Practice Nurse - Bank Practice Nurse

Job summary
As a Practice Nurse within the E4 PCN Enhanced Access Service, you will play a key role in delivering safe, high-quality and responsive nursing care to our diverse patient population.

The E4 PCN is a strong and trusted provider of primary care services, working closely with our five member practices to deliver accessible, consistent and patient-centred care.

Enhanced Access provides evening and weekend appointments, improving access for patients who cannot attend routine daytime services. The successful candidate must be available to work flexibly across these hours, with the majority of nursing services delivered on Saturdays. Please do not apply if you are not available to work on Saturdays.

The role requires a nurse who is confident working autonomously and without direct nursing supervision, using sound clinical judgement to assess, manage and treat patients within their scope of practice. You will be expected to recognise clinical risk, escalate appropriately, manage your own workload and maintain accurate clinical records.

This is an important role within our PCN and requires a clinically confident, accountable and adaptable nurse committed to delivering excellent patient care.

Main duties of the job
The role requires the nurse to work autonomously and be self-sufficient in clinical practice, without direct nursing supervision, while recognising and escalating any concerns outside their scope of practice.

The postholder will undertake comprehensive patient assessments, deliver appropriate nursing interventions, provide health promotion and preventative care, and support the management of long-term conditions in line with agreed clinical pathways, policies and professional standards.

The nurse will be expected to exercise sound clinical judgement, maintain accurate and timely clinical documentation within EMIS, manage their own workload, and work collaboratively with members of the wider multidisciplinary team.

The role requires a high level of professional accountability, effective communication and the ability to identify and respond appropriately to clinical risk. The postholder will maintain their professional competence and adhere to the NMC Code.

Key characteristics of the role:

• Autonomous practice with no direct nursing supervision.
• Independent clinical assessment, decision-making and management within scope of practice.
• Ability to recognise deterioration, clinical risk and the need for escalation.
• Delivery of evidence-based nursing care across a range of clinical presentations.
• Effective management of workload
• Clear communication and collaborative team-working
• Maintenance of professional standards, competence, documentation and patient safety.

About us
The E4 PCN serves a diverse population of over 55,000 patients across Chingford, London, providing high-quality, patient-centred care to individuals and communities with a wide range of health and social care needs.

The PCN brings together Chingford Medical Centre, Churchill Medical Practice, The Old Church Surgery, The Ridgeway Surgery and Handsworth Medical Practice . We have developed a strong, collaborative relationship across all five practices, enabling us to work collectively, share expertise and deliver services that respond effectively to the needs of our local population.

Our population is diverse, encompassing patients across all age groups, from young families and working-age adults to older people with increasingly complex health needs. We also provide support to more than 350 residents living in local Care Homes, requiring a responsive, coordinated and multidisciplinary approach to care.

We are committed to delivering exceptional standards of patient care, with a strong focus on safety, clinical quality, continuity and patient experience. Through partnership working across our practices and wider multidisciplinary teams, we aim to continually develop and improve our services, ensuring our patients receive the right care, from the right professional, at the right time.

We are proud of our collaborative culture and are committed to creating a service where clinical excellence, professional accountability and patient-centred care are at the heart of everything we do.

Job responsibilities

• The Practice Nurse will provide high-quality, evidence-based nursing care to patients accessing the E4 PCN Enhanced Access Service. The postholder will work as an autonomous and accountable practitioner, providing assessment, treatment, monitoring, health promotion and management of patients across a broad range of clinical presentations.

The role is particularly suited to an experienced Practice Nurse who is confident working independently and able to manage a clinical workload without direct nursing supervision. The postholder will be expected to exercise sound clinical judgement, recognise and manage clinical risk, work within their scope of professional competence and escalate appropriately when a patient's needs exceed their level of expertise or the resources available within the service.

The Enhanced Access Service provides additional primary care appointments during evenings and weekends. The successful candidate must be able to work flexibly during these periods, with the majority of nursing activity delivered on Saturdays.

The Practice Nurse will work collaboratively with GPs, Advanced Practitioners, Healthcare Assistants, administrative teams and other members of the multidisciplinary team across the PCN and its member practices. The postholder will contribute to the PCN's commitment to providing safe, accessible, responsive and consistently high-quality patient care.

Main Duties and Responsibilities
Clinical Practice

• Provide a high standard of evidence-based nursing care to patients accessing the Enhanced Access Service.
• Undertake comprehensive nursing assessments, identifying physical, psychological and social needs and developing appropriate plans of care.
• Independently assess, manage and treat patients within the limits of professional competence, local pathways and agreed protocols.
• Use clinical reasoning and professional judgement to make appropriate decisions regarding patient management.
• Implement and evaluate individualised treatment and management plans.
• Monitor patients' progress and modify care appropriately in response to clinical findings.
• Recognise when a patient requires further assessment, investigation, treatment or referral and arrange appropriate escalation.
• Prioritise health problems and respond appropriately to complex, urgent or emergency situations.
• Initiate appropriate emergency care within the limits of competence and ensure timely escalation to a GP, Advanced Practitioner, emergency services or other appropriate clinician.
• Recognise and respond appropriately to safeguarding concerns, including those relating to children, adults at risk and vulnerable patients.
• Promote patient dignity, privacy, choice and involvement in decisions regarding their care.
• Provide appropriate health education and support patients to develop confidence in self-management.
• Maintain accurate, contemporaneous and confidential clinical records following every patient contact.
• Ensure all clinical activity is appropriately coded and documented on the relevant PCN or practice clinical system.

Treatment Room and General Practice Nursing
The postholder should have competence in some or all of the following areas, depending on experience, training and service requirements. This list is not exhaustive:

• Wound assessment and management.
• Wound dressings and general treatment room procedures.
• Assessment and management of minor wounds and uncomplicated skin conditions within scope of practice.
• Urinalysis and appropriate interpretation/escalation of results.
• Blood pressure, pulse, respiratory rate, oxygen saturation, temperature, blood glucose and weight measurement.
• ECG recording and appropriate recognition and escalation of abnormal findings.
• Blood taking/phlebotomy where appropriately trained.
• Spirometry and respiratory assessment where appropriately trained.
• Cervical screening/cytology.
• Contraceptive advice and family planning.
• Sexual health advice and appropriate signposting/referral.
• Warfarin/INR monitoring where locally commissioned and within competence.
• Ear care, including ear irrigation where appropriately trained.
• Diet and lifestyle advice.
• Health promotion and preventative interventions.
• Administration of prescribed medicines and injections within competence and in accordance with local policy.
• Travel health assessments and travel vaccinations.
• Vaccine stock monitoring, checking and ordering.
• Appropriate maintenance of vaccine storage and cold-chain requirements.

Immunisation and Vaccination
The Practice Nurse may be required to administer and support a range of immunisation programmes, subject to appropriate training and authorisation.

This may include:

• Seasonal influenza vaccination.
• COVID-19 vaccination.
• Childhood immunisations.
• Pneumococcal vaccination.
• Pertussis vaccination.
• Shingles vaccination.
• Other locally commissioned vaccination programmes.
• Travel vaccinations.

The postholder will:

• Confirm appropriate vaccination status and eligibility.
• Check relevant clinical information and contraindications.
• Obtain appropriate consent.
• Administer vaccines safely in accordance with current guidance and local protocols.
• Recognise and appropriately manage adverse reactions, including anaphylaxis.
• Maintain accurate vaccination records.
• Ensure appropriate coding and documentation.
• Maintain appropriate vaccine stock levels.
• Check expiry dates and storage conditions.
• Follow cold-chain requirements.
• Escalate any concerns regarding vaccine storage or safety.

Long-Term Condition and Chronic Disease Management
The Practice Nurse will contribute to the assessment, monitoring, treatment and ongoing management of patients with long-term conditions.

This may include, but is not limited to:

• Hypertension.
• Diabetes.
• Asthma.
• COPD.
• Mental health conditions.
• Cardiovascular disease and associated risk factors.
• Other long-term conditions within the nurse's scope of competence.

Responsibilities will include:

• Undertaking appropriate clinical reviews and assessments.
• Monitoring relevant clinical parameters and identifying changes requiring intervention.
• Developing, implementing and reviewing individualised care and treatment plans.
• Providing education and advice to support effective self-management.
• Identifying patients at increased clinical risk and escalating appropriately.
• Supporting medication adherence and lifestyle modification.
• Providing appropriate dietary, smoking cessation, physical activity and weight management advice.
• Identifying opportunities for preventative care and early intervention.
• Ensuring appropriate recalls and follow-up arrangements are documented and communicated.
• Working collaboratively with the patient's registered practice where ongoing management or follow-up is required.

Professional Development
The Practice Nurse will be responsible for maintaining and developing their professional knowledge and clinical competence.

This will include:

• Maintaining current NMC registration.
• Working in accordance with the NMC Code and relevant professional standards.
• Undertaking mandatory and role-specific training.
• Maintaining competence in relevant clinical skills.
• Participating in continuing professional development.
• Undertaking reflective practice.
• Keeping up to date with relevant clinical guidance, legislation and best practice.
• Identifying personal learning needs through appraisal, supervision and clinical practice.
• Maintaining evidence of competence for procedures undertaken within the role.

Key Clinical Competencies
The successful candidate should demonstrate competence in a range of Practice Nursing skills, including where relevant:
General Practice Nursing

• Wound care and dressings.
• Treatment room procedures.
• Blood pressure, pulse, weight and other routine observations.
• Immunisations and Injections
• Blood testing/phlebotomy.
• Urinalysis.
• ECG.
• Spirometry.
• LTC Condition Management
• Ear care.
• Cervical screening.
• Contraception and family planning.
• Health promotion and lifestyle advice.

Person Specification
Qualifications
Essential

• Registered Nurse with current NMC registration.
• Relevant Practice Nursing experience. 3 years or over.
• Demonstrable ability to work autonomously and without direct nursing supervision.
• Strong clinical assessment and decision-making skills.
• Ability to recognise and respond appropriately to clinical deterioration and risk.
• Experience in the management of long-term conditions.
• Experience of delivering health promotion and preventative care.
• Cervical screening qualification.
• Immunisation and vaccination qualification.
• Ability to maintain accurate clinical records.
• Willingness and ability to work evenings and weekends, including Saturday sessions.

Desirable

• Spirometry competency.
• Travel health qualification.
• Experience of Enhanced Access or out-of-hours services.
• Independent prescribing qualification

Experience
Essential

• Experience of working within Primary Care for a minimum of 3 years.

Desirable

• Experience of working in an out of hours/urgent care setting
• Experience of EMIS

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.

UK Registration
Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).

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.

Applicants must have current UK professional registration.