Community Palliative Clinical Nurse Specialist

Community Palliative Clinical Nurse Specialist

The Specialist Community & Crisis Support Service (SCCS) provides 24-hour specialist advice, support & facilitation of care for people with complex symptom management due to life-limiting illness via telephone, within the home setting or at a nurse-led clinic to people we care for and their loved ones and other health care professionals in the community.

This post requires various senior experience in a multidisciplinary working environment delivering a 24/7 service. Our hospice ward triages calls between 23.00-07.00hrs.

The SCCS Service operates within Barking & Dagenham, Havering and Brentwood & provides out of hours telephone support to include Redbridge.

Any community experience with lone working would be valuable in addition to the non-medical prescribing qualification or working towards this.

Are you someone who has excellent communication, assessment and prioritisation skills and understands the needs of those receiving palliative/end of life care? Do you have a working knowledge of evidence-based practice and the ability to develop a good knowledge base of current initiatives and developments in palliative care?

Applications will be sent for shortlisting upon receipt, therefore interviews will take place on an ongoing basis and shortlisted candidates will be given at least 7 days notice by email of invitation to interviews.

Main duties of the job

Work collaboratively with the primary care team to provide high-quality specialist support, advice and symptom control to people who we care for and their loved ones and other healthcare professionals.

To provide specialist telephone assessment via the Specialist Advice Line.

To work both autonomously and as a team member to provide specialist resource in palliative care in close collaboration with acute hospital and other specialist palliative care services and the wider multidisciplinary team.

To provide specialist support, decision-making skills, expert advice/consultancy and education to members of the primary care team to support them with the management and care of people with life-limiting illness in the community.

To contribute and take forward the development of specialist community palliative care services in line with the Palliative Care Strategy, Cancer Reform Strategy and NICE Guidance.

To undertake evidence-based, cost-effective non-medical prescribing decisions after making patient assessment/diagnosis ensuring safe prescribing practice within professional and Saint Francis Hospice policies/guidelines. To reflect on clinical appropriateness of individual prescribing decisions and activity.

About us

We are not a Licensed Sponsor & therefore are unable to provide sponsorship to applicants who do not have the Right to Work in the UK.

Saint Francis Hospice is a dynamic, forward-thinking organisation delivering a full range of specialist palliative care services for all patients with life-limiting illness. We achieved Outstanding in our CQC inspection in April 2016. We have adapted and reconfigured our services to meet the changing needs of our local community. The hospice supports five Clinical Commissioning Groups and has a robust governance structure in place. We provide inpatient clinical services within a modern, personal and friendly 18-bedded unit, as well as Specialist Community Crisis Support Service, Hospice at Home Service and Specialist Day Therapy Services provided at Pemberton Place. Alongside these clinical services, we have the hospice Pepperell Education Centre that has an excellent reputation for delivering high-quality education programmes and study days.

PLEASE NOTE THAT SAINT FRANCIS HOSPICE IS A CHARITY AND NOT PART OF AN NHS TRUST. THE HOSPICE IS SITUATED IN A QUIET LOCATION IN THE VILLAGE OF HAVERING-ATTE-BOWER ON THE OUTSKIRTS OF ROMFORD; THEREFORE YOU ARE ADVISED TO CONSIDER OUR LOCATION WHEN APPLYING.

Job responsibilities

MAIN DUTIES AND RESPONSIBILITIES

CLINICAL EXPERTISE, LEADERSHIP AND TEAMWORKING

• Work within community services to respond to referrals and individuals on the telephone and visiting caseloads within allocated geographical areas as the need dictates in line with community service standards, to offer skills of a clinical nurse specialist.
• Provide specialist holistic telephone assessment and support ongoing for healthcare professionals, people who we care for and their families in line with service standards.
• To work within an allocated Clinical Nurse Specialist role daily to ensure smooth service provision and allow for flexibility of service demand.
• Provide face-to-face holistic assessment and monitoring either at home, hospice outpatient session or within a specialist outreach environment.
• Responsible for initial contact to all new referrals and re-referrals to community services to: carry out a holistic telephone assessment and complete all relevant documentation to liaise appropriately with primary health care team to resolve problems identified to provide them with a contact details of the service.
• Provide expertise in complex symptom control and advise any health care professionals associated with palliative care, helping them to evaluate the effects of prescribed interventions and recognise and appropriately manage palliative care emergencies.
• Offer skilled psycho/social support for people who we care for with specialist palliative care needs and their loved ones, providing them with appropriate information about their condition, its management and the services available to support them both pre and post bereavement.
• Liaise with other hospice services regarding their waiting list and any other matters.
• Take responsibility for assessment and clinical judgement of those persons at home known to the service, referred for admission to the Ward.
• Administer sub cut PRN injectable medication as prescribed and authorised in the event of an urgent need, being competent to do so; and in the patients home, following assessment and clinical judgement and with appropriate equipment.
• Provide ongoing telephone support to people who we care for and their loved ones whilst they are waiting to be seen by other hospice services.
• Gather, document and co-ordinate information from other professionals and the specialist care teams relating to individuals referred to community services.
• Promote and facilitate communication within the multi-disciplinary team and in Community CNS Nov 2020 all other settings utilising advanced communication skills.
• Lead on a specialist area of non-malignant interest and participate in any related meetings, audits and network opportunities using allocated sessions as part of the Saint Francis Hospice Widening Access programme.
• Participate in weekly multidisciplinary meetings internally and as allocated at external acute hospital MDT and ensure that the palliative care service has a high profile with other disciplines and professionals.
• Responsibility for attendance and contribution at monthly team meeting when on duty.
• Fully understand the importance of multi-professional team working and the ability to champion it within the organisation.
• Have an understanding and awareness of behaviours and interpersonal skills that are vital to effective team working and practice them at all times and ongoing commitment to service and organisation values.
• Possess a proactive and supportive leadership style that encourages team participation in decision-making processes.
• Maintain accurate, up to date documentation in accordance with Saint Francis Hospice policies and within guidelines laid down by the NMC.
• Input, record and maintain all form of records (written and electronic), data and statistics onto I Care and any other data collection systems in place in accordance with hospice policies.
• Write and maintain service standards, and prepare written reports with regard to services provided, as requested.
• Contribute to the audit, monitoring and development of the community services.
• Have a flexible approach to supporting the community services with face-to-face home assessments & regular on-calls as per rota.
• Participate in the community team on-call rota as allocated- this will include overnight (5pm-9am) and all weekend/Bank Holiday cover 7 days a week for all persons known to Saint Francis Hospice services and external professionals.

