Review the use of medicines most commonly associated with unplanned hospital admissions and readmissions through audit and individual patient reviews. Implement changes to reduce the prescribing of these medicines to high-risk patient groups.

7. Medicines Reconciliation

Reconcile medicines following communications from other health settings (e.g., hospital discharges, clinical letters from secondary care, private healthcare providers etc) including identifying, resolving and appropriately escalating unexplained changes to medicines when required. Work collaboratively with patients, carers and the wider MDT to ensure timely access to medicines and continuity of care including those requiring medicines compliance aids and care home residents.

Provide mentorship, supervision, and appropriate delegation of medicines reconciliation activities to pharmacy technicians and junior pharmacists, including foundation pharmacists, in line with their competence and agreed governance arrangements.

8. Medicine Information & Advisory Support

Respond to relevant medicine-related enquiries from GPs, other network staff, other healthcare teams (e.g., community pharmacy) and patients with queries about medicines acting as a visible and accessible medicines expert within the PCN. Suggest and recommend evidence-based solutions. Provide appropriate follow-up where changes are made.

9. Signposting

Ensure that patients are referred to the appropriate healthcare professional for the appropriate level of care within an appropriate time period e.g., pathology results, common/minor ailments, acute conditions, long-term condition reviews etc. Collaborate with and refer to relevant non-clinicians e.g. social prescribing link workers to connect patients with non-clinical community support where wider determinants of health are contributing to medicines non-adherence or health inequalities.

10. Repeat prescribing

Manage the repeat prescribing reauthorisation process by reviewing patient requests for repeat prescriptions and reviewing medicines reaching review dates and flagging up those needing a review. Ensure patients have appropriate monitoring tests in place when required. Support the practice to reduce prescribing errors and promote safe, efficient repeat prescribing workflows.

11. Service development

Contribute pharmaceutical expertise to the development and implementation of new services that have medicinal components (e.g., advice on treatment pathways and patient information leaflets).

12. Information management

Analyse, interpret and present medicines data to highlight issues and risks to support decision making.

13. Medicines quality improvement

Undertake clinical audits of prescribing in areas directed by the GPs and the PCN team, feedback the results and implement changes in conjunction with the relevant practice team.

14. Medicines safety

Implement changes to medicines that result from MHRA alerts, product withdrawal and other local and national guidance. Contribute to the practice's and PCNs patient safety agenda by participating in significant event analysis (SEA), reporting incidents as appropriate, supporting learning from near-misses and medicines errors. Work with the practice team and PCN to embed a culture of medicines safety.

15. Implementation of local and national guidelines and formulary recommendations

Monitor practice prescribing against the local health economys RAG list and make recommendations to GPs for medicines that should be prescribed by hospital doctors (red drugs) or subject to shared care (amber drugs).

16. Education, Mentoring and Clinical Supervision

Provide education and training to primary healthcare team on therapeutics and medicines optimisation. Mentor, supervise and delegate, as appropriate, clinical workflow to pharmacy technicians and more junior pharmacists (including foundation pharmacists), to optimise skill-mix and aid team development.

17. Care Quality Commission

Work with the general practice teams to ensure the practices are compliant with CQC standards where medicines are involved.

18. Public health

Support public health campaigns and provide specialist knowledge on all public health programs available to the general public.

19. Collaborative working arrangements

As part of an integrated pharmacy team, foster and maintain collaborative working relationships with practice teams, ICB colleagues including medicines management pharmacy professionals, the Ageing Well

Team and social prescribing team, and all other relevant services across the PCN and other stakeholders as needed for the collective benefit the practice and its patients.

Skills and Knowledge

Essential

• Demonstrates understanding of, and conforms to, relevant standards of practice and professional and organisational policies and procedures
• Awareness of common acute and long-term conditions that are likely to be seen in general practice
• Excellent Interpersonal, influencing & negotiating skills, to make shared decisions in situations where barriers to this may be present
• Excellent verbal and written communication skills, with the ability to communicate complex and sensitive information clearly and appropriately to a range of audiences, adapting communication to meet different needs and levels of understanding (e.g. patients).
• Recognises priorities when problem solving and identifies deviations from the normal pattern and able to recognise limitations of own competence, referring to more senior clinical colleagues when appropriate
• Able to work under pressure and meet deadlines, including prioritisation, time-keeping, adaptability, self-motivation and sustainable working, including when resource levels change.
• Work effectively independently and as a team member
• Ability to identify risk and assess/manage risk when working with individuals

Desirable

• In depth therapeutic & clinical knowledge and an understanding of evidence-based medicine, clinical terminology, medicines optimisation and shared decision-making
• An appreciation of GPs and General Practice, including the relationship between GP, PCNs and ICBs in the context of the larger NHS and NHS funding.
• Experience of collaborative working and building relationships across a variety of organisations
• Able to plan, manage, monitor, advise & review general medicines optimisation issues in core areas for long term conditions (LTCs)
• Knowledge of IT systems, including ability to use clinical systems e.g. EMIS/SystmOne, word processing skills, spreadsheets and emails to communicate effectively, document consultations and code accurately and safely, and produce timely and accurate reports
• Able to obtain and analyse complex technical information with accuracy, appropriate management of errors and logical innovation of solutions

Experience

Desirable

• Experience of working in Primary Care

Other

Essential

• Meets DBS reference standards and has a clear criminal record, in line with the law on spent convictions
• Appropriate Immunisation Status
• Access to own transport and ability to travel across the locality when required e.g. meetings or visiting care homes

Qualifications

Essential

• Mandatory registration with the General Pharmaceutical Council

Desirable

• Completion/working towards CPPE Primary Care Pharmacy Education Pathway (PCPEP)
• Clinical Diploma
• Independent Prescribing or currently working towards qualification

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).