Site Nurse Practitioner - Inpatient Services

Guy's and St Thomas' NHS Foundation Trust

Permanent and 12-month fixed term cover opportunities

The SNP role provides professional and clinical leadership in the acute hospital and community Trust settings to patients, carers, and staff. The post holder will act as a visible presence as a Trust senior operational and clinical manager, and senior on-site manager out of hours, taking on the responsibility for the management of the emergency/elective pathways including bed management and overall operational management of the Trust.

Closing: 02/01/25

Interview: Tuesday 14th January 2025

Main Duties of the Job

In October 2023, the Trust launched a new electronic health record, Epic. This has transformed the current bed management process providing a 'Live bed status', improving patient flow and patient experience, changing the way the site team works. This will give the post holder the opportunity to enact change management skills within a dynamic team.

The SNP is a high-profile role whose key responsibilities are to lead the 'Out of Hours' teams, coordinate the hospital team handover, manage Trust targets, and ensure staff compliance with Trust-wide policies and procedures. In addition, the Site Nurse Practitioner leads the Trust's emergency response to fire, security alerts, Code 10 (mental health emergency), cardiac arrests, and first line management of Major and Serious/Critical site incidents as required.

All SNPs have a unique opportunity to maintain and develop their clinical skills in a dual role working designated clinical shifts as part of the Clinical Response Team (CRT). This involves the assessment and management of acutely unwell patients in ward/clinical areas as part of a multi-professional team. Facilitate the safe transfer of patients to an appropriate clinical area such as Critical care where required. The clinical aspect of the role involves working closely with the multi-disciplinary team to support wards and critical care where required.

About Us

Guy's and St Thomas' NHS Foundation Trust comprises five of the UK's best-known hospitals - Guy's, St Thomas', Evelina London Children's Hospital, Royal Brompton, and Harefield - as well as community services in Lambeth and Southwark, all with a long history of high-quality care, clinical excellence, research, and innovation.

We are among the UK's busiest, most successful foundation trusts. We provide specialist care for patients including heart and lung, cancer, and renal services as well as a full range of local hospital and community services for people in Lambeth and Southwark.

Job Responsibilities

Site / Duty Management

1. To be responsible for the immediate coordination and first line management of the Trust's emergency response to Fire, Major Incidents, Security alerts, Code 10 (mental health emergency), and Serious/Critical site incidents.
2. To provide leadership to the Out of Hours teams and to coordinate the hospital handover focusing on safety, support, patient referrals, and new admissions.
3. Responsibility out of hours for the operational management of the Trust, implementing Policies and Procedures as required and providing support and advice to patients, staff, and Trust employees. In addition to this, recognising when to escalate to Senior Site Nurse Practitioner team.
4. To routinely undertake ward walkarounds and to provide senior nursing support, advice, and clinical leadership to clinical areas within the Trust to provide a safe clinical environment for patients.
5. To manage and implement the Trust's Complaints, Disciplinary, Violence and Aggression Policies and other policies as required.
6. To liaise with Security managers and communication team, and on behalf of the Trust to external agencies such as the police and media.
7. To coordinate and redeploy staff to maintain safe staffing according to acuity levels in Hospital and community settings. Utilising the Safe care system to plan and mitigate staffing levels to maintain patient safety.
8. Responsibility as a hospital manager to formally accept mental health section papers for any patient detained under the Mental Act (1983) on behalf of the Trust and inform the patient of their rights under the MHA and how to appeal against the section.
9. Appropriate escalation of patients needing placement within mental health services as per locally agreed guidance, both in and out of hours with senior management.
10. To act as a trouble-shooter, and give support and advice to all Trust employees.
11. To support the implementation of a new electronic health record, Epic that launched in October 2023. Transforming bed management improving the efficiency of patient placement and patient experience.
12. To maintain the new electronic health record, Epic bed occupancy/site status, and to contribute to the required daily collection and analysis of data relating to bed management.
13. To coordinate both emergency and elective patient pathways through the Trust to allow for sufficient inpatient bed capacity to maintain patient flow and patient safety. This requires the ability to balance the demand for an optimal level of elective activity with a high emergency rate.
14. Provide operational support to clinical areas identifying patient discharges, challenging bed occupancy, and utilising alternative pathways to optimise the use of inpatient beds and enable efficient patient discharges.
15. To work alongside the senior site nurse practitioners to monitor the trigger factors associated with and when necessary implement the Trust's Full capacity protocol in order to minimise bed pressures through effective planning.
16. Manage the placement of external urgent transfers and repatriations using the Epic transfer centre.
17. Maintain bed management data for both internal audit and external reporting requirements.

Clinical Leadership

1. To work autonomously, managing a caseload of patients working as part of the multidisciplinary team, delivering individualised and direct patient care.
2. Direct, support, encourage and advise clinical teams providing senior nursing support to all clinical areas within the Trust to provide a safe clinical environment.
3. Demonstrate appropriate expert practice and specialist advice in the assessment, planning, implementation, and evaluation of patient care. This includes advanced patient assessment skills.
4. Including history taking, physical examination, and initiating immediate care on the basis of your findings and referring for medical intervention appropriately ensuring the prompt and effective management of patients.
5. To undertake a wide range of advanced clinical interventions which may include prescribing, Advanced Life Support Skills, advanced assessment skills, transfer, and care of acutely unwell patients (including patients requiring level 2 & 3 care).
6. To support staff in the management and care of patients requiring Level 2 / 3 type care and to provide a transfer service for patients who require their level of care stepping up.
7. To prescribe medications as required for patients within the individual's scope of practice of non-medical prescribing clinical competence.
8. To respond to and provide senior nursing support in the event of a clinical emergency or as a member of the Trust Resuscitation Team.
9. To provide infection control advice, with the assistance of the infection control team.

General

1. To liaise with Ward Managers, Matrons, Deputy Heads of Nursing, Heads of Nursing, and General Managers regarding the clinical and operational management of their areas.
2. Provide mentorship and support to a various range of staff including Student nurses, staff nurses, and new Paediatric nurse practitioners (PNPs).
3. To participate in the development of the Site Practitioner service by maintaining accurate records for the Audit process, and by liaising with clinical areas and other service users in order to receive feedback and to evaluate the effectiveness of the service.
4. To operate an effective service the Site Nurse Practitioner needs to work flexibly across both Hospital sites, participating in the Out of Hours on-call rota and providing cover for colleagues unexpected sickness or any other service requirement.
5. To act in accordance with relevant professional codes and statutory guidelines and be wholly accountable for professional practice at all times.
6. To be responsible for individual professional development and to participate in projects and research that enhance personal performance and the operation of the service. And, to contribute towards meeting the objectives of the Nursing & Midwifery Strategy.
7. To be aware of and work within the policies and procedures of Guys and St Thomas Hospital NHS Trust, carrying out such duties as may be required and which are consistent with the responsibility of the grade and to undertake any other duties which may be appropriate to the post at the management's discretion.

Person Specification

Values and Behaviours

• Broad clinical experience in specialist area ITU, CCU, HDU or A&E
• Experience of hospital site and bed management
• Ability to be flexible to changing needs of service and NHS

Qualifications/ Education

• Bachelor Degree in nursing, health or management related studies or evidence of equivalent knowledge and experience
• Mentorship qualification and extensive experience of teaching and mentoring peers and junior staff
• Post Registration qualification within ITU, CCU, HDU or A&E or equivalent experience
• Clinical and classroom teaching/facilitation experience
• Non-medical prescribing
• Advanced assessment course
• Leadership course

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.