Chronic Disease Nurse inBath inBath PUBLISHED 22 MAY 2024

Job summary


Who are we looking for?

• Chronic Disease management expertise.
• A committed, enthusiastic and collaborative clinician to join the practice
• Ideally 3-4 days per week
• This role would suit a practice nurse with relevant diplomas and ideally a prescribing qualification.

JobSummary:


This is a blended role with a strong focus on supportingChronic Disease Management alongside other duties to utilize skills of the postholder, for example, wound management, health promotion, womens health ormedicines management.

Main duties of the job


What is the role?


Reviewing patients with chronicdisease i.e. diabetes, hypertension, heart disease

Assessing lifestyle and medicationsand suggesting changes where appropriate

Review of medications following anacute illness/admission

Oversight of QOF / IFF clinicaltargets and ensuring reviews meet these quality indicators

The clinician would be reviewingpatients both on the phone and face to face

Lead for infection prevention andcontrol


What will my day look like?


Your day will be split intoappointments with a mix of treatment room and chronic disease. Time is bookedaccordingly i.e. 30 minutes to review diabetes. Each member of the nursing teamhave different skills sets and our medical administrators ensure the rightpatient is seen by the right clinician in the correct time slot.

Admin time will be allocated toreview results and time blocked for infection control audits and management.


Who will I work with?


Our nursing team is made up of aNurse Practitioner, Acting Lead Nurse, Trainee Nurse Associate, HealthcareAssistant and 2 phlebotomists. They work as a team on a dedicated nursing floorof the surgery which has been recently decorated and refurbished.

The nursing team are backed up by 3GP Partners, 4 salaried GPs, 3 registrars and a supportive admin team.

About us


Who are we?

• Enthusiastic partnership enhanced by a strong clinical and management team; making Newbridge Surgery a supportive, kind and welcoming place to work.
• We are a well-established, well-regarded family practice with a forward thinking approach.
• We have a motivated and happy team who have embraced integrated working and new care models whilst keeping true to the values of general practice.
• Approximately 8800 patient list.
• High QOF scores
• CQC-rated good
• Nurse practitioner, Community matron, practice-based clinical pharmacy team and paramedic home visiting service.
• Member of strong, supportive and productive PCN with whom we have very effective and established relationships.
• Modern, purpose-built premises with attached pharmacy.
• Work-life balance important.
• Long-established training practice.
• Working towards our Green Impact Awards and ecological sustainability profile.
• LGBTQ+ and Dementia friendly practice.
• Opportunities to undertake NIHR research and medical student teaching.

Job description

Job responsibilities


IN RELATION TO DIABETES MANAGEMENT


The clinician should have an in depth understanding of diabetes and the health implications associated with the disease and how diabetes is diagnosed, treated/managed.

The clinician running clinics is expected to:

• Initiate the process of diagnosis for patients with suspected diabetes and refer to GP as appropriate.
• Assist in the management of patients with newly diagnosed diabetes following practice guidelines, protocols and policies
• Support patients in the management of their diabetes (type I and type II)
• Support educate and provide literature for patients with diabetes
• Provide emergency treatment for hypo/hyperglycaemic emergencies
• Make appropriate referrals (dietician, podiatrist etc)
• Be able to adjust medication/give guidance in changing dosage of insulin and refer to GP as necessary.
• Contribute to the implementation of the National Service Framework
• Contribute to the maintenance of the practice diabetic register
• Manage diabetic patients in line with the Quality & Outcomes Framework (QOF), including the use of relevant templates.
• Attendance at in-house and external review meetings.
• The clinician should work with the relevant Administrator to ensure appropriate patients are invited and attend relevant Chronic Disease Clinics.

