Nhs Tayside – Agenda For Change

Important Job Application Information

Thank you for your interest in NHS Tayside vacancies

Please see below Job Description/Specification and General Conditions of Service

Your Application Form must be completed in full. Please note copies of Curriculum Vitae, Qualifications and Course Certificates will not be accepted at this stage.

Please return your completed Application Form to [email protected] (quoting the vacancy reference number in the subject box) or to the postal address given on the General Conditions of Service.

All completed applications are held in Human Resources until the closing date. After the closing date a panel will meet to prepare an interview shortlist. Once this decision has been made, all shortlisted applicants will be emailed to invite them to attend for interview. It is important that you check your emails regularly.

This process takes approximately 6 weeks. Therefore, if you have not been contacted regarding interview within 6 weeks of the closing date, your application has been unsuccessful and you will receive no further correspondence from Human Resources.

ADDITIONAL INFORMATION:-

Find out more about living and working in Tayside at:

www.dundeecity.gov.uk

www.angus.gov.uk NHS TAYSIDE – AGENDA FOR CHANGE JOB DESCRIPTION

Community Macmillan Clinical Nurse Specialist Job Title 1. JOB IDENTIFICATION (Independent Nurse Prescriber) Perth & Kinross CHP, Palliative Services, Department(s)/ Cornhill Macmillan Centre, Location / Base Perth Royal Infirmary, Jeanfield Road, Perth PH1 1NX

No of job holders 4 Community & Palliative Services Manager, Responsible to Perth & Kinross CHP Community & Palliative Services Manager, Reports to Perth & Kinross CHP 4. JOB PURPOSE

 The Community Macmillan Clinical Nurse Specialist (CMCNS) role is to provide expertise and influence patient care in cancer and specialist palliative care in the community, by exercising high levels of judgment and decision-making in clinical care.

 The primary concern of the CMCNS is to bring the highest standards of clinical care to patients and families through a variety of means. These include advanced clinical practice, providing a consultative service for healthcare professionals, educating, empowering and supporting professional colleagues, providing clinical leadership and contributing to research functions and working collaboratively across healthcare boundaries.

 The CMCNS concentrates direct clinical care on patients and families with highly complex needs and has continuing responsibility for a clinical caseload, where there is a diagnosis of cancer or other life limiting disease, including assessment of care needs, development, implementation and evaluation of programmes of care. They also provide specialist advice to healthcare professionals, other agencies, carers, and relatives.

 The role encompasses bereavement support for carers and direct specialist advice to other health care professionals and agencies on bereavement issues.

5. ORGANISATIONAL POSITION

Lead Nurse for Nursing and Public Health, Perth & Kinross CHP

Community and Palliative Services Head of Nursing, Perth & Kinross CHP

Community Macmillan Clinical Nurse Specialists (Independent Nurse Prescriber’s) 6. SCOPE AND RANGE

 The Community Macmillan Nursing Service is part of Specialist Palliative Services within the Perth & Kinross Community Health Partnership and is based at Cornhill Macmillan Centre, Perth. The service provides specialist palliative care community nursing intervention for the population of Perth & Kinross.  Each CMCNS has responsibility for managing an individual caseload.  Each CCMNS exercises a high level of self management and autonomy in the practice and provision of specialist palliative care nursing support to patients, families and assigned primary health care teams.  Each CMCNS works in partnership with all agencies involved in the care of patients with palliative care needs, to maintain a high standard of palliative care and quality of life for clients.  Each CMCNS participates in the development and delivery of educational programmes to medical and nursing staff, other professionals, patients and carers.  Each CMCNS is actively involved in clinical research, audit and quality assurance.  Each CCMNS participates in planning, development and evaluation of nursing services within Specialist Palliative Services.  Each CMCNS holds responsibility for ongoing projects within Specialist Palliative Services, eg integrated care pathways, syringe driver policy implementation, documentation development, referral criteria and education programmes.  Each CMCNS has the potential to manage a wider skill mix of staff within the team as the service develops.  Each CMCNS advises General Practitioners and District Nurses on medication prescribing.

Population and Area, GP Practices, Community Hospitals Nursing Homes etc.

