Band 7 Respiratory Clinical Nurse specialist

Our trust has around 10,000 staff serving 1.6 million patients. It comprises Barnet Hospital, Chase Farm Hospital, the Royal Free Hospital and more than 30 services in the community. This larger scale organisation provides an unprecedented opportunity for us to continue our pioneering work, particularly in finding ways to deliver even better care to our patients.

Our mission is to deliver world class care and expertise in our clinical services, underpinned by world class teaching and research and we will continue to measure our progress against our five governing objectives: excellent outcomes, excellent patient and staff experience, excellent value for taxpayers’ money, being safe and meeting our external duties, and building a strong organisation.

Everyone is welcome at Royal Free London NHS Foundation Trust. We're proud of our diversity and we continue to undertake new initiatives to advance equality for LGBT+, BME, gender equality, staff carers and people with disabilities and lived experiences to promote good relations and understanding between our staff.

Detailed job description and main responsibilities

• Clinical Practice
• Independently conduct nurse-led outpatient clinics for patients with chronic lung disease, including optimising treatments, liaising with consultants and others as appropriate. This will include patient education, developing personalised action plans, measurement of FeNO, performance of peak flow monitoring and checking inhaler technique.
• Perform clinical assessment and management of complex patients with chronic respiratory disease. This may include performing oxygen assessments +/- blood gas sampling, providing nebuliser assessments and developing practitioner prescriber skills.
• Support the severe asthma MDT to systematically assess and manage patients with severe asthma. This will include reviewing patients in the multidisciplinary severe asthma clinic, organising specialist blood and allergy tests, using validated patient questionnaires, maintaining entries into the UK Severe Asthma registry and the delivery of asthma biologics including omalizumab, mepolizumab, benralizumab in the ambulatory and/or home setting.
• This will also include attendance at the monthly severe asthma MDT at Royal Free Hampstead and less frequently the regional MDT at Barts Hospital.
• Work with relevant teams to plan and organise specific post-discharge interventions and advance care planning for individual patients. This will involve close communication with e.g. community respiratory teams, palliative care teams, general practices.
• Liaise with other local community health-care providers to optimise support for patients from different and diverse agencies including community provider teams, multidisciplinary hub, local Breathe Easy groups.
• To assess and manage inpatients with respiratory disease, including interface with ED and other medical specialties, in order to optimise care and facilitate timely and safe discharge.
• Contribute to the COPD best practice tariff to ensure compliance. This includes early specialist review and implementation of COPD care bundles.
• Support the weekly interstitial lung disease service alongside the lead consultant.
• Be accessible for patients phoning in concerned about their condition and to provide advice or involve other clinicians as appropriate.
• Be an ambassador for smoking cessation within the hospital, including early discussion +/- prescribing of therapies and referral onwards to local smoking cessation teams.
• Support the new ambulatory pleural service at Barnet Hospital.

• Leadership / Management
• Share expertise with healthcare professionals on a local and national level through professional conferences, forums and bodies.
• To liaise and work with other CNSs across the trust to share best practice and ideas to strengthen practice and reduce unwarranted variation in care.
• Continually assess and monitor risk in own and others’ practice and challenge practice where appropriate.
• Exercise sound leadership and inspire colleagues to improve standards and quality and to develop professional practice.
• Develop appropriate strategies to make use of technology in the interests of patients.
• Attend and be an active participant in relevant clinical and managerial groups at a divisional, Trust, regional and national level.
• Act as an expert respiratory practitioner in implementing appropriate local guidance / NICE guidance across the Trust.
• Audit of the service, particularly regarding key outcomes such as patient satisfaction and re-admission rates. This will include maintenance of appropriate databases, e.g. for oxygen toxicity or frequent hospital attenders.
• The post holder will be expected to play a lead role in quality improvement within the service and will be supported to implement their own ideas and projects.

• Education / Practice and Development
• Demonstrates knowledge of contemporary clinical practice, explores new ideas and introduces evidence-based change in line with local and national initiatives.
• Utilise specialist skills to provide training, education, information and support to staff involved in the delivery of respiratory care as well as patients and carers.
• Act as an advisor and role model to doctors, nurses and therapists as well as students to ensure appropriate care is planned, implemented and evaluated.
• Develop and provide written information and educational materials for patients and carers.
• Work with the consultant team to plan and implement on-going education for nursing, medical and therapy staff as well as students (including UCL medical students).
• To be responsible for own professional development and keep abreast of new clinical practices. Maintain a portfolio for your professional development reflecting personal professional development through attending courses and reflective practice.
• Ensure mandatory and statutory training is current.
• Attend National conferences eg. BTS, ARNS.
• Act at all times in accordance with Royal Free London NHS Foundation Trust and the Nursing and Midwifery Council guidelines.

• Research Responsibilities
• Periodically the department helps to recruit to research studies and the post-holder may be asked to help identify or refer patients for these.
• There will also be opportunities to take part in local research and the department has a good track record of presentations at local and international meetings; the post-holder would be encouraged to become involved in these.

