Job description template for an advanced nurse

practitioner in general practice

Title: Advanced nurse practitioner in general practice
Salary Level Recommendation:  The group would recommend that this role is considered equivalent to
a level 8A on the Agenda for Change scale (salary range for 2013/14: £39,239 - £47,088)
Hours of duty:   to be agreed on appointment
Responsible to:  GP
Accountable to:  GP
Line Management Responsibilities: this will be updated by the practice if staff management is required

Job summary
The post holder will demonstrate courageous and critical thinking and is a caring, compassionate and
committed experienced nurse who, acting within their professional boundaries, will provide care for the
presenting patient from initial history taking, clinical assessment, diagnosis, treatment and evaluation of
care. They will demonstrate safe, competent clinical decision-making and expert care, including
assessment and diagnostic skills, for patients within the general practice. The post holder will commit to
demonstrating critical thinking in the safe clinical decision-making process. They will communicate and
work collaboratively with the general practice team to meet the needs of patients, supporting the delivery
of policy and procedures, and providing nurse leadership as required.

Key responsibilities
Clinical practice

 Assess, diagnose, plan, implement and evaluate treatment/interventions and care for patients
presenting
with an undifferentiated diagnosis
 Clinically examine and assess patient needs from a physiological and psychological perspective,
and plan
clinical care accordingly
 Assess, diagnosis, plan, implement and evaluate interventions/treatments for patients with
complex needs
Proactively identify, diagnose and manage treatment plans for patients at risk of developing a
long-term
condition (as appropriate)
 Diagnose and manage both acute and chronic conditions, integrating both drug- and non-drug-
based
treatment methods into a management plan
 Prescribe and review medication for therapeutic effectiveness, appropriate to patient needs and
in accordance with evidence-based practice and national and practice protocols, and within scope
of practice
 Work with patients in order to support compliance with and adherence to prescribed treatments
Provide information and advice on prescribed or over-the-counter medication on medication
regimens, side-effects and interactions
 Prioritise health problems and intervene appropriately to assist the patient in complex, urgent or
emergency
situations, including initiation of effective emergency care
 Support patients to adopt health promotion strategies that promote healthy lifestyles, and apply
principles of self-care
 Support and manage health needs of women presenting for family planning, cervical cytology or
sexual health consultation
 Assess, identify and refer patients presenting with mental health needs in accordance with the
NSF for Mental Health
Implement and participate in vaccination and immunisation programmes for both adults and
children
 Advise, support and administer vaccinations for patients travelling abroad, where appropriate
 Promote and deliver evidence-based care for patients presenting with aural conditions
 Meet the needs of patients presenting for opportunistic wound care
 Undertake minor surgery as appropriate to competence 

Communication

 Utilise and demonstrate sensitive communication styles, to ensure patients are fully informed and
consent
to treatment
 Communicate with and support patients who are receiving ‘bad news’
 Communicate effectively with patients and carers, recognising the need for alternative methods of
communication to overcome different levels of understanding, cultural background and preferred
ways of communicating
 Anticipate barriers to communication and take action to improve communication
 Maintain effective communication within the practice environment and with external stakeholders
 Act as an advocate for patients and colleagues
 Ensure awareness of sources of support and guidance (eg PALS) and provide information in an
acceptable format to all patients, recognising any difficulties and referring where appropriate 

Delivering a quality service

 Recognise and work within own competence and professional code of conduct as regulated by
the NMC
 Produce accurate, contemporaneous and complete records of patient consultation, consistent
with legislation, policies and procedures
 Prioritise, organise and manage own workload in a manner that maintains and promotes quality
 Deliver care according to NSF, NICE guidelines and evidence-based care
 Assess effectiveness of care delivery through self and peer review, benchmarking and formal
evaluation
 Initiate and participate in the maintenance of quality governance systems and processes across
the organisation and its activities
 Utilise the audit cycle as a means of evaluating the quality of the work of self and the team,
implementing improvements where required
 In partnership with other clinical teams, collaborate on improving the quality of health care
responding to local and national policies and initiatives as appropriate
 Evaluate patients’ response to health care provision and the effectiveness of care
 Support and participate in shared learning across the practice and wider organisation
 Use a structured framework (eg root-cause analysis) to manage, review and identify learning from
patient complaints, clinical incidents and near-miss events
 Assess the impact of policy implementation on care delivery
 Working with the practice management monitor and develop the performance of the GPN team in
accordance with local policies
 Contribute to the appraisal of the performance of the team, providing feedback as appropriate
 Understand and apply legal issues that support the identification of vulnerable and abused
children and adults, and be aware of statutory child/vulnerable patients health procedures and
local guidance
  Working with practice management to ensure the whole team have skills and knowledge
regarding domestic violence, vulnerable adults, substance abuse and addictive behaviour.
Provide guidance and support to ensure appropriate referral if required 