 The service provides specialist palliative care for the population (144,180) of Perth & Kinross.  All CMCNS are autonomous specialist palliative care practitioners who work unsupervised; the team is aligned to 26 Primary Health Care Teams, 5 Community Hospital sites and 16 Nursing Care Homes throughout Perth & Kinross.  All CNCNS liaise and collaborate with Marie Curie and Care at Home Team nurses, Acute Services, Roxburghe House (Dundee) and the Day Care Hospice, Perth.  All CMCNS liaise with diverse agencies and client groups, as appropriate and at need.

7. MAIN DUTIES/RESPONSIBILITIES

Clinical

Each CMCNS:  takes overall responsibility for the management of an individual caseload or client group within cancer and specialist palliative care, ensuring that care needs are assessed and programmes of care are developed, implemented and evaluated in partnership with patients / carers / clients / relatives for patients whose needs may be predictable or unpredictable eg sudden deterioration or emergency, to ensure delivery of a high standard of care.  applies a high level of understanding of the effect of life-threatening illness and ensures the best quality of patient-centred care.  in their consultative role, facilitates and promotes high quality care for patients and families with specialist and complex palliative care needs and provides expert clinical advice, information and support in relation to all aspects of palliative care to primary care teams and a wide range of other service providers eg acute, voluntary, statutory and independent.  acts on direct referrals from other healthcare professionals for patients and carers with complex needs.  provides highly developed, direct and indirect specialist nursing intervention in outpatient, primary care or community settings.  assists patients towards self-care and rehabilitation or tertiary health promotion through provision of therapeutic, educative, advocacy and supportive interventions. Clinical (continued)

 provides specialist bereavement support including risk assessment and advanced counselling skills to families and carers.  promotes best practice and encourages innovation.  manages change for the benefit of patient care and can take a lead in the development of nursing staff and policymaking.  promotes holistic and seamless care by liaising with primary, secondary and tertiary care providers.  advises on medication and management of syringe drivers, for symptom management, to General Practitioners, nursing colleagues and nursing homes.  undertakes Independent Nurse Prescribing to improve Pain and Symptom Management  participates in research and maintains a high level of awareness of evidence-based practice to influence and improve patient care.  provides a supportive role in assisting multidisciplinary teams in dealing with and following stressful case scenarios, using advanced counselling skills.  provides family and carer assessment, case conferencing, on-going support and bereavement support.  inputs to Single Shared Assessment in assessing patient need.  contributes to the Health Improvement Agenda.  participates in regular clinical supervision.

Documentation

Each CMCNS:  ensures that up-to-date written and electronic records are maintained in accordance with Nursing and Midwifery Council (NMC), NHS Tayside and local standards.  ensures that documentation reflects an accurate record of patient information whilst maintaining confidentiality.  complies with relevant national legislation, eg Freedom of Information Act, Data Protection Act and Vulnerable Adults Legislation.

Professional Ethics

Each CMCNS:  complies with the NMC Professional Codes, local and national policies, protocols and procedures.  upholds the individuality, values, cultural and religious diversity of patients and contributes to the provision of a service sensitive to these needs.  is accountable for their own professional actions.

Leadership and Managerial

Each CMCNS:  ensures effective systems are in place to co-ordinate, assess and prioritise workload to ensure that the interests of patients are met.  ensures effective use of physical, human and financial resources for the service.  reviews and reflects on own practice and performance through effective use of clinical supervision and operational appraisal.  takes a role in the identification of training needs in eg a wide range of healthcare and social care staff, addressing scope of practice issues and competencies around palliative care.  leads and implements change in practice, initiates discussion and debate to influence and action quality improvement in practice.  leads effective teamwork and fosters healthy working relationships through provision of consistent and visible support.

Leadership and Managerial (continued)

 participates in multidisciplinary team meetings and senior nurse meetings within Specialist Services as requested.  implements local risk management and health and safety strategies and acts on any identified risks in accordance with local policy.  assists the Palliative Services Manager to investigate complaints, learning from the experience of users to improve their episode of healthcare.  interprets Health and Social Policy (eg SIGN Guidelines, Palliative Care Gold Standards Framework, Partnership of Care, Joint Future, Agenda for Change) and is influential in local cancer developments through participation in steering and working groups and leading implementation at clinical level.Provides clinical supervision and mentorship for nursing colleagues.  participates in local and national professional organizations/groups eg Scottish Partnership Agency, Quality Improvement Scotland and Managed Clinical Networks.

