The post holder is an ANP who, acting within their professional boundaries, will provide care for the presenting patient from initial history taking, clinical assessment, diagnosis, treatment and evaluation of their care. They will demonstrate safe, clinical decision-making and expert care for patients within the general practice. They will work collaboratively with the multi-disciplinary general practice and attached teams to meet the needs of patients, supporting the delivery of policy and procedures, and providing leadership as required. In order to work at this level, NMC requirements for advanced practice must be met. 1. SCOPE AND PURPOSE OF THE ROLE To deliver a high standard of patient care as an ANP in general practice, using advanced autonomous clinical skills, and a broad and in-depth theoretical knowledge base To manage a clinical caseload, dealing with presenting patients needs in a primary care setting 2. JOB DIMENSIONS To manage own clinical workload in general practice responding effectively to patient need and ensuring patient choice and ease of access to services. The development and use of referral pathways for ANPs to the local acute NHS Trust services and to Diagnostic and Treatment Centres. To mentor and support other nurses in developing and maintaining clinical skills PRIMARY DUTIES & AREAS OF RESPONSIBILITY A. CLINICAL ROLE: The post-holder will: Provide the choice of direct access to an ANP, in the Practice, to Community Team and over the telephone, for the general practice population Make professionally autonomous decisions for which he/she is accountable Provide a first point of contact within the Practice for patients presenting with undifferentiated, undiagnosed problems, making use of skills in history taking, physical examination, problem-solving and clinical decision-making, to establish a diagnosis and management plan Instigate necessary invasive and non-invasive diagnostic tests or investigations and interpret findings/reports To prescribe safe, effective and appropriate medication as defined by current legislative framework Provide safe, evidence-based, cost-effective, individualised patient care Offer a holistic service to patients and their families, developing where appropriate an on-going plan of care/support, with an emphasis on prevention and self-care Promote health and well-being through the use of health promotion, health education, screening and therapeutic communication skills Refer patients directly to other services/agencies as appropriate Work as part of the Practice team in developing and delivering specialist primary care services Screen patients for disease risk factors and early signs of illness Work with nursing, medical and health care assistant colleagues to ensure that National Service Frameworks (e.g. Coronary Heart Disease/Older People/ Diabetes /Mental Health) are being delivered Work with multi-disciplinary team within the Practice, and across the wider Operational Unit (Moray Health & Social Care Partnership), to promote integrated and seamless pathways of care Contribute to the practice achieving its quality targets to sustain the high standards of patient care and service delivery Participate in identification of community health needs and develop patient/family-centred strategies to address them Help develop and set up new patient services and participate in initiatives to improve existing patient services Be aware of and contribute to planning and delivery of practice-based commissioning B. TEACHING AND MENTORING ROLE: The post-holder will: Promote a learning environment for patients, nurses and other health professionals. Contribute to the planning and implementation of the teaching for existing staff, such as medical students, NP students, GP registrars, within the Practice. C. PROFESSIONAL ROLE: The post-holder will: Promote evidence-based practice through the use of the latest research-based guidelines and the development of practice-based research. Monitor the effectiveness of their own clinical practice through the quality assurance strategies such as the use of audit and peer review Maintain their professional registration Participate in continuing professional development opportunities to ensure that up-to-date evidence-based knowledge and competence in all aspects of the role is maintained Work within the latest NMC Code of Professional Conduct Record accurate consultation data in patients records in accordance with the latest NMC guidance and other pertinent standards Keep up to date with pertinent health-related policy and work with the practice team to consider the impact and strategies for implementation Work collaboratively with colleagues within and external to the practice. Demonstrate leadership Pro-actively promote the role of the ANP within the Practice, and externally to key stakeholders and agencies D. MANAGERIAL ROLE: The post-holder will: Encourage and develop teamwork within the practice. Participate in multi-disciplinary protocol and Patient Group Directions development Help the practice operate in a cost-effective manner. Identify and manage care risks on a continuing basis. Participate in practice meetings and practice management meetings, reporting progress as required. Participate in audits and inspections as appropriate. Work closely with the doctors and administrative managers in the setting up and/or improving of practice systems for monitoring/measuring performance against Clinical Governance and Quality Indicator targets. Ensure that all Practice Policys are fully implemented E. AREAS OF PRACTICE EXCLUDED FROM THE POST-HOLDERS REMIT: Depending on skills / experience, it is recognised that there may be some aspects of care which the post-holder may refer to the Duty GP.