EDUCATION AND QUALITY

• Participate in the development and delivery of an education strategy for nursing and other disciplines relating to all aspects of palliative care in both formal and informal settings.
• Attend mandatory training as specified by the hospice.
• Responsible for development and delivery of individual educational sessions within organisational teaching programme and responsive to external requests as appropriate.
• Take responsibility for own professional development, in accordance with appraisal and performance review. Attend study courses in agreement with line manager and maintain current registration of the required qualifications for the post with the NMC.
• Ensure nursing practice in the field of palliative care remains evidence-based and ensure active dissemination of relevant findings.
• Be involved and support the Gold Standard Framework Training Programme with GPs, in Care Homes and in any other settings as appropriate and availability allows.
• Review, initiate and participate in research programmes as appropriate using the findings to enhance clinical standards, clinical effectiveness and outcomes.
• Ensure that post-registration training meets the requirements necessary to be considered a clinical nurse specialist within the field of palliative care nursing.
• Commitment in educational opportunities provided to ensure development of use of clinical diagnostics and nurse prescribing skills during face-to-face assessments either onsite or in persons home in accordance with organisational guidelines.
• Generate and use appropriate learning opportunities and apply own learning to the future development of practice-attendance at organisational Specialist Updates encouraged.
• Articulate and reflect palliative care skills, enabling others to learn and be responsible for acting as a resource and sharing of knowledge to help others develop increased skills across the organisation.
• Be responsible as role of mentor for new and more junior staff within the team and organisation.
• Implement and evaluate planned teaching programmes.

MANAGEMENT

• Be responsible for and manage service (individual & corporate combined) caseload of patients whilst ensuring that the palliative care service remains responsive to crisis support, all new referrals and those seeking advice.
• Establish and maintain effective lines of communication with hospital, multi-services in the community and other organisations to ensure continuity of care.
• Initiate and develop nursing policies, protocols, standards and relevant care pathways within the team and ensure that there is a systematic programme of audit in place, planned and reviewed annually.
• Participate in forums for discussion on research and audit programmes, and in clinical governance initiatives e.g. clinical review.
• Lead and undertake audits relevant to the service and ensure that audit results presented at local and national forums as appropriate in order to influence practice and demonstrate strong effective clinical leadership as change agents.
• Participate & engage in group clinical supervision and self-evaluation and use this to improve care and practice.
• Support to Team Lead with learning opportunities for cross cover of operational internal/ external meetings as appropriate.
• Responsible for management and organisation of own workload and prioritisation of work within core hours on duty as part of organisational service provision.

PROFESSIONAL RESPONSIBILITIES

• To act within the legal and statutory rules relating to nursing practice as laid down by the Nursing & Midwifery Council.
• To be responsible and ensure adherence to professional Revalidation expectations and process.
• To adhere to the policies, procedures, standards and conditions of service of Saint Francis Hospice relating to sickness and absence, conduct, Health and Safety, Data Protection, and any others that are relevant.
• To take responsibility for own professional and personal development which will be monitored in supervision sessions and in the annual appraisal.
• To keep up-to-date with the developments within nursing and in particular in the field of palliative care.

Person Specification

Experience

• Excellent symptom control knowledge
• Knowledge of current issues in palliative care
• Evidence of recent and ongoing professional development in palliative care
• Ability to work autonomously as well as part of a team both within hospice MDT, primary health care services and hospital trust teams
• Motivated and enthusiastic-ability to be flexible, innovative and keen for ongoing service development
• Ability to flourish in during organisational and service development
• Advanced communication skills and evidence of collaborative working
• Ability to manage own work and work within a corporate caseload
• Good IT skills and knowledge of electronic healthcare systems
• Flexible approach to team working and an awareness of effective team dynamics
• Good personal support mechanisms
• Community based experience
• Experience of undertaking audits and use in improving practice

Other Requirements

• Should have the ability to travel efficiently and effectively to a person's home address across various locations within the hospice community catchment area.
• Able to work flexibly as part of a rota providing 24/7 service
• Covid-19 Vaccination - During the Covid-19 pandemic, it has been necessary to take significant steps to protect the health and safety of our staff, service users, patients and those attending our sites. To comply with ongoing duty of care, we strongly encourage our staff to have the Covid vaccine.

Qualifications

• RGN with significant post registration experience
• Teaching Qualification or equivalent level of experience
• Degree or equivalent level of experience
• Significant senior post registration experience at a similar level in palliative care or another associated specialty
• Non-Medical prescriber or working towards
• Counselling qualification/experience

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.

£44,177 to £51,343 a year. Our posts do not attract High Cost Area or fringe allowances.