IN RELATION TO THE MANAGEMENT OF CORONARY HEART DISEASE & ATRIAL FIBRILLATION

• The clinician should have an understanding of CHD and AF
• The clinician running clinics is expected to:
• Contribute to the implementation of the National Service Framework.
• Develop and maintain practice register for primary & secondary prevention of CHD.
• Work within agreed protocols when managing risk factors to enable patients to manage their own disease.
• Provide psychological support by discussing interventions and treatments.
• Work with patients to set action plans for changes of lifestyle .
• Advise patients on lifestyle management and drug compliance for reducing the CHD risk factors eg: Hypertension, Angina, Myocardial infarction & Cerebrovascular accident.
• Manage patients in line with the Quality & Outcomes Framework (QOF), including the use of relevant templates.
• Attendance at in-house and external review meetings.
• The clinician should work with the relevant Administrator to ensure appropriate patients are invited and attend relevant Chronic Disease Clinics.

IN RELATION TO HYPERTENSION


The clinician should have an understanding of hypertension.

The clinician running clinics is expected to:

• Contribute to the implementation of the National Service Framework
• Develop and maintain practice register for hypertension.
• Work within agreed protocols when managing risk factors to enable patients to manage their own disease.
• Manage patients in line with the Quality & Outcomes Framework (QOF), including the use of relevant templates.
• Be competent at performing and analysing blood pressure readings and advising/ prescribing as appropriate.

IN RELATION TO PATIENT REVIEWS


The clinician should have an understanding of stroke and myocardial infarction and be able to carry out patient reviews including review of post admission medication once the patient has been discharged and provide appropriate follow-up advice.


IN RELATION TO OTHER CLINICAL WORK



SCREENING

• Undertake routine & opportunistic screening and health checks BP checks, height, weight, BMI, smoking status, alcohol intake, blood sugar measurement, peak flow (if clinically competent).

HEALTH PROMOTION

• Recognise patients readiness to change in supporting their attempts to change unhealthy behaviour.
• Provide healthy eating advice to individuals or to groups.
• Provide smoking cessation signposting individually in opportunistic and planned consultations.
• Provide individual advice to patients about increasing activity or exercise.
• Offer advice on recommended safe limits for alcohol consumption and safe drinking practice.
• Contribute towards the maintenance of health promotion material within the practice and waiting room notice boards.
• Refer as appropriate.

INFECTION CONTROL

• Support patients and colleagues in adopting sound infection control measures.
• Apply infection control measures within the practice according to national and local guidelines.

This includes:

1. Completion of Infection Control Audits, and acting upon any identified areas.
2. Universal hygiene precautions.
3. The collection and handling of laboratory specimens.
4. Segregation and disposal of waste material.
5. Decontamination of instruments and clinical equipment.
6. Reporting and treatment of sharps injuries in accordance with the Practice Needlestick injury policy.
7. Dealing with blood and body fluid spillage.
8. Educate colleagues in adopting sound infection control measures.

EMERGENCY MANAGEMENT

1. Maintain competency in basic anaphylaxis and resuscitation techniques.
1. Attend two yearly update re managing anaphylaxis.
2. Attend annual resuscitation training.
3. Attend annual defibrillation training.

CHILD HEALTH/CHILD PROTECTION

1. Recognise the signs, symptoms and categories of child abuse.
2. Understand the importance of recognition, observation, documentation and communication.
3. Awareness of child health procedures, statutory local procedures and points of referral.
4. Knowledge of other practitioners and agencies roles.
5. Understand basic legal issues around child abuse.

SAFEGUARDING

1. Recognise the signs, symptoms and categories of abuse in children and vulnerable adults.
2. Undergo appropriate levels of safeguarding training at designated intervals.
3. Extensive knowledge of in-house safeguarding procedures.
4. Knowledge of other practitioners and agencies roles.
5. Understand basic legal issues around abuse or children and vulnerable adults.

MENTAL HEALTH

1. Recognise and have awareness of appropriate referral mechanisms for family violence, vulnerable adults, substance abuse and addictive behaviours.
2. Recognise psychological needs of patient presenting with depression or suicidal tendency.

DEPENDING ON THE SKILLSET OF THE CLINICIAN, THE ROLE COULD ALSO INCUDE:



MENS HEALTH

• Initiate opportunistic consultations with patients to cover issues of mens health.

Raise awareness and give basic advice on issues covering:

Testicular self examination.

