Highland Health and Social Care Partnership
AGENDA FOR CHANGE

NHS JOB EVALUATION SCHEME

JOB DESCRIPTION TEMPLATE

1.  JOB IDENTIFICATION

Job Title: Senior Nurse Practitioner (CPN)
- Adult Community Mental Health Team
Reports to: Team Leader
Accountable to: Professional Lead CPN’s
Department: Community Mental Health Team
Directorate: South and Mid Highland Operational Unit
Job Reference: SENESSNURSCNMH02 Band 6
No of Job Holders: 10
Last Update (insert date): October 2015

2. JOB PURPOSE

To provide Senior Practitioner level (as defined within careers framework) care in mental health nursing within the operational unit area. Managing the clinical caseload of adult patients with mental ill health as delegated by the Team Leader, CPN. Support primary care colleagues to enhance their knowledge and skills in the management of mental health in the community and promoting recovery.
3. DIMENSIONS
Service Dimensions
The service is provided within the South and Mid Operational unit area of Inverness, Foyers and Drumnadrochit.
Population size: 69,559
GP Practices: 14
CMHT’s 1

4. ORGANISATIONAL POSITION

5. ROLE OF DEPARTMENT

To provide a community psychiatric nursing service to patients with mental illness within their family and community environment. To practice within agreed clinical pathways, promoting self management and recovery, minimising relapse.
The post holder will liaise with a range of Statutory, Independent and 3rd sector agencies regarding the care of their patients.
Contacts will take place mostly in patient’s homes, health and social care settings.

6. MAIN TASKS, DUTIES AND RESPONSIBILITIES

Senior Practitioner Level Clinical Practice
1.  Lead in assessing, planning, providing and evaluating evidence informed care in line with Mental Health Strategy, SIGN guidelines, Care Programme Approach (CPA) Mental Health Act principles and care pathways, providing individualised care and support to people who have mental ill health and who require complex case management.
2.  Practice within relevant generic national and local standards to provide safe and effective mental health nursing care to individuals, families and carers, in the home or community, as part of the multidisciplinary team.
3.  Participate in the CMHT duty rota, primarily to undertake urgent assessments/crisis management work, also to provide advice and support to staff/agencies dealing with complex and challenging cases.
4.  Provide, coordinate and manage complex packages of mental health care to people in the community.
5.  Co-ordinate and manage services as case holder, engaging in multidisciplinary and multi agency team working and partnership.
6.  Utilising a case management approach, assess patient care needs, develop, implement and evaluate clinical care of patients requiring complex mental health management. Plan care to promote self care and advance care planning.
7.  Assist patients to achieve optimum health and well being, taking account of patient choice, implications for patient’s lifestyle, employment, driving etc, promote self care management including diet and exercise.
8.  Participate in the Health Check MOT clinics, undertaking training as required.
9.  To administer depot medication and assess the clinical effectiveness of medication regimes, titrate and prescribe medications (if non medical prescriber).
10. Identify patient who fulfil the CPA criteria for Anticipatory Care Alerts and complete/update Alerts informing relevant members of the multi disciplinary care team.
11. To participate in the planning and facilitation of therapeutic group activities in collaboration with other professionals.
12. Undertake relevant training in psychological therapies according to the needs of the service.
Clinical/Professional Leadership
1.  Promote the implementation of the agreed model of mental health care, facilitating the
transfer of patients from Secondary to Primary Care management through the delivery of education and support to colleagues in primary care and promoting recovery.
2.  Provide clinical advice and support and supervision to multi disciplinary colleagues in relation to mental health management.
3.  Act as a positive role model and encourage effective multi disciplinary team working relationships across care sectors.
4.  Give and receive feedback in a constructive, open and honest manner.
5.  In the absence of the Team Leader/Professional Lead, attend relevant for a and meetings.
6.  Identify opportunities for service change; make suggestions for health improvement outcomes and development of healthcare delivery.
Facilitating Learning
1.  Utilise adult learning theories and provide a range of patient education in groups or one-to-one sessions appropriate to individual’s motivation preferred approach to learning; assess effectiveness of learning. Seek opportunities to work with and provide education to patient support groups.
2.  Provide patient/carer medication management education, assessment of side effects, use of side effects rating scales, knowledge of lithium and Clozapine monitoring.
3.  Support Team Leader/Professional Lead to conduct learning needs analysis and provide learning opportunities for multi disciplinary colleagues and students including mentorship, coaching, clinical supervision, action learning, promoting a learning environment and building capability and capacity.
4.  Contribute to the development of an organisational culture that supports continuous learning and development.
5.  Continuously assess and update own professional mandatory and core education needs including Effective Practitioner initiative to achieve learning.
Improving quality and developing practice
1.  Support the Team Leader/Professional Lead to develop and implement clinical governance processes including clinical audit to monitor and improve the quality of community mental health care and the effectiveness of practice.
2.  Support multi disciplinary colleagues in the implementation of clinical audit activities and evaluation of quality improvement processes.
3.  Collate clinical caseload activity data and support Team Leader/Professional Lead in the evaluation and development of the service.
4.  Participate in clinical supervision and seek networking opportunities to further own professional knowledge and development.
5.  Contribute to the development of local guidelines and policy.
6.  Demonstrate research awareness.
7.  To undertake the Independent Non Medical Prescribers qualification, if required.