Education and Training

Each CMCNS:  actively contributes to the development, delivery and evaluation of Palliative Care Education programmes for health and social care professionals and other agencies.  identifies and responds to educational needs and requests from primary care colleagues.  organises and facilitates study days and workshops to a wide range of educational needs eg Introduction to Palliative Care Course (5 days), Syringe Driver Training (rolling programme), Senior Nursing Staff Updates on Palliative Care and Cancer issues.  participates as requested in the delivery of education programmes at local Universities at pre- and post- registration level eg degree, post graduate and masters’ level.  participates in the induction, orientation and mentorship of new staff.  contributes to learning programmes in the clinical area for pre- and post-graduate nursing and medical colleagues.

Service Development and Delivery

Each CMCNS:  takes an active role in the operational planning and implementation of policy and service developments within Specialist Palliative Care and takes the lead on delegated projects.  takes an active role in professional nursing and multidisciplinary developments within Specialist Palliative Care, Perth and Kinross CHP and NHS Tayside eg Integrated Care Pathways, Syringe Driver Policy and guideline and service audits. Clinical Governance, Quality and Standards

Each CMCNS:  identifies and develops frameworks and mechanisms to monitor standards and quality of clinical practice and facilitate quality improvement.  works in partnership with the Clinical Governance department to provide appropriate information to evaluate the service and identify areas for development.  encourages and participates in audit and research to support and improve care.  collates and records information as required by information services, NHS Quality Improvement Scotland and other statutory bodies.  facilitates the use of best practice and evidence-based nursing care.  contributes to the development of local policies and comments on local and national policies, protocols and guidelines.  complies with all relevant NHS Tayside and local policies and procedures.  promotes patient and public involvement in the specialist area, leading to improvement in service.

Induction Standards & Code of Conduct  Your performance must comply with the national “Mandatory Induction Standards for Healthcare Support Workers in Scotland” 2009; and with the Code of Conduct for Healthcare Support Workers.

Research and Practice Development

Each CMCNS:  undertakes research and or audit projects relevant to the clinical area, disseminating findings at local and national level.  utilises and develops research skills through participation in local research and audit projects.  identifies areas for further research and development within the clinical area.  disseminates and implements relevant research findings to improve patient care and treatment, and reduce the theory practice gap.  leads on the development, implementation and evaluation of evidence based policies, procedures and guidelines within the service.

8. COMMUNICATIONS AND RELATIONSHIPS

Each CMCNS:  has responsibility for establishing and maintaining open communication networks with patients, carers, multidisciplinary teams, other health care workers and external agencies through a variety of means including face-to-face and telephone contact, written correspondence and e-mail.  makes contacts, which may be internal to the NHS but also with a variety of external agencies including local authority, other statutory and voluntary agencies.  uses, on a daily basis, advanced counselling skills to explore complex, highly sensitive issues identified in the patient’s disease pathway, which also impact on family, carers and healthcare professionals, and maintains therapeutic relationships with patients and carers to support them in potentially stressful and difficult transitions.  participates in multidisciplinary meetings within GP practices to negotiate, motivate, educate and persuade healthcare professionals to provide the highest quality palliative care.  develops and maintains relationships with allocated primary healthcare teams to ensure a co-ordinated approach to patient care.  on a daily basis, communicates sensitive and complex information to patients and carers requiring highly developed interpersonal and communication skills eg discussion about death and dying, bereavement counselling.  regularly conveys information of a sensitive and emotive nature when it is contradictory to patient and carers’ expectations and desires eg breaking bad news, facilitates family communication.  develops effective communication strategies for patients who have barriers to communication including eg denial or collusion, as well as the need to use language interpreters.  ensures that effective flow of communication is maintained within the organisational structure.  participates in Single Shared Assessment and the Joint Futures Agenda.

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

 1st level nurse with current NMC registration.  Five years post-registration clinical experience at Senior Charge Nurse level or above.  Evidence of post-registration education to degree level within relevant field of practice.  Motivation to undertake education and attain to Masters Degree level or education normally associated with Masters level.  Experience of management of patients with highly complex cancer or specialist palliative care needs.  High level of understanding of legislation and national guidelines relating to community care, cancer and palliative care.  Proven management and leadership skills.  Advanced level of communication skills.  Experience of teaching at undergraduate and post-graduate level and presentation skills.  Skills and experience to enable the practitioner to function autonomously and in isolation, as well as part of a team.  Computer literacy.  The postholder must be innovative, self-motivated and have the necessary interpersonal skills to motivate others and manage change.  Independent Nurse Prescribing

ESSENTIAL ADDITIONAL INFORMATION

8. SYSTEMS AND EQUIPMENT

Responsibility for Records Management

All records created in the course of the business of NHS Tayside are corporate records and are public records under the terms of the Public Records (Scotland) Act 1937. This includes e-mail messages and other electronic records. It is your responsibility to ensure that you keep appropriate records of your work in NHS Tayside and manage those records in keeping with the NHS Tayside Records Management Policy and with any guidance produced by NHS Tayside specific to your employment.