1. Testicular self examination.
2. Incontinence and prostatic disease.
3. Family planning.
4. Sexual health.
5. Participate in screening programmes as appropriate.
6. Make appropriate referrals.

CONTRACEPTION AND SEXUAL HEALTH ADVICE

1. Advise patients on available methods of contraception and refer patients as appropriate.
2. Support patients attending for emergency contraception and prescribe/refer as appropriate.
3. Perform interval health checks for patients using hormonal contraception.
4. Offer health promotion / lifestyle advice to patients on reducing risk of sexually transmitted infection and refer as appropriate in line with practice policy.
5. Undertake appropriate diagnostic and / or screening tests for sexual infection as clinically indicated following a period of training and supervision.

WOMENS HEALTH

1. Advise patients on national and local cervical cytology and mammography screening programmes.
2. Undertake routine and opportunistic cervical cytology sampling (if in skill set) in accordance with the NHS Cervical screening programme following a period of accredited training and supervision.
3. If undertaking audit a minimum of twenty consecutive smears each year to demonstrate an adequate sampling rate of 12.7%.
4. Promote breast self-awareness, demonstrate breast self examination and provide supporting literature.

WOUND MANAGEMENT

1. Devise and follow appropriate wound management plans for individuals.
2. Perform wound care using aseptic technique.
3. Suture and clip removal.
4. Assist with minor surgical procedures.
5. Assist with IUCD insertions/checks.

IMMUNISATIONS, VACCINATIONS & INJECTABLES

1. Administer medications and vaccinations under an individualised prescription or Patient Group Direction and in accordance with the Guidelines for Administration of Medicines (NMC 2000).
2. After a period of training and supervision to deliver the national Childhood Vaccination Programme.
3. Ensure safe storage, rotation and disposal of vaccines and drugs throughout the surgeries - including those held in doctors bags

MEDICINES MANAGEMENT

1. Work in collaboration with the PCN Pharmacy Team on medicines optimization and quality improvement.

PRESCRIBING

1. Qualified Independent or supplementary prescribers to prescribe within scope of competence.

Job description
Job responsibilities


IN RELATION TO DIABETES MANAGEMENT


The clinician should have an in depth understanding of diabetes and the health implications associated with the disease and how diabetes is diagnosed, treated/managed.

The clinician running clinics is expected to:

• Initiate the process of diagnosis for patients with suspected diabetes and refer to GP as appropriate.
• Assist in the management of patients with newly diagnosed diabetes following practice guidelines, protocols and policies
• Support patients in the management of their diabetes (type I and type II)
• Support educate and provide literature for patients with diabetes
• Provide emergency treatment for hypo/hyperglycaemic emergencies
• Make appropriate referrals (dietician, podiatrist etc)
• Be able to adjust medication/give guidance in changing dosage of insulin and refer to GP as necessary.
• Contribute to the implementation of the National Service Framework
• Contribute to the maintenance of the practice diabetic register
• Manage diabetic patients in line with the Quality & Outcomes Framework (QOF), including the use of relevant templates.
• Attendance at in-house and external review meetings.
• The clinician should work with the relevant Administrator to ensure appropriate patients are invited and attend relevant Chronic Disease Clinics.

IN RELATION TO THE MANAGEMENT OF CORONARY HEART DISEASE & ATRIAL FIBRILLATION

• The clinician should have an understanding of CHD and AF
• The clinician running clinics is expected to:
• Contribute to the implementation of the National Service Framework.
• Develop and maintain practice register for primary & secondary prevention of CHD.
• Work within agreed protocols when managing risk factors to enable patients to manage their own disease.
• Provide psychological support by discussing interventions and treatments.
• Work with patients to set action plans for changes of lifestyle .
• Advise patients on lifestyle management and drug compliance for reducing the CHD risk factors eg: Hypertension, Angina, Myocardial infarction & Cerebrovascular accident.
• Manage patients in line with the Quality & Outcomes Framework (QOF), including the use of relevant templates.
• Attendance at in-house and external review meetings.
• The clinician should work with the relevant Administrator to ensure appropriate patients are invited and attend relevant Chronic Disease Clinics.

