Advanced Clinical Practitioner (ACP)

The Advanced Clinical Practitioner will provide autonomous clinical care across NEMS urgent care services. The role is designed to provide a true mix of telephone and face-to-face consultations, supporting patients across Integrated Urgent Care Services, urgent treatment centres and other agreed service models.

The post holder will be an experienced registered clinician, able to assess, diagnose, treat, refer and discharge patients with undifferentiated urgent care presentations. They will work within their professional registration, agreed scope of practice, NEMS policies and local clinical pathways.

Telephone consultations will usually be undertaken within Integrated Urgent Care Services. Following induction, and where agreed by the service, some telephone consultation work may be undertaken remotely from home, provided that the post holder is meeting agreed KPIs, quality standards, governance requirements and information governance expectations.

Face-to-face work will include assessment and management of patients presenting to NEMS urgent treatment services. The post holder will be expected to recognise serious illness, clinical deterioration, safeguarding concerns, mental health risk and presentations requiring escalation or transfer to another service.

Job description

The Advanced Clinical Practitioner will provide autonomous clinical care across NEMS urgent care services. The role is designed to provide a true mix of telephone and face-to-face consultations, supporting patients across Integrated Urgent Care Services, urgent treatment centres and other agreed service models.

The post holder will be an experienced registered clinician, able to assess, diagnose, treat, refer and discharge patients with undifferentiated urgent care presentations. They will work within their professional registration, agreed scope of practice, NEMS policies and local clinical pathways.

Telephone consultations will usually be undertaken within Integrated Urgent Care Services. Following induction, and where agreed by the service, some telephone consultation work may be undertaken remotely from home, provided that the post holder is meeting agreed KPIs, quality standards, governance requirements and information governance expectations.

Face-to-face work will include assessment and management of patients presenting to NEMS urgent treatment services. The post holder will be expected to recognise serious illness, clinical deterioration, safeguarding concerns, mental health risk and presentations requiring escalation or transfer to another service.

The post holder will work flexibly across NEMS sites and services in line with service need. They will also support clinical supervision, learning, audit, incident review and service improvement, ensuring that care remains safe, effective, patient centred and financially sustainable.

The post holder will have responsibility for the following areas:

o Autonomous telephone and face-to-face assessment of patients with urgent care needs

o Safe clinical decision-making, including treatment, discharge, referral, transfer and safety-netting

o Recognition and escalation of serious illness, clinical risk and safeguarding concerns

o Clinical leadership, supervision and support for the wider team

o Participation in governance, audit, learning and service improvement activity

Clinical Practice and Service Delivery

Work as an autonomous Advanced Clinical Practitioner across NEMS urgent care services, providing both telephone and face-to-face consultations.

Assess, examine, diagnose, treat and safely discharge or refer patients with undifferentiated urgent care presentations.

Make safe decisions around admission, transfer, referral, follow-up and safety-netting, working within professional competence and agreed local pathways.

Recognise and act on serious illness, clinical deterioration, safeguarding concerns, mental health risk and presentations that require escalation to another service.

Request and interpret appropriate investigations, including blood tests, urine tests, ECGs and imaging, in line with local policy, competence and relevant regulations.

Prescribe, review and advise on medicines where qualified to do so, or use agreed local medicines mechanisms within scope.

Maintain clear, accurate and timely clinical records, including assessment findings, clinical reasoning, advice given, decisions made and onward plans.

Telephone Consultations

Undertake telephone consultations within Integrated Urgent Care Services, using safe clinical assessment, decision-making and documentation.

Recognise the limitations of remote assessment and arrange face-to-face review, ED attendance, ambulance response or other escalation where clinically required.

Provide clear advice and safety-netting to patients and carers, ensuring that the plan is understood and documented.

Undertake remote work from home where agreed after induction, provided that performance, KPIs, quality standards and information governance requirements are being met.

Face-to-Face Urgent Care

Undertake face-to-face consultations across NEMS urgent care services, including assessment of minor illness, minor injury and other appropriate urgent care presentations.

Carry out clinical procedures where trained, competent and required for patient care.

Provide safe clinical handover to ED, specialties, GPs, community services or other colleagues where ongoing care is required.

Support patient flow, streaming and redirection decisions where this forms part of the service model.

Clinical Leadership and Team Working

Act as a senior clinical presence on shift, supporting colleagues and contributing to the safe running of the service.

Provide advice, supervision and support to trainee ACPs, UCPs, nurses, AHPs, UCAs and non-registered staff.

Support induction, training, clinical supervision and competency development across the wider team.