Leadership – personal and people development

 Act as a clinical leader in the delivery of practice nursing services ensuring that the needs of the
patient are a priority
 Take responsibility for own learning and performance including participating in clinical supervision
and acting as a positive role model
 Support staff development in order to maximise potential
 Actively promote the workplace as a learning environment, encouraging everyone to learn from
each other and from external good practice
 Encourage others to make realistic self-assessment of their application of knowledge and skills,
challenging any complacency or actions that are not in the interest of the public and/or users of
services
 Critically evaluate and review innovations and developments that are relevant to the area of work
 Enlist support and influence stakeholders and decision-makers in order to bring about new
developments in the provision of services
 Work with practice management to ensure sufficient staff of appropriate ability, quality and skill-
mix are available to meet current and future service delivery, that selection and recruitment
processes are effective and that equality of treatment of the team incorporates quality HR
principles and processes
 Contribute to the development of local guidelines, protocols and standards
 Maintain effective communication with those responsible for the overall commissioning and
procurement process
 Maintain active involvement in the planning and processes of practice-based commissioning or
similar initiatives
 Promote the role of the advanced nurse practitioner in general practice 

Team working

 Understand own role and scope and identify how this may develop over time
 Work as an effective and responsible team member, supporting others and exploring the
mechanisms to develop new ways of working
 Delegate clearly and appropriately, adopting the principles of safe practice and assessment of
competence
 Create clear referral mechanisms to meet patient need
 Prioritise own workload and ensure effective time-management strategies are embedded within
the culture of the team
 Work effectively with others to clearly define values, direction and policies impacting upon care
delivery
 Discuss, highlight and work with the team to create opportunities to improve patient care
 Manage and lead on the delivery of specifically identified services or projects as agreed with the
practice management team
 Agree plans and outcomes by which to measure success

Management of risk

 Manage and assess risk within the areas of responsibility, ensuring adequate measures are in
place to protect staff and patients
 Monitor work areas and practices to ensure they are safe and free from hazards and conform to
health, safety and security legislation, policies, procedures and guidelines
  Ensure appropriate supervision of safe storage, rotation and disposal of vaccines and drugs.
Oversee the monitoring, stock control and documentation of controlled drug usage according to
legal requirements where appropriate
 Working with the practice management, ensure the nursing team has access to and undertakes
mandatory and statutory training requirements
 Apply infection-control measures within the practice according to local and national guidelines
 Advocate for policies that reduce environmental health risks, are culturally sensitive and increase
access to health care for all
 Interpret national strategies and policies into local implementation strategies that are aligned to
the values and culture of general practice

Managing information

 Use technology and appropriate software as an aid to management in planning, implementation

and monitoring of care, presenting and communicating information
 Review and process data using accurate Read codes in order to ensure easy and accurate
information retrieval for monitoring and audit processes
 Manage information searches using the internet and local library databases
 Understand responsibility of self and others to the practice and primary care trust regarding the
Freedom of Information Act

 Collate, analyse and present clinical data and information to the team
 Communicate essential financial restraints with the team and discuss with them ideas for effective
and efficient working within these constraints
 Manage, if agreed, the nursing budget within financial principles

Learning and development

 Undertake mentorship for more junior staff, assessing competence against set standards
 Disseminate learning and information gained to other team members in order to share good
practice and inform others about current and future developments (eg courses and conferences)

Assess own learning needs and undertake learning as appropriate
 Provide an educational role to patients, carers, families and colleagues in an environment that
facilitates learning

Equality and diversity

 Identify patterns of discrimination and take action to overcome this and promote diversity and
equality of opportunity
 Enable others to promote equality and diversity in a non-discriminatory culture
 Support people who need assistance in exercising their rights
 Monitor and evaluate adherence to local chaperoning policies
 Act as a role model in the observance of equality and diversity good practice
 Accept the rights of individuals to choose their care providers, participate in care and refuse care
 Assist patients from marginalised groups to access quality care 
Person specification
Criteria Essential Desirable
 Advanced clinical practice skills Management
of patients with long-term conditions
 Management of patients with complex needs  Knowledge of public health
 Clinical examination skills issues
 Accountability of own role and other roles in a  Able to identify determinants
Knowledge nurse-led service on health in the area
 Local and national health policy  Knowledge of public health
 Wider health economy issues in the area
 Clinical governance issues in primary care
 Patient group directions and associated policy