7a. EQUIPMENT AND MACHINERY

Syringes, needles, sharps boxes
MOT health check equipment
Computers and lap top/Maintenance of patient records
Printers
Phone systems
7b. SYSTEMS
1.  Maintains patient records in accordance with NMC Guidelines and NHS Highland Standards for Record Keeping and Care Planning.
2.  Works as a practitioner within the Statutes and Guidelines of the Nursing and Midwifery Council.
3.  Utilise computerised systems to support practice, eg ISOFT, SCI-Clinical, E-Mail.
4.  Provides service activity reports to Team Leader/Professional Lead.
5.  Workload Measurement Tools.
6.  Participates and acts upon relevant statistics such as audit, to enhance delivery and quality of patient care.

8. ASSIGNMENT AND REVIEW OF WORK

1.  Patient caseload is delegated by the Team Leader who acts as Line Manager.
2.  Education, learning and development needs are identified via e-KSF and PDP & R process.
3.  Supervision is provided by Team Leader/Professional Lead.
4.  Clinical supervision by range of options as per NHS Highland Clinical Supervision Policy.
5.  Regular professional discussions with MDT.
6.  Additionally there will be an annual PDP/E-KSF review carried out by Professional Lead.
7.  Post holder will be expected to participate in annual audit of record keeping and care planning.
9. DECISIONS AND JUDGEMENTS
1.  Works independently with the freedom to exercise judgement about actions, while accepting professional accountability and responsibility, taking account of the guidance and standards of the NMC and National, NHS Highland and local policies, procedures and protocols.
2.  Makes autonomous clinical nursing decisions in planning and prioritising patient care including urgent assessments of patients presenting in crisis or own caseload/duty sytem.
3.  Recognises own limitations in the provision of clinical care and seeks advice and guidance of Team Leader/Professional Lead.

10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB

1.  Isolated and lone working, awareness of personal safety.
2.  Developing and sustaining the service and nursing practice while responding to and satisfying the varying needs of the patients, relatives and staff.
3.  Dealing with challenges that have a high degree of clinical care complexity, including acute presentations, suicidality, and substance misuse.
4.  Difficulties associated with non-compliance of patients with prescribed treatment, disengagement from mental health services.
5.  Prioritising a varied and demanding workload across a wide geographical area.
6.  Driving alone, often in inclement weather and in remote areas.
7.  Giving advice to other health care professionals in the management of acute situations, using information delivered over the phone and face to face.
11. COMMUNICATIONS AND RELATIONSHIPS
1.  Establish and maintain professional relationships with nursing and medical colleagues, health care professionals and voluntary services, outside agencies, hospitals and to provide a planned, co-ordinated seamless service for patients.
2.  Identify potential and existing challenges in care options for patients, carers and staff, using negotiation and counselling skills to achieve recovery and the best outcomes for patients.
3.  Participate in clinical meetings with nursing colleagues, Consultants, Psychologists, Social Workers etc.
4.  Communicates with patients, relatives, carers face to face, by telephone and by e-mail.
12. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB
1.  Concentration, decision making and organisational skills to cope with competing demands (crisis situations, answering constant telephone enquiries). Daily.
2.  Teaching and clinically supervising multidisciplinary staff, patients and carers. Daily.
3.  Dealing with the emotional effects of care for acutely and chronically ill patients and their families. Daily.
4.  Frequent exposure to acute psychosis, suicidality, unpredictable behaviour, resulting from mental ill health. Daily.
5.  Ability to manage/de-escalate aggression/confrontation. Daily.
6.  Managing verbal abuse and challenging behaviour. Daily.
Environmental
1.  Geographical distances involved in delivering care, necessitating driving alone in urban and rural environments and occasionally in adverse weather conditions.
2.  Working within a range of NHS and non NHS settings.
3.  Exposure to bodily fluids.

13. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB

1.  First level Registered Mental Health Nurse.
2.  A minimum of 3 years relevant post registration experience.
3.  Professional knowledge, skill and clinical expertise of mental health nursing attained through experience for a minimum of 3 years in a relevant post.
4.  Evidence of Post Registration, Mental Health Education/Psychological Therapies and training.
5.  Evidence of relevant ongoing professional development PDP&R.
6.  Specific training/skills gained through experiential learning/willingness to undertake training:
eg Specialist in Community Psychiatric Nursing or equivalent
Psychological therapies, Risk Assessment/Management (STORM)
7.  Independent Non Medical Prescribing or willingness to undertake training if required.
8.  Experience of working in the community or can demonstrate knowledge and skills essential to community practice.
9.  IT Skills – eg general PC skills, e-mail, caseload/workload data inputting.
14. JOB DESCRIPTION AGREEMENT
I agree that the above Job Description is an accurate reflection of my duties and responsibilities at the date of signing.
Job Holder’s Signature:
Manager’s Signature: / Date:
Date: