Advanced Clinical Practitioner

An exciting opportunity has arisen to join the dynamic multi-disciplinary head and neck oncology team based at the Christie. The Christie head and neck team provide specialist care and management for patients diagnosed with a head and neck malignancy. The service is always striving to improve patient care and outcomes through service development and clinical trial activity. The post holder will work alongside clinical oncology and medical oncology consultants prescribing sact treatments and reviewing radiotherapy patients as well as providing specialist information, support, co-ordination of care and these patients, in both outpatient and inpatient settings., Along with the service line senior leadership team, including Advanced Practitioners and Consultant Practitioners, Advanced Practitioners will provide positive leadership, connecting patients, staff and partners with the vision and values of The Christie NHS Foundation Trust. They will use their expert knowledge and skills to assist in leading and delivering safe and clinically effective, quality driven, personalised care for people within our communities. Working alongside the senior managers and clinicians, they will assist in leading services that meet the needs of patients and their families to achieve improved health outcomes and promote health and wellbeing while demonstrating care, compassion, competence, communication, courage, and commitment. The post holder will provide advanced and specialist level comprehensive assessments for patients with highly complex presentations, case management, treatment, and education. This will predominantly be delivered within the setting of their service line and may extend into inpatient and clinic settings to support with highly complex cases and patient pathways. Please refer to job description for further details. The service is committed to providing the highest quality of care, advancing practice through clinical trials, quality improvement and clinical audit. The post-holder would be integral to service development and delivering a high standard of care for this complex disease. The Christie is one of Europe's leading cancer centres, treating over 60,000 patients a year. We are based in Manchester and serve a population of 3.2 million across Greater Manchester & Cheshire, but as a national specialist around 15% patients are referred to us from other parts of the country. We provide radiotherapy through one of the largest radiotherapy departments in the world; chemotherapy on site and through 14 other hospitals; highly specialist surgery for complex and rare cancer; and a wide range of support and diagnostic services. We are also an international leader in research, with world first breakthroughs for over 100 years. We run one of the largest early clinical trial units in Europe with over 300 trials every year. Cancer research in Manchester, most of which is undertaken on the Christie site, has been officially ranked the best in the UK. Communication