 Microsoft Office, Tayside Health Board IT systems including intranet, and Internet.  Responsible for safe use of patient-related equipment eg syringe drivers, oxygen therapy, PEG feeding pumps, nebulisers, TENS machines, central and peripheral venous lines and manual handling devices.  Completion of monthly statistical forms regarding caseload analysis, education and administration data for local and national information.  Daily use of mobile phones. 9. PHYSICAL DEMANDS OF THE JOB

Physical

 Administer medication via injections, syringe drivers and infusions, subcutaneous and intramuscular as requested.  Daily use of IT systems.  Daily demands of travel across all of NHS Tayside to deliver clinical care, attend meetings and deliver education.  Daily demands of moving and handling of equipment eg overhead projector, laptop computer, educational paperwork and books, screens and flipchart.  Frequent demands of moving and handling adult patients.  Daily requirement for sitting in a restricted position in patients’ homes.  Potentially daily exposure to body fluids.  Exposure to physical and verbal aggression, which is unpredictable but occurs on a regular basis.

Emotional

 Daily exposure to highly distressing, highly emotional and complex circumstances including breaking bad news, communicating with distressed patients, relatives and carers, dealing with difficult family situations, dealing with dying patients.  Frequent support of staff involved in distressing situations.

Mental

 Daily lone working in the community and the need to risk assess with reference to client, carers and environment.  Daily decision-making in isolation.  High level of concentration required on a daily basis when interpreting information, checking documents and patients’ notes, and scheduling visits.  Concentration over prolonged visits requiring observation and interpretation of highly complex patient information on a daily basis.  Daily prioritisation of workload and multi-tasking when patients have rapidly changing needs.

Working Conditions

 Daily exposure to a wide variety of settings, over which there is limited control to observe health and safety regulations eg body fluids, passive smoking, cramped environments, noxious odours, untrained animals and substance abuse.

10. DECISIONS AND JUDGEMENTS

Each CMCNS:  works with a high level of autonomy in the community setting, within the agreed management structure and NMC Code of Conduct.  takes responsibility for decisions on a daily basis to ensure holistic patient management.  assesses and interprets changes in patients’ condition and advises on or makes relevant changes to patient management.  independently, or in consultation with primary healthcare colleagues, advises and refers to other healthcare professionals and statutory and voluntary agencies.  in clinical emergency situations, takes control and organizes care, in communication with the primary health care team eg oncological emergency.  participates in service development within palliative services team. e.g. health and safety, risk management  is involved in personal development planning, setting objectives and appraisal. 11. MOST CHALLENGING / DIFFICULT PARTS OF THE JOB

 The high level of autonomy and clinical decision-making required on a daily basis due to working within a nurse-led team in the community setting.  The emotional demands of daily and ongoing exposure to death and dying and highly emotive and sensitive issues and supporting patients, relatives and staff who are also exposed to this emotional demand.  Prioritising competing demands from patients, carers and healthcare professionals and effectively managing these demands to provide an efficient, safe and effective service which is responsive and flexible to meet the rapidly changing needs of people facing advanced life- limiting illness.  Being the clinical expert within the community nursing arena and empowering others to deliver best practice.