 Clinical leadership skills

 Communication skills, both written and verbal
 Communication of difficult messages to
patients and families
Skills  Negotiation and conflict management skills  
 Change management
 Teaching and mentorship clinical setting
 Resource management

 Significant post registration experience

 Recent primary and community nursing
experience
 Nurse-led management of minor illness, minor
 Project management
ailments and injuries
 Working with community
 Nurse-led triage
Experience development initiatives
 Compiling protocols and clinical guidelines
 Health-needs assessment
 Clinical Leadership
 Audit
 Research
 Nurse prescribing

 Registered first level nurse MSc or equivalent

 Relevant nursing/health degree  Community nursing
 Mentor/teaching qualification specialist
Qualifications
 Clinical supervision training and experience qualification
 Extended/independent nurse

 Self-directed practitioner
 Highly motivated
 Flexibility
Other  Enthusiasm  
 Team player
 Ability to work across boundaries
Suggested competences for an advanced nurse
practitioner
The following competences are an example of competences associated with this role as outlined on the
general practice nursing (GPN) career pathway. They are based on the sample job descriptions,
developed as part of the GPN career pathway. They have also been aligned to the knowledge and skills
framework.

Skills for
Health
Skills for Health National
NHS competence Note
WIPP Competence/Level Occupational Standards/National
KSF suite and s
Workforce Competences
competence
status
Support the development of
Interprets national strategies and
strategies to meet local needs for
policies into local implementation
Core health care services Users of this
strategies that are aligned to the Gen53 NOS  
4/4 competence will need to ensure that
values and culture of general
practice reflects up to date
practice.
information and policies.
Assessment and treatment
planning
Establish a diagnosis of an
individual's health condition
When working at this level, the
advanced nurse practitioner in
This workforce competence is about
general practice is required to:
determining a diagnosis following
'assess physiological and/or
initial assessment and investigations
psychological functioning when
of an individual's suspected health
there are complex and/or
HWB6/ condition. It involves reviewing the
undifferentiated abnormalities, CHS40 NOS  
4 results of the initial assessment and
diseases and disorders, and
initiating any further tests to confirm
develop, monitor and review related
the diagnosis and the possible
treatment plans.'
underlying causes.
Analyses and interprets history,
Users of this competence will need
presenting symptoms, physical
to ensure that practice reflects up to
findings and diagnostic information
date information and policies
to develop the appropriate
differential diagnoses.
HWB7/ The advanced nurse practitioner CHD_HB1 Recognise indications of heart  
3 in general practice is required to: NWC conditions and take appropriate
'plan, deliver and evaluate action
interventions and/or treatments
when there are complex issues This workforce competence is about
and/or serious illness.' recognising the indications of acute
cardiac syndromes and taking
Prioritises health problems and appropriate action. This workforce
intervenes appropriately to assist the competence has been developed for
patient in complex, urgent or practitioners who may be working in
emergency situations, including settings outside the Coronary Heart
 initiation of effective emergency Disease area e.g. primary care
care. setting, general wards.
The advanced nurse practitioner in
general practice is required to: Promote your organisation and its
'assist with public relations and services to stakeholders
marketing activity.'
This workforce competence is about
Promote the role of advanced nurse promoting your organisation and the
practitioner enhances the services services it provides to a range of
offered by general practice to the stakeholders.
G8/3 GEN48 NOS  
public, other health care
professionals and wider This involves developing plans to
stakeholders and policy makers. promote your organisation and its
services, communicating key
Discusses, highlights and works with messages to stakeholders, and
the team to create opportunities to evaluating the effectiveness of
promote the team, the practice and promotional activities.
its services in the local community
HWB7/ Prescribing Following successful CM_A7 NWC Prescribe medication for  
4 completion of a national training individuals with a long term
programme, undertakes the condition
professional role of
independent/supplementary nurse This competence is about
prescriber. prescribing medication to reduce the
impact of a long term condition on
individuals' health and wellbeing. It
covers relating the prescription to the
individual's condition and treatment
plan and, where appropriate, making
arrangements for repeat
prescriptions.

This competence is relevant to those

who may be responsible for
prescribing medication. In order to
prescribe, you are legally bound to
have successfully completed the
Extended Formulary/Supplementary
Prescribing course.

This competence is relevant to those

who provide proactive and co-
ordinated Case Management. Here,
Case Management means
identifying and risk stratifying
vulnerable, high-risk people with
complex multiple long term
conditions. Case Management
should take place within the
philosophy of enabling and
promoting self care, self
management and independence.

Users of this competence will need

to ensure that practice reflects up to
date information and policies.