• Produce accurate and complete documentation and patient records consistent with legislation, policies, and procedures. These should develop to demonstrate the use of expertise in decision making skills which have informed advanced clinical reasoning.
• Communicate effectively, in a highly emotive, antagonistic, or hostile environment about highly complex, sensitive, and potentially distressing information - such as in an oncology setting, giving prognostic information for poor clinical outcome based on diagnostic cancer markers, or breaking bad news, relapse or progression of disease and discuss options with sensitivity and compassion.
• Anticipate barriers to communication, be empathetic and offer reassurance. Establish methods of overcoming these barriers, ensuring patients and significant others are kept fully informed and consent to treatment is maintained and fully documented.
• Provide and receive highly complex reports that may contain highly sensitive or highly contentious information. This information will be completed to a high standard to ensure accuracy, relevance, and sensitivity, with clear outcomes and recommendations.
Knowledge Training and Experience
• The post holder will have highly specialist knowledge through the attainment of a post registration master's (MSc) in advanced practice or through the e-portfolio supported route and have a digital badge. They will have theoretical knowledge and extensive relevant practical experience, acquired through a combination of in-depth experience and postgraduate post-registration study. They will have received significant formal training in, or experience within their clinical specialty.
• Work independently and autonomously within medico-legal frameworks, making highly complex expert clinical decisions, working within local and national policies being responsible for how these policies are interpreted.
• They will maintain and develop this expertise and competence to enable collaboration with senior colleagues and medical staff, and to facilitate the management of patients.
• To act autonomously as an expert resource and provide advice and support to ward/departmental areas and to The Christie's local, regional, national, and international partners.
• The post holder will practice in compliance with relevant code of professional conduct and maintain professional registration and practice through CPD including maintaining a professional portfolio to demonstrate competency in line with the trust competency framework to ensure that skills remain optimal and new elements can be added to the skills portfolio and presented at annual appraisal.
• They will identify their own development needs in line with service requirements and participate in setting a personal development plan. To support this, they will work with a named mentor from within the medical team or a senior advanced practitioner.
• Through ongoing supervision and mentorship identify personal learning needs, participating in personal continuing education and other activities to promote one's own personal growth across the four pillars.
• Practice the skills to interpret and evaluate information from diverse sources to make informed judgements about its quality, appropriateness for practice and service delivery.
• Develop and maintain expertise, skills and appropriate competencies in their clinical area ensuring the highest level of precision to ensure patient safety.
• Identify and support the development and implementation of advanced practice within services.
• Assist in maintaining and disseminating knowledge and expertise within their specialist field.
• Seize opportunities to apply new knowledge to their own and others practice in structured ways, which are capable of evaluation.
• Be expected to autonomously assess patients, receive, and make referrals, assess patients, receive, and make referrals, interpret, and act upon assessments, consider differential diagnosis, evaluate, treat, plan, refer and discharge patients within the Trust. Using non-medical prescribing skills and radiology requesting as relevant to professional background and training, have
IRM(E)R training.
• Actively engage in and promote the organisational learning culture within their service line in all aspects of clinical practice, facilitating staff to develop specific areas of expertise and proficiency to meet the needs of the caseload within the available resources.
• Work closely with the advanced practice lead, Senior Nursing and AHP Teams and the CICE to ensure staff have access to clinical updates and achieve required level of competency.
• Support the clinical areas within the area of responsibility to be excellent learning environments for all students to include robust supervision.
• Work closely with the leadership teams and Educator in Practice leads to encourage students to work in the Trust on qualification.
Analytical and Judgement Skills
• The post holder will assess complex facts and situations, using analytical skill, interpretation, and comparison of a range of options using a wide variety of assessment methods. In the clinical management of patients, competing, contradictory or unclear inputs are expected. Owing to the nature of the post following the whole patient pathway, they may have competing expected outcomes from the patient, the Trust, and other healthcare partners.
• The post holder will continually review and evaluate their own role and clinical practice informing the annual appraisal review process. They will practice evidence-based health care and by assessing clinical evidence, best practice guidelines and national policy statements will be responsible for defining developing, monitoring, and updating Trust clinical policies in relation to their own area of practice.
• Use quality improvement methodology to assist in changes in practice and service delivery in accordance with evidence-based standards and policy, challenging traditional boundaries and current thinking; and overcoming resistance and conflict at the Trust, system, and national level.
Planning and Organisational Skills
• Act as an autonomous practitioner in their specialist field using highly specialist clinical knowledge ensuring patient centred care and family involvement, including health promotion and disease prevention.
• Be directly responsible for the management of patients within own caseload.
• Apply advanced theoretical and practical knowledge to the clinical care of people, their families and partner agencies involved when delivering and shaping services in line with national guidelines, best practice, and the national personalised care agenda.
• Support the development and implementation of advanced practice within services.
Physical Skills and Effort
• Will be required to examine patients, pre, during and after treatment often in highly complex situations, where patients may be in distress or pain and examination needs to be performed using highly developed physical skills.
• Perform clinical, technical, or invasive procedures safely according to defined protocols, adhering to manual handling policy.
• There is a frequent requirement for light physical effort for several short periods during a shift.
Responsibility for Patient Care
• Practice in compliance with relevant code of professional conduct, delivering and participating in the clinical care of patients within scope of practice; being accountable for decisions, actions, and omissions at this level of practice.
• Develop advanced clinical decision making based on highly complex facts and situations and encourage critical thinking regarding both ethical and legal issues related to high quality care delivery.
• Develop and maintain expertise, skills and appropriate competencies in their clinical area ensuring the highest level of precision to ensure patient safety.
• Develop the ability to initiate, evaluate and modify a range of interventions which may include equipment, prescribing medicine, care plans, exercise, lifestyle advice, social prescribing, therapies, and self-management in accordance with evidence-based practice and national and local policy and protocols. Provides highly specialist clinical or technical services that contribute to the diagnosis, care or treatment of patients.
• Understands and applies the legal safeguarding framework that supports the identification of vulnerable and abused adults/children and is aware of statutory vulnerable patients' health procedures and The Christie NHS Foundation Trust guidance.
• Consent patients for treatment procedures in line with Trust policy and role.
• Provides highly specialist advice which contributes to the diagnosis, care, or education of patients.
• Prescribe licensed and non-licensed drugs within the capacity of non-medical prescribing, adhering to Trust policy and existing frameworks.
• Prescribe appropriate blood products as per Trust policy.
  
  We welcome applications from those from a nursing or allied health background with an advanced clinical practice masters. Oncology experience or head neck experience is desirable but not essential as we are a teaching hospital, but the right candidate would expected to practice within the 4 pillars of advanced practice.
The post holder will be motivated and eager to improve the quality of patient care and the patient experience and have skills in audit service innovation. The post demands excellent oral and written communication skills and good interpersonal skills are paramount together with the confidence to engage and work with a range of colleagues at all levels and from all professional groups. Flexibility in working is also essential.