Advanced Nurse Practitioner

Role Overview

This role is based within the Ashfield North PCN Home Visiting Service, providing high‑quality clinical care to patients who are unable to attend GP practices. Working autonomously, you will assess, diagnose and manage a wide range of acute and long‑term conditions through home visits and same‑day consultations. You will work closely with GPs, community teams and the wider MDT, supporting frailty pathways, reducing avoidable hospital admissions and improving access for house‑bound patients. As part of the ARRS workforce you will be fully integrated into a supportive PCN structure with strong clinical leadership and opportunities for ongoing development.

Key Responsibilities

• Deliver advanced autonomous clinical care through home visits, assessing, diagnosing and managing acute and chronic presentations.
• Support frailty and admission avoidance pathways by responding to GP triage, coordinating safe care at home and referring to appropriate services.
• Contribute to MDT working and service development through proactive communication, audit, teaching and participation in integrated care initiatives.
• Act as an autonomous advanced practitioner working independently and in conjunction with other health‑care professionals to assess, diagnose and treat the conditions of patients.
• Avoid inappropriate admissions and maintain patients in their home environments with a safe package of care and referral to other agencies as necessary, including direct admission to hospital when required.
• Respond to GP triage for home visiting both in the patient’s home and in care homes.
• Provide evidence‑based professional advice to patients, carers and colleagues and ensure the maintenance of clinical excellence with a proactive approach to care.
• Develop and lead new and innovative concepts, models, methods and practices to deliver new and improved primary care services to meet the needs of the practice population.
• Provide education and training to other staff and students.
• Undertake research and audit as part of the role.

Advanced Clinical Practice

The Advanced Clinical Practitioner works autonomously and is accountable for own professional actions. Undertakes clinical practice at an advanced level using expert knowledge and clinical skills to deliver holistic care to people accessing primary health‑care services. Utilises the four pillars of Advanced Practice: clinical practice, leadership, facilitating learning and evidence, research and development.

• Assesses diagnoses and treats patients in own home who require acute/none‑acute medical attention and sets up a package of care and/or refers to appropriate agencies if appropriate.
• Prescribes appropriate treatment in line with local/national prescribing guidelines according to assessment.
• Refers patients to other medical specialities for assessment if deemed appropriate.
• Refers patients to other members of the multidisciplinary team, secondary care and to other statutory and voluntary organisations including referral for further clinical investigations such as ECHO, ECG, blood tests, X‑ray.
• Interprets a range of diagnostic tests and routine clinical procedures.
• Makes critical judgments of the highest order to satisfy the expectations and demands of the job, e.g. first contact with patients presenting acutely and manages care in the presence and absence of protocols.
• Decides on direct referral of patients to Hospital Consultants without prior reference to other medical colleagues when appropriate.
• Advises and supports others where standard protocols do not apply.
• Works within professional guidelines and codes of conduct and all relevant practice policies and procedural guidelines (e.g., infection control, chaperoning, risk management).
• Communicates highly sensitive condition‑related information to patients, relatives and carers.
• Initiates the process of diagnosis with patients suspected to have a chronic disease (e.g., diabetes, COPD, asthma, IHD) and refers to other clinical staff as appropriate.
• Audits outcomes of care against standards and initiates changes as necessary.
• Refers to other members of the extended primary health‑care team as appropriate.

Professional Development

Responsible for maintaining own competency through continuing professional development activities and participation in the review and appraisal process. Adheres to the individual Professional Code of Conduct and practice. Reflects on own practice individually and/or through regular clinical supervision. Participates in relevant training, courses and conferences. Engages in peer review, attends team meetings and periodically attends Federation meetings. Maintains up‑to‑date mandatory training records. Develops and disseminates specialist knowledge of evidence‑based practice and critically evaluates own work using evidence‑based projects, audits and outcome measures. Works autonomously as a Home Visiting Practitioner within professional and PICS guidelines, policies and procedures.

Communication and Relationship Skills

Ensures close liaison with line manager and clinical lead on clinical issues. Organises and attends regular MDT/supervision. Provides and receives highly complex, sensitive or contentious information and frequently deals with situations which are hostile or emotive. Uses developed communication, negotiation and conflict‑management skills requiring empathy, reassurance and persuasive skills where significant barriers to acceptance must be overcome. Communicates service‑related information to GPs, practice manager, nursing and administrative staff, patients, relatives and carers. Makes operational judgments, manages conflicting views and reconciles inter‑ and intra‑professional differences of opinion. Builds and communicates therapeutic working relationships with a wide array of statutory and voluntary organisations for the benefit of patient care. Facilitates good working relationships. Develops and delivers presentations to large groups (e.g., local and national conferences, clinical meetings, conferences) and empowers staff to develop presentation skills to promote good practice.

Information Resources

Maintains accurate and comprehensive documentation in line with legal, professional and organisational requirements. Ensures all information regarding each patient‑related contact is recorded within SystmOne records. Recognises that mobile working can sometimes lead to difficulties with IT/telephone systems and uses initiative to maintain a quality service.

Clinical Governance

Identifies risk issues that impact on patients’ health or social needs, takes appropriate action consistent with protection procedures, follows lone worker procedure and demonstrates effective team working. Reports all accidents/incidents, ill health, equipment failures or environmental issues to line managers. Contributes towards audit and data collection as required.

Benefits and Working Environment

• NHS Pension 2015 Scheme (subject to eligibility) and alternative government‑based scheme (subject to eligibility).
• Competitive leave entitlement that includes maternity, paternity and adoption leave, study leave allowance, and sickness provisions.
• Access to education and training opportunities, depending on your role (CPPE Pharmacy, NHS England Roadmap for First Contact Practitioners, apprenticeship schemes, support professional development).
• Working in a multi‑disciplinary team with support from a wide variety of professionals.
• A flexible approach to work‑life balance.
• Cycle‑to‑work scheme (subject to eligibility). Access to Blue Light Card scheme.
• All staff events and conferences. Staff engagement (Wellbeing Group, EDI Network, Staff Focus Group).
• Free parking across many sites.
• Personalised induction into the company and job role.

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