MSKAPS Advanced Practitioner

Job overview

We are looking for a highly skilled MSK Podiatrist with proven experience of working within the NHS, who is dynamic, innovative and effective in supporting an established MSK team.

The post holder will work with the MSKAPS team to provide advanced foot and ankle assessment and diagnosis, collaborative treatment planning and supported self-management. They will also perform complex specialist musculoskeletal foot and ankle triage as part of the single point of access MSK Specialist Triage Service as part of the commissioned MSK pathway.

We are looking for a Podiatrist with a NHSE AP Digital Badge or evidence of experience of working across all four pillars of practice, with a willingness and ability to undertake an accredited AP Pathway.

The post holder will work collaboratively and support the Clinical and Operational Leads in the delivery of best practice care and will work across the four pillars of Advanced Practice.

If you are passionate, enthusiastic and committed to Advanced Practice and ready for a challenge, this may be the post for you.

For informal enquiries please contact:

Joanna Griffin MSKAPS Clinical Lead or

Lawrence Bevan MSKAPS Podiatry Advanced Practitioner 0300 421 8323

Main duties of the job

The Trust provides specialist mental health and learning disability services, together with physical health community services to the population of Gloucestershire.

The post holder will work with the Integrated Care Service (ICS) to provide a Musculoskeletal Advanced Practitioner and MSK Specialist Triage service to patients aged 18 and over, including advanced assessment and diagnosis, collaborative treatment planning and supported self-management. They will be required to perform complex specialist musculoskeletal triage using advanced practice skills for musculoskeletal referrals received from Primary Care (GP and FCP), Core Physiotherapy services, Podiatry Services, Consultant secondary care services and other orthopaedic and musculoskeletal service providers.

Detailed job description and main responsibilities

• Act as a specialist clinical expert in musculoskeletal care, with an ability to make high level decisions informed by advanced history taking, diagnostic assessment and treatment. Demonstrate a critical understanding of own level of responsibility and accountability for own decisions, actions and omissions at this level of practice, including when working with complexity, risk, uncertainty and incomplete information.
• Undertake clinical triage of patients referred into the orthopaedic single point of access MSK Specialist Triage service, using highly developed specialist knowledge of pathways and commissioning criteria. Prioritise treatment and care for individuals according to their health status and need, accepting responsibility for own caseload of patients, and ensuring  that all patients have accurate, up to date and complete records of patient care, consistent with current legislation and local policies.
• Practice highly complex musculoskeletal clinical assessment of patients identified at triage as appropriate for the AP service applying highly specialised knowledge, advanced skills and clinical reasoning of a broad spectrum of patients with highly complex presentations, requiring time to address their complexities and needs.
• Utilise a range of assessment methods including comprehensive history taking, physical