12. JOB DESCRIPTION AGREEMENT

The job description will need to be signed off using the attached sheet by each post holder to whom the job description applies. POST REF NO: P/ER/163 JOB TITLE/BAND: COMMUNITY MACMILLAN CLINICAL NURSE SPECIALIST B 7 LOCATION: PERTH & KINROSS CHP, BASE CORNHILL, PRI

HOURS: 30 HRS

CRITERIA ESSENTIAL DESIRABLE

EXPERIENCE:  Extensive post-registration experience  Experience in the Community at Senior Charge Nurse level or  Previous oncology or palliative equivalent care experience  Caseload / workload management  Evidence of leadership

QUALIFICATIONS:  First level nurse  DN qualification (Training; Research;  Evidence of relevant CPD and post-  Masters degree or willingness to Publications) registration education at degree level work towards post-graduate  Independent prescriber or prepared to qualification obtain qualification

KNOWLEDGE &  High level of understanding of needs of  Experience of teaching SKILLS: cancer and palliative patients and their  Interest in research families  Skilled in communication, counselling and assessment  Ability to motivate others and manage change  Computer literate  Ability to maintain professional and personal credibility across all staff groups  Ability to lead practice and continuous professional development

PERSONAL  Integrity QUALITIES:  Ability to function as a team player within Palliative Services and Primary Health Care teams  Personal motivation and enthusiasm with a focus on person centred care and quality  Innovative  Ability to function autonomously

OTHER:  Ability to be mobile throughout Tayside  Driving Licence General Conditions of Service

POST REF NO: P/ER/163 JOB TITLE/GRADE: Community Macmillan Clinical Nurse Specialist Band 7 LOCATION: Cornhill Macmillan Centre, PRI

Conditions of The terms and conditions of service for this post are those Service determined by the NHS Staff Council. Remuneration The current salary scale for the post is £30,764 to £40,558 per annum (pro rata for part-time staff). Placing on the scale on appointment is normally at the minimum but may be higher subject to verification of previous relevant service.

Salary is paid monthly by Bank Credit Transfer. Hours of Duty The hours of the post are 30 per week.

Start and finish times will be determined by the needs of the service. Superannuation Membership of the NHS Superannuation Scheme is not compulsory but is open to all staff between the ages of 16 and 70 (65 in some instances).

The contributions paid are a percentage of superannuable pay, which is essentially basic pay excluding, for example, overtime or travelling expenses.

Contribution rates with effect from 01.04.13 are as follows:

Annual Pensionable Pay Contribution (Full-time equivalent) Up to £15,278 5% £15,279 to £21,175 5.3% £21,176 to £26,557 6.8% £26,558 to £48,982 9.0% £48,983 to £69,931 11.3% £69,932 to £110,273 12.3% £110,274 and over 13.3%

Contributions are subject to tax relief and reduced National Insurance contributions. NHS Tayside also makes a substantial contribution towards scheme benefits – currently around 14% of basic pay. Annual Leave On appointment = 27 days (pro rata for part-time Staff) or 5.4 weeks per year.

After 5 years aggregated service = 29 days (pro rata for part- time staff) or 5.8 weeks per year

After 10 years aggregated service = 33 days (pro rata for part- time staff) or 6.6 weeks per year

Public Holidays = 8 days (pro rata for part-time staff) or 1.6 weeks per year References All offers of appointment are subject to receipt of two satisfactory references Occupational All offers of appointment to new entrants to the National Health Health Service are subject to a medical examination. Clearance Medical examinations are arranged and undertaken by the Occupational Health and Safety Advisory Service (OHSAS). Rehabilitation of All current or spent criminal convictions, cautions, warnings or Offenders Act any case pending must be disclosed prior to commencing in 1974 employment as detailed on the application form. (Exclusions and Exceptions) Please note that having a conviction will not automatically debar (Scotland) Order you from obtaining employment with NHS Tayside. Careful 2003 consideration will be given to the relevance of the offence to the particular post in question. However, if you are appointed, and it is found that you did not reveal a previous conviction your employment may be terminated. Disclosure The successful applicant will be required to become a member Scotland of the Protecting Vulnerable Groups Scheme (PVG) in respect of regulated work with protected adults. Immigration, It is a criminal offence for an employer to employ anyone who does not Asylum and have permission to live or work in the UK. Nationality Act 2006 Shortlisted applicants will be asked to produce specific original documentation at interview e.g. Passport, or full birth certificate together with an official document giving the applicants permanent National Insurance Number and name issued by a Government Agency or a previous employer, as well as photocopies of these documents. Professional you should have current and continuing professional registration Registration/ with NMC Induction Standards & Code of Conduct Smoking Policy Smoking is prohibited within NHS premises and grounds. Applications Completed forms should be returned to:

[email protected] quoting the job reference in the subject line

to Human Resources Directorate, NHS Tayside, Perth Royal Infirmary, Perth PH1 1NX

By closing date of Friday, 14 February 2014