IN RELATION TO HYPERTENSION


The clinician should have an understanding of hypertension.

The clinician running clinics is expected to:

• Contribute to the implementation of the National Service Framework
• Develop and maintain practice register for hypertension.
• Work within agreed protocols when managing risk factors to enable patients to manage their own disease.
• Manage patients in line with the Quality & Outcomes Framework (QOF), including the use of relevant templates.
• Be competent at performing and analysing blood pressure readings and advising/ prescribing as appropriate.

IN RELATION TO PATIENT REVIEWS


The clinician should have an understanding of stroke and myocardial infarction and be able to carry out patient reviews including review of post admission medication once the patient has been discharged and provide appropriate follow-up advice.


IN RELATION TO OTHER CLINICAL WORK



SCREENING

• Undertake routine & opportunistic screening and health checks BP checks, height, weight, BMI, smoking status, alcohol intake, blood sugar measurement, peak flow (if clinically competent).

HEALTH PROMOTION

• Recognise patients readiness to change in supporting their attempts to change unhealthy behaviour.
• Provide healthy eating advice to individuals or to groups.
• Provide smoking cessation signposting individually in opportunistic and planned consultations.
• Provide individual advice to patients about increasing activity or exercise.
• Offer advice on recommended safe limits for alcohol consumption and safe drinking practice.
• Contribute towards the maintenance of health promotion material within the practice and waiting room notice boards.
• Refer as appropriate.

INFECTION CONTROL

• Support patients and colleagues in adopting sound infection control measures.
• Apply infection control measures within the practice according to national and local guidelines.

This includes:

1. Completion of Infection Control Audits, and acting upon any identified areas.
2. Universal hygiene precautions.
3. The collection and handling of laboratory specimens.
4. Segregation and disposal of waste material.
5. Decontamination of instruments and clinical equipment.
6. Reporting and treatment of sharps injuries in accordance with the Practice Needlestick injury policy.
7. Dealing with blood and body fluid spillage.
8. Educate colleagues in adopting sound infection control measures.

EMERGENCY MANAGEMENT

1. Maintain competency in basic anaphylaxis and resuscitation techniques.
1. Attend two yearly update re managing anaphylaxis.
2. Attend annual resuscitation training.
3. Attend annual defibrillation training.

CHILD HEALTH/CHILD PROTECTION

1. Recognise the signs, symptoms and categories of child abuse.
2. Understand the importance of recognition, observation, documentation and communication.
3. Awareness of child health procedures, statutory local procedures and points of referral.
4. Knowledge of other practitioners and agencies roles.
5. Understand basic legal issues around child abuse.

SAFEGUARDING

1. Recognise the signs, symptoms and categories of abuse in children and vulnerable adults.
2. Undergo appropriate levels of safeguarding training at designated intervals.
3. Extensive knowledge of in-house safeguarding procedures.
4. Knowledge of other practitioners and agencies roles.
5. Understand basic legal issues around abuse or children and vulnerable adults.

MENTAL HEALTH

1. Recognise and have awareness of appropriate referral mechanisms for family violence, vulnerable adults, substance abuse and addictive behaviours.
2. Recognise psychological needs of patient presenting with depression or suicidal tendency.

DEPENDING ON THE SKILLSET OF THE CLINICIAN, THE ROLE COULD ALSO INCUDE:



MENS HEALTH

• Initiate opportunistic consultations with patients to cover issues of mens health.

Raise awareness and give basic advice on issues covering:

Testicular self examination.

1. Testicular self examination.
2. Incontinence and prostatic disease.
3. Family planning.
4. Sexual health.
5. Participate in screening programmes as appropriate.
6. Make appropriate referrals.

CONTRACEPTION AND SEXUAL HEALTH ADVICE

1. Advise patients on available methods of contraception and refer patients as appropriate.
2. Support patients attending for emergency contraception and prescribe/refer as appropriate.
3. Perform interval health checks for patients using hormonal contraception.
4. Offer health promotion / lifestyle advice to patients on reducing risk of sexually transmitted infection and refer as appropriate in line with practice policy.
5. Undertake appropriate diagnostic and / or screening tests for sexual infection as clinically indicated following a period of training and supervision.