Escalate clinical or operational concerns early, particularly where patient safety, staffing, flow or professional practice may be affected.

Address unsafe practice or poor behaviour in a professional and proportionate way, escalating concerns where required.

Governance, Quality and Service Improvement

Contribute to a culture where incidents, complaints, audit, feedback and day-to-day operational learning are used to improve care.

Take part in incident reviews, significant event analysis, complaint responses and shared learning activity where required.

Support audit, quality improvement and service evaluation work across NEMS urgent care services.

Contribute to the development and review of clinical guidelines, SOPs, pathways and local standards, ensuring they are practical, evidence-based and relevant to the way services are delivered.

Use available data, feedback and clinical experience to support improvements in patient flow, clinical quality, productivity and patient experience.

Education and Professional Development

Maintain professional registration, mandatory training, clinical supervision, CPD and revalidation requirements.

Maintain an up-to-date portfolio showing competence, scope of practice, reflective learning and prescribing practice where applicable.

Share learning with colleagues through teaching, case discussion, supervision, peer review and practical shift-based support.

Support students, trainees and developing practitioners in a safe and constructive way, recognising their competence and learning needs.

Professional Responsibilities

Work within relevant NMC, HCPC or equivalent code of conduct NEMS policies and agreed scope of practice.

Communicate clearly with patients, carers and colleagues, particularly where information is complex, sensitive or distressing.

Involve patients in decisions about their care and ensure that consent, capacity and best-interest issues are considered and documented appropriately.

Maintain confidentiality and information governance standards at all times.

Work flexibly across NEMS sites and services where reasonably required, in line with service need, competence and contractual arrangements.

Undertake any other reasonable duties requested by a manager, where these are appropriate to the role, grade and competence of the post holder.

Act in a manner that reflects and promotes the values of NEMS.

Person specification

Values

Essential

• Values and respects others, treats everyone as an individual, is non-judgemental
• Motivated to be genuinely kind and caring
• Helps and co-operates with colleagues
• Pro-active and takes responsibility
• Willing to learn, open to change
• Motivated to make a difference

Experience

Essential

• Experience of working clinically in a primary, community, urgent care, emergency care or out-of-hospital setting
• Experience of autonomous assessment and management of undifferentiated patients
• Experience of telephone or remote clinical assessment
• Experience of face-to-face urgent care consultations
• Experience of supervising, supporting or teaching other clinical staff or students

Desirable

• Experience working in Urgent Treatment Centres, GP Out-of-Hours, Clinical Assessment Services or Emergency Departments
• Experience of acting as shift lead, clinical co-ordinator or senior clinician on duty

Knowledge

Essential

• NMC, HCPC or equivalent professional standards
• Medico-legal aspects of advanced practice
• Assessment and management of urgent care presentations, including recognition of red flags and clinical deterioration
• Safeguarding adults and children
• Mental capacity, consent and mental health risk

Desirable

• Knowledge of NEMS services, local urgent care pathways and system partners
• National standards relevant to urgent care, out-of-hours and clinical assessment services

Qualifications

Essential

• Current professional registration with NMC, HCPC or equivalent professional body
• Evidence of working at an advanced level of clinical practice
• Masters level qualification in Advanced Clinical Practice, or equivalent evidence of advanced practice capability
• Independent non-medical prescribing qualification, or willingness to complete where required for the role
• Evidence of continuing professional development

Desirable

• Minor illness or minor injury qualification
• IR(ME)R / imaging requesting training where relevant
• ILS, ALS or equivalent urgent care training

Other

Essential

• Full driving licence and the ability to travel between locations
• The ability to work flexibly when required in line with the demands of the role
• Ability to work across NEMS sites and services, including telephone and face-to-face clinical work
• Ability to work remotely for telephone consultations where agreed following induction, and where KPIs and quality standards are being met

Skills & Abilities

Essential

• Able to make safe, autonomous clinical decisions and recognise when to seek advice or escalate

Desirable

• Competent in the use of Adastra, SystmOne, EMIS, Nervecentre or other relevant clinical systems
• Able to contribute to audit, service improvement and pathway development

About the employer

NEMS Community Benefit Services (NEMS) is a not-for-profit social enterprise and a Company Limited by Guarantee. It has been operating in Nottinghamshire for over 25 years, now providing a population of more than 1.2 million with urgent primary health care services. It operates out of 2 registered locations and four bases and deploys a team of more than 370 healthcare professionals, including 150+ sessional GPs, 90+ substantive staff, 30+ agency workers, and 140+ non-healthcare staff.

NEMS provides services to a population of circa 1.2 million under the following service portfolio headings;