Advanced Clinical Practitioner (ACP) - Community Emergency Medicine

CEMS is a unique service commissioned by Lincolnshire NHS to provide enhanced assessment and intervention to patients who have accessed the NHS by dialling 999. Bringing the Emergency Department to the patient, three dual-crewed CEMS vehicles containing a multi-disciplinary team of pre-hospital nurses, paramedics, doctors and advanced clinical practitioners attend complex emergencies in partnership with East Midlands Ambulance Service. Using skills and equipment normally found in hospital, CEMS teams are able to provide enhanced clinical assessment, diagnostic testing and treatment beyond what is usually provided by the ambulance service. Most patients episodes of care are able to be completed at the scene of the emergency, and for those needing to go to hospital or receive ongoing community management, teams are often able to access alternative pathways avoiding the emergency department.

CEMS teams also provide an initial or supporting response to life-threatening emergencies such as cardiac arrest or major trauma when requested by the ambulance service

Main duties of the job

As one of our CEMS ACPs, you will be responsible for triaging, assessing, investigating and treating patients with illness and injuries across the whole spectrum of acuity and age. You will be dispatched to jobs in our modern fleet of blue-light response vehicles equipped with the latest ultrasound and point of care technology. Working in conjunction with a colleague, and supported by the senior clinical leadership team, you will manage a high percentage of our patients in the community by delivering care beyond the scope of the typical ambulance, primary care or urgent care provider.

CEMS ACPs will be encouraged to utilise and develop pathways into primary and secondary care services, and take ownership for aspects of the service according to service need. You will be given ample opportunities to develop additional clinical skills and extend your scope of practice. Where patients need to be referred into other parts of the NHS, we aim to direct patients to the right speciality first time and enhance their pre-hospital management by the interventions we perform.

About us

LIVES is a forward-thinking innovative charity that first started 50 years ago. We passionately believe it takes a team to save a life, and that means we value our team and everything they do! CEMS is an exciting and motivated team of like-minded healthcare professionals who go above and beyond for their patients. LIVES is a flexible and supportive employer, who places education and continuing development at the centre of its focus. Looking after our team and our local communities is what LIVES does best.

Every member of the LIVES team is vital to delivering the best outcome for patients, from the volunteer Community First Responder (CFR) and Medical First Responders (MFR)s attending a cardiac arrest, to experienced health care professionals bringing advanced treatments into the community. To enable all this to happen, LIVES is supported by a team of dedicated people across various departments, all united in the mission to save lives and improve patient outcomes across Lincolnshire. This role is part of that team.

Job responsibilities

Pre-Operational Training

• Undertake required training and sign-off for role

Clinical Practice / Operational Response

• Attend ambulance service emergencies identified by the CEMS team or Emergency Operations Centre
• Act as the lead clinician for of a two-person team
• Assess patients in accordance with under and postgraduate training, LIVES and national guidelines
• Use diagnostic equipment including multi-parameter monitoring and point-of-care ultrasound and blood testing equipment as part of patient assessment
• Provide emergency treatment in accordance with LIVES and national guidelines
• Formulate an ongoing management plan, taking into account the wishes of the patient, which may include transfer to an Emergency Department, referral to an alternative hospital or community pathway, or discharge at scene
• Supply prescriptions or medications where appropriate
• Document care episodes using the appropriate systems
• Where appropriate initiate end-of-life care or planning
• Provide clinical advice via telephone, video-call or face-to-face discussion to ambulance service and other LIVES team members
• Undertake regular checks and restocking of medical and operational equipment and medicines
• Use on-board communication and technology equipment

Driving and Vehicle Checks

• Conduct vehicle checks in line with CEMS Standard Operating Procedures, ensuring the vehicle is re-fuelled, re-stocked and operationally ready to respond
• Conduct vehicle and equipment inspections at the start and end of clinical shifts, ensuring all defects, accidental damage or loss is reported in accordance to CEMS Standard Operating Procedures and the inspection is logged
• Drive LIVES vehicles in accordance with the Highway Code, road traffic legislation and LIVES driving policy, under emergency driving conditions where appropriately trained

Education, Development and Research

• Maintain compliance with statutory and mandatory training
• Maintain requirements of professional registration
• Maintain required clinical skills currencies as prescribed by LIVES
• Engage in the appraisal process for LIVES as well as the designated body if this is not LIVES
• Undertake initial training and sign-off processes
• Undertake ongoing training in accordance with the individual training plan
• Maintain a portfolio of evidence against an appropriate Faculty of Pre-Hospital Care curriculum or syllabus
• Undertake an appropriate faculty of pre-hospital care examination (e.g. Diploma in Urgent Medical Care or Diploma in Immediate Medical Care) in accordance with individual training plan
• Support new team members and clinicians in training with their educational requirements
• Support undergraduate and postgraduate students on clinical placement with the team
• Support internal and external observers on placement with the team
• Participate in clinical audit
• Participate in research opportunities
• Assist in the identification and development of pre-hospital pathways
• Undertake teaching and training within CEMS, LIVES and externally according to training, experience and personal interest

Management, Leadership and Clinical Governance

• Support the leadership team in development of the service
• Doctors with appropriate seniority and experience may be asked to act as duty senior clinician
• Report incidents, near misses and good practice using the Learning Events system in line with LIVES policies and co-operate with any investigation processes
• Regularly attend clinical governance meetings as per currency requirements
• Engage with clinical governance processes and activities within LIVES

Infection Prevention and Control

• Undertake and maintain mandatory training in Infection Prevention and Control
• Comply with LIVES policies and procedures regarding Infection Prevention and Control
• Comply with LIVES policies and procedures regarding use of Personal Protective Equipment

Health and Safety

• All team members are required to make every effort to maintain a safe working environment in accordance with LIVES Standard Operating Procedures and the Health and Safety at Work Act (1974).
• Comply with LIVES policies and procedures regarding Health and Safety
• Undertake dynamic risk assessment at incident scenes
• Use Personal Protective Equipment where required and in accordance with training and safe systems of work
• Undertake and maintain mandatory training on Health & Safety

Fundraising and Public Relations

• Participate in public relations activities where required
• Deal with offers of donations or support in an appropriate manner in line with LIVES fundraising policy
• Represent LIVES and CEMS by acting professionally at all times and complying with LIVES communications policy.

Confidentiality & Data Protection

• Maintain professional standards regarding confidentiality in accordance with GMC guidance, Caldicott principles and LIVES policies and procedures
• Undertake and maintain mandatory training on information governance
• Comply with policy and legislation around data protection
• Store paper records in accordance with LIVES policies
• Comply with IT access policies and procedures
• Report any Information Governance breaches according to policy

Success in the Role

• Continued appointment to the role is subject to annual performance reviews, completion of initial training and sign-off for which appropriate training and support will be given

Person Specification

• Enhanced DBS clearance
• Eligible to work in the UK
• Full UK driving license and level of health to DVLA standards (maximum 6 points)
• Able to attend initial training and induction course

Qualifications

• Registered with NMC, HCPC or professional regulatory body, including a license to practice with no restrictions
• MSc in Advanced Clinical Practice or equivalent
• Registered Independent Prescriber (V300) award
• Adult and paediatric advanced life support training
• BSc degree level education on one or more speciality areas
• Higher qualification in pre-hospital emergency medicine e.g., Diploma in Immediate Medical Care, Diploma in Urgent Medical Care, Diploma in Retrieval Transfer Medicine, Fellowship in Immediate Medical Care
• Emergency driving qualification

Personal Attributes

• Commitment to uphold the LIVES values: Integrity, Community & Excellence
• Good written and verbal interpersonal communication skills
• Ability to work as part of a team.
• Ability to lead a team
• Ability to work in unpredictable pre-hospital settings
• Ability to remain calm under pressure and during emotive situations.
• Demonstrates tact and diplomacy
• Ability to develop effective working relationships with colleagues, patients and the public
• Adaptable and flexible approach to work
• Punctual
• Acts with honesty, integrity and professionalism
• Caring attitude
• Ability to self-motivate and motivate others
• Promotes anti-discriminatory practice and equality and diversity

Experience

• 5 years post-registration clinical experience
• Recent experience in independently managing undifferentiated acute presentations in all age groups
• Recent experience in an emergency care setting or community setting with regular exposure to acute/urgent presentations
• Experience of wound closure e.g., suturing, stapling, steri-strips
• Knowledge or experience of end-of-life care
• Experience of teaching/instructing on resuscitation, trauma care or emergency care courses
• Pre-hospital experience

Knowledge and Skills

• Evidence of career progression and continuous professional development
• Knowledge of clinical governance systems
• Good IT skills, including use of Office 365
• Ability to demonstrate management of complexity
• Local knowledge of health care systems and geographical area

Physical Requirements

• Occupational health clearance
• Fit to perform pre-hospital care work

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.

Full-time,Part-time,Flexible working,Annualised hours