WOMENS HEALTH

1. Advise patients on national and local cervical cytology and mammography screening programmes.
2. Undertake routine and opportunistic cervical cytology sampling (if in skill set) in accordance with the NHS Cervical screening programme following a period of accredited training and supervision.
3. If undertaking audit a minimum of twenty consecutive smears each year to demonstrate an adequate sampling rate of 12.7%.
4. Promote breast self-awareness, demonstrate breast self examination and provide supporting literature.

WOUND MANAGEMENT

1. Devise and follow appropriate wound management plans for individuals.
2. Perform wound care using aseptic technique.
3. Suture and clip removal.
4. Assist with minor surgical procedures.
5. Assist with IUCD insertions/checks.

IMMUNISATIONS, VACCINATIONS & INJECTABLES

1. Administer medications and vaccinations under an individualised prescription or Patient Group Direction and in accordance with the Guidelines for Administration of Medicines (NMC 2000).
2. After a period of training and supervision to deliver the national Childhood Vaccination Programme.
3. Ensure safe storage, rotation and disposal of vaccines and drugs throughout the surgeries - including those held in doctors bags

MEDICINES MANAGEMENT

1. Work in collaboration with the PCN Pharmacy Team on medicines optimization and quality improvement.

PRESCRIBING

1. Qualified Independent or supplementary prescribers to prescribe within scope of competence.

Person Specification

Qualifications

Essential

• Qualified Nurse or Qualified Clinical Pharmacist with several years post qualification experience
• Active NMC/GPhC registration
• Experience of completing multiple tasks in a busy environment.
• Trustworthy and reliable.
• Ability to work effectively in a team and willingness to support colleagues.
• Able to work quickly and calmly under pressure and still maintain accuracy.
• Able to demonstrate good written and verbal communication skills.
• Ability to interact effectively with people at all levels
• Flexibility of approach and willingness to learn new tasks.
• Able to ensure patients are treated with respect and dignity at all times.
• Able to understand and exercise confidentiality and discretion at all times.
• Ability to demonstrate initiative.
• Ability to demonstrate Patience.
• Willingness to be able to cover for colleagues/to meet business demand.

Desirable

• Independent Prescriber
• Experience of working in primary care health or the NHS or similar environment.
• General Practice experience
• Diploma/experience in diabetes
• RCN accredited in Contraception & Reproductive Health
• Experience of using a computerised patient systems e.g. TPP SystmOne.

Person Specification
Qualifications

Essential

• Qualified Nurse or Qualified Clinical Pharmacist with several years post qualification experience
• Active NMC/GPhC registration
• Experience of completing multiple tasks in a busy environment.
• Trustworthy and reliable.
• Ability to work effectively in a team and willingness to support colleagues.
• Able to work quickly and calmly under pressure and still maintain accuracy.
• Able to demonstrate good written and verbal communication skills.
• Ability to interact effectively with people at all levels
• Flexibility of approach and willingness to learn new tasks.
• Able to ensure patients are treated with respect and dignity at all times.
• Able to understand and exercise confidentiality and discretion at all times.
• Ability to demonstrate initiative.
• Ability to demonstrate Patience.
• Willingness to be able to cover for colleagues/to meet business demand.

Desirable

• Independent Prescriber
• Experience of working in primary care health or the NHS or similar environment.
• General Practice experience
• Diploma/experience in diabetes
• RCN accredited in Contraception & Reproductive Health
• Experience of using a computerised patient systems e.g. TPP SystmOne.

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.
UK Registration

Applicants must have current UK professional registration. For further information please see

Additional information
UK Registration

Applicants must have current UK professional registration. For further information please see

Employer details

Employer name

Newbridge Surgery
Address

Newbridge Surgery

129 Newbridge Hill

Bath

BA1 3PT

Employer's website