Advanced Clinical PractitionerNHS

Job summary

The Advanced Clinical Practitioner is an experienced registered healthcare professional working at an advanced level of practice. The post holder will provide autonomous, person centered care for patients presenting with undifferentiated, undiagnosed and complex problems in general practice or at the patients residence, while recognising the limits of individual competence and seeking appropriate advice, supervision or referral when required.

The role is aligned to the four pillars of advanced practice: clinical practice; leadership and management; education; and research.

The post holder will work as part of the multidisciplinary primary care team and will be accountable for their own professional decisions and actions. Their precise clinical scope will be defined by professional registration, qualifications, competence, prescribing status, local governance arrangements and the needs of the practice population.

Main duties of the job

The ACP will:

• Provide advanced assessment, clinical examination, formulation of differential diagnoses and management of patients in both the practice and the patients residence.
• Manage clinical complexity, risk and uncertainty, including recognising red flags, deterioration and the need for urgent or emergency escalation.
• Support education, supervision and development of colleagues and learners within the post holder's competence.
• Use evidence, audit, data and critical appraisal to improve care and reduce unwarranted variation.
• Maintain professional development, evidence of capability and a clearly documented advanced practice.
• Request, interpret and act on appropriate investigations within competence and local pathways.
• Develop, agree and review personalised treatment and management plans using shared decision-making and safety-netting.
• Prescribe medicines independently where appropriately qualified, registered and authorised, in accordance with legislation, evidence and local formulary guidance.
• Refer to and collaborate with GPs, community, secondary care, pharmacy, mental health, social care and other services as clinically appropriate.
• Provide clinical leadership, support quality improvement and contribute to safe service development.

Job description

Key Responsibilities

1. Advanced Clinical Practice

• Undertake comprehensive, person-centred assessment including relevant history, physical examination and assessment of psychological, functional and social factors.
• Exercise autonomous clinical judgement to develop and evaluate differential diagnoses, including where presentations are atypical, uncertain or complex.
• Initiate and interpret investigations, using results to inform diagnosis, treatment, monitoring, referral or escalation.
• Provide evidence informed management of acute presentations, long-term conditions and multimorbidity.
• Recognise significant illness, safeguarding concerns and clinical deterioration; initiate immediate management and escalate appropriately.
• Use shared decision making to explain options, benefits, risks and uncertainties, respecting a patient's values, preferences and capacity.
• Provide clear safety netting and follow up arrangements, including advice on when and how to seek urgent help.
• Make appropriate referrals and provide high quality clinical information to support continuity of care.
• Promote prevention, self-management, vaccination, screening and healthy lifestyle interventions where appropriate.
• Maintain accurate, contemporaneous clinical records that clearly demonstrate assessment, reasoning, decisions, advice, follow up and escalation.

2. Prescribing and Medicines Management

• Where an independent prescriber, prescribe only within individual competence.
• Undertake medicines reconciliation and medication review where appropriate, considering interactions, contraindications, monitoring, adherence and patient preference.
• Use national and local guidance, antimicrobial stewardship principles and formulary arrangements to support safe and cost-effective prescribing.
• Recognise and report adverse drug reactions, medication incidents and prescribing concerns through appropriate systems.
• Where not independently qualified to prescribe, work within the appropriate legal and local medicines framework and do not act beyond authorised mechanisms.

3. Clinical Governance and Safety

• Maintain current professional registration and comply with the relevant professional code, standards and requirements for revalidation or equivalent.
• Work within competence and recognise when a presentation requires support, a second opinion, GP review, specialist advice or transfer of care.
• Participate in clinical supervision and professional support arrangements appropriate to the role and level of practice.
• Report and contribute to learning from incidents, near misses, complaints, significant events and patient safety concerns.
• Comply with practice policies for safeguarding, infection prevention and control, information governance, consent, chaperoning, medicines management and health and safety.
• Use professional curiosity and appropriate escalation where abuse, neglect, coercion, exploitation or risks to children or adults are suspected.
• Support audit, clinical assurance, inspection readiness and implementation of learning from governance activity.

4. Leadership and Management

• Provide visible clinical leadership and act as a positive role model for safe, compassionate and evidence informed care.
• Promote effective multidisciplinary working, respectful challenge and clarity of professional roles and responsibilities.
• Support improvements to clinical pathways, access, continuity, population health and use of practice resources.
• Identify unwarranted variation, clinical risk or system problems and work with colleagues to develop proportionate solutions.
• Contribute to practice meetings, service planning, policy development and implementation where relevant to the role.
• Support a culture in which staff can raise concerns, learn from errors and contribute to improvement.
• Manage workload responsibly, prioritising clinical need while recognising the impact of capacity and operational pressures on safety.

5. Education and Development

• Maintain an advanced practice portfolio demonstrating ongoing capability across the four pillars.
• Participate in appraisal, supervision, continuing professional development and learning relevant to the role.
• Share knowledge with colleagues through case discussion, teaching, coaching, clinical supervision or structured learning where competent to do so.
• Support learners and developing clinicians within agreed supervision arrangements and escalate concerns about competence or patient safety.
• Reflect on feedback, outcomes, incidents and evidence to identify individual learning needs and changes to practice.

6. Research, Evidence and Quality Improvement

• Critically appraise and apply current evidence, national guidance and local pathways to clinical decision making.
• Participate in clinical audit, service evaluation and quality improvement activity relevant to the practice population.
• Use data and feedback to identify opportunities to improve safety, experience, effectiveness, equity and outcomes.
• Contribute to implementation and evaluation of evidence informed change, sharing learning with the wider team.
• Participate in research activity where appropriate, ensuring relevant governance, consent and ethical requirements are met.

7. Communication and Collaborative Working

• Communicate complex or sensitive information clearly, adapting communication to health literacy, disability, language, culture and individual need.
• Work collaboratively with patients, carers and professionals while maintaining confidentiality and appropriate information sharing.
• Provide clear clinical handovers and referrals, ensuring responsibility for follow-up is understood.
• Promote continuity and coordinated care for people with complex needs, including effective liaison across organisational boundaries.
• Address disagreement or uncertainty professionally and escalate concerns where patient safety may be compromised.

8. Equality, Diversity and Inclusion

• Treat patients, carers and colleagues with dignity, fairness and respect.
• Recognise and seek to reduce health inequalities and barriers to access, experience and outcomes.
• Support reasonable adjustments and inclusive communication.
• Challenge discriminatory behaviour and practice through appropriate routes.
• Consider the wider determinants of health when assessing need and planning care.

About us

At The Bay Medical Practice, we are committed to delivering high-quality, patient-centred healthcare while providing a positive, supportive and forward-thinking working environment.

Our work is guided by:

The REAL Strategy

R Relationships: We build strong, trusted relationships with patients, colleagues and the wider healthcare system.

E Environment: We provide safe, inclusive and welcoming spaces for patients and staff.

A Accountability: We take responsibility for excellent care and continuous improvement.

L Leadership: Everyone is a leader we inspire each other to grow and innovate.

The Bay Way

Our team lives and works by the principles of Respect and Support:

• We communicate with kindness, professionalism and fairness.
• We celebrate diversity, build people up and look after one another.
• We lead with compassion, solve problems constructively and share success.