To enable patients with MND to have a single point of contact to reduce stress, carer burden and improve communication across systems and sectors. To work collaboratively to develop expertise and resources to provide sound clinical advice and judgement to patients and their families, and other health and care professionals. Attend and co-ordinate clinics and MDTs. To provide home visits to enhance early monitoring and anticipatory care planning and support access to appropriate psychological support. To monitor local provision against relevant best practice guidance, working as a colleague within Neuro-Outreach Team, Specialist Palliative Services, other Community Services and with neurological specialists nationally. To manage an active caseload of people with MND, throughout their disease pathway, working with patients and their carers to coordinate the provision of interventions, create self-management plans to optimise health and quality of life, and reduce avoidable hospital admissions. To recognise new symptom onset, and liaise when indicated with other services to ensure appropriate medical or specialist support is provided. To act as a representative or advocate for patients when required, ensuring that mental capacity is assessed and engaging in best interests meetings where appropriate. To work in collaboration with patients and their carers, GPs (General Practitioners) & Hospital Consultants to achieve optimum therapeutic benefit from medication and treatment regimes To discuss Advance Care Plans including identification of Preferred Place of Care (PPC), Advance Decisions to Refuse Treatment (ADRT) and undertake ReSPECT authorship with specialist Palliative care support To work with the Health & Social Care professionals across a variety of settings (e.g. acute trust, hospice) to offer support, education, and advice in the management of MND. To link in and work with the MND Association and other relevant agencies to ensure integrated care for the patient. To support the multidisciplinary team to provide specialist care to patients with MND. To share expertise which is relevant to other long-term neurological conditions with other members of the MDT (multidisciplinary team) where appropriate. Professional To be pivotal in the development and review of local evidence-based standards, policies and guidelines based on NICE guidelines, current research and benchmarking of the speciality To develop and deliver education and training relating to specialist area - for the MDT, for other health and social care professionals and for people affected by their condition and carers. To participate in implementing national standards and frameworks at a local level within the speciality. To undertake research and audit, review, and evaluation of the service. Be able to undertake Quality Improvement and feedback effectiveness at board level To develop knowledge and up-to-date, evidence based practice inMND. To take part in local and regional support networks such as SNAP (regional forum for specialist nurses and Allied Professionals). To use effective prioritisation, problem solving and delegation skills to manage time effectively. To familiarise yourself with guidelines and regulations relevant to the role, particularly those relating to health and safety at work, and governance, and ensure they are always met. Be pivotal in the development and review of policies and guidelines based on best practice research and benchmarking for the speciality To comply with the Data Protection Act 1998. Managerial To utilise patient and carer feedback, learning from their experiences to continuously improve quality and delivery of care. To develop and maintain a peer network of support, information and learning with other specialists across East Midlands To work as part of the community team for peer support and supervision. To act as a resource forthe relevant supporting teams within Lincolnshire. To maintain appropriate professional links with other health and social care agencies. To report incidents, concerns, or complaints to your line manager in a timely way, ensuring the optimum safety and wellbeing of patients, their families, and colleagues. To adhere to the lone working policy and procedure when working in the community. To preserve the confidentiality of any information relating to patients, staff, or the organisations business. To engage with line manager for regular reviews against objectives and keep oneself professionally updated. Training and Development Influence the development of knowledge, ideas, and clinical practice. To provide specialist education, advice, and support to colleagues within the organisation and external organisations, who support and provide care for patients with MND .