• Role-specific administration
• Case finding for COPD and asthma admissions.
• Help to lead and ensure timely electronic data entry into the National Asthma and COPD audit (NACAP).
• Help to lead and ensure timely electronic data entry of patients with severe asthma onto the UK Severe Asthma Registry.
• Completing Home Oxygen Order Forms (HOOFs) for hospital inpatients prior to discharge.
• Completing onward referrals where appropriate, for example to the National Referral Service for smoking cessation.
• Completion of appropriate casenote documentation for inpatients and telephone conversations.
• Where appropriate, completion of Coordinate My Care records to facilitate advance care planning in certain patients.
• Writing and electronically signing clinic letters for outpatients.
• Other admin as arises, for example around documentation of the severe asthma MDT.

• General Responsibilities

Infection Control

Infection control is everyone’s responsibility. All staff, both clinical and non-clinical, are required to adhere to the Trust’s Infection Prevention and Control policies and procedures and The Health and Social Care Act 2008: Code of Practice for the prevention and control of healthcare associated infections and make every effort to maintain high standards of infection control at all times thereby reducing the risk of Healthcare Associated infections.

It is the duty of every member of staff to take personal responsibility for the prevention and control of infection, as laid down in the Trust’s polices and procedures which reflect the statutory requirements of the Hygiene Code.

• To work in close collaboration with the Infection Control Team.
• To ensure that monitoring of clinical practice is undertaken at the agreed frequency.
• To ensure that the ward environments are cleaned and maintained to the highest standards; ensuring that shortfalls are rectified, or escalate as necessary.
• To ensure that all relevant monitoring data and issues are provided to the Directorate’s Governance structures.
• To ensure that all staff are released to attend infection control-related educational sessions and staff with specialist roles, e.g. link practitioners, are released to undertake their duties.

Health and Safety at Work

The post holder is required to:

• Take reasonable care for the health and safety of himself/herself and other persons who may be affected by their actions or omissions at work.
• Co-operate with the employer in ensuring that all statutory and other requirements are complied with.

Confidentiality & Data Protection

The post holder has a responsibility to comply with the Data Protection Act 1998 and maintain confidentiality of staff, patients and Trust business.

If you are required to process information, you should do so in a fair and lawful way, ensuring accuracy is maintained. You should hold information only for the specific registered purpose and not use or disclose it in any way incompatible with such a purpose.

You should disclose information only to authorised persons or organisations as instructed. Breaches of confidentiality in relation to information will result in disciplinary action, which may include dismissal. Employees are expected to comply with all Trust policies and procedures and to work in accordance of the Data Protection Act 1998. For those posts where there is management or supervision of other staff it is the responsibility of that employee to ensure that their staff receive appropriate training (e.g. HISS induction, organising refresher sessions for staff when necessary.)

Conflict of Interest

The Trust is responsible for ensuring that the services for patients in its care meet the highest standards. Equally, it is responsible for ensuring that staff do not abuse their official position, to gain or benefit themselves, their family or friends.

Equality and Diversity

Person specification

• Covid-19 Vaccination

  Getting vaccinated, and getting a booster, remains the best defence against COVID-19.
  We encourage and support staff to get COVID-19 vaccine and a booster dose as and when they are eligible.
• AT* - Apprenticeship Training. Where AT* is entered next to the job title indicates that this vacancy is for an apprenticeship role.
• By applying for this role, you accept if successful, that your personal data may be transferred from the Trust to another NHS organisation where your employment transfers within the NHS. This is in accordance with the streamlining programme which aims at saving you time and improving efficiencies within the NHS when your employment transfers. Therefore we require you to complete your stat and Man e-learning modules prior to joining our organisation.
• If you are an EU/EEA citizen who does not have EU Settlement or Pre-Settled status, you will require a visa to work in the UK.
• Applications from job seekers who require sponsorship to work in the UK are welcome and will be considered alongside all other applications. Before submitting your application and to avoid disappointment please check that you are eligible under the UKVI points based system.
• If you are offered a role with one of the NLPSS partner trusts, as part of pre-employment checks your identity and right to work documentation will be verified remotely (in most circumstances), using a certified identity verification service provider TrustID. You will be asked to capture an image of the relevant documents as well as a “selfie” using your smartphone/tablet (if available) for facial matching. TrustID will also perform a digital address check using Trunarrative and Equifax, which is a soft check and does not leave a footprint on your credit rating. For more information, visit www.trustid.co.uk
• The Trust uses electronic new starter forms on Trac to collect personal details. Information collected is securely stored and used to set up the employee record on the ESR HR system.
• The Trust will request a DBS (CRB) if post involves regulated activities. The Trust is compliant with the Disclosure and Barring Service Codes of practice and the Rehabilitation of offenders act.
• By applying for this post you are agreeing to Royal Free London NHS Foundation Trust transferring the information contained in this application to its preferred applicant management system. If you are offered a job, information will also be transferred into the national NHS Electronic Staff Records system.
• Please be aware of scams – unless specified above, we will only communicate with you via @recruit.trac.jobs or nhs.net e-mails and we will never ask you for any payments.

Applications are welcome from people wishing to job share or work flexible patterns. We are committed to equal opportunities.

Please note:

• Due to the high number of applications that are received for some posts we may close this vacancy before the advertised closing date. Therefore please apply for this post as soon as you can, if you are interested and you meet the requirements of the Person Specification.
• Only those candidates who clearly demonstrate how they meet the person specification will be shortlisted for this job.
• Interview arrangements will be communicated via email so please check your email regularly following the closing date.