Advanced Nurse Practitioner

Lancashire and South Cumbria Integrated Care Board (ICB) has been selected to take part in one of four national Fit Note Reform Pilots commissioned by the Department for Work and Pensions, helping to test a new approach that aims to improve support for people whose health affects their ability to work. The pilot is designed to address a recognised challenge within the current system, where fit notes often focus on certifying sickness absence rather than providing practical support to help people remain in work or return to work safely., Undertake advanced, autonomous work and health assessments for patients referred into the pilot, employing an extended scope of practice including advanced consultation, history taking and, where within the post holders assessed competence, physical assessment.

Assess undifferentiated presentations in the context of work, applying systematic clinical reasoning to distinguish between patients whose needs can be met by a Workability Plan, those requiring parallel clinical management, and those requiring urgent escalation.

Formulate and co-produce personalised Workability Plans focused on functional capability, phased return, adjustments and the practical support required to sustain work.

Exercise independent judgement in determining whether a period away from work is clinically appropriate, and articulate that judgement in terms that withstand challenge from patients, employers, referring clinicians and, potentially, an employment tribunal.

Recognise deteriorating or high risk presentations, including physical deterioration, mental health crisis, safeguarding concern and undisclosed serious pathology, and escalate without delay through agreed routes.

Issue fit notes for patients

Request, review and interpret investigations where clinically indicated and within agreed pilot scope, communicating and acting on findings appropriately.

Morecambe Bay Primary Care Collaborative is the largest employer of Primary Care colleagues in South Cumbria, we are a not-for-profit Community Interest Company, and work to support, guide and underpin primary medical care across Lancashire and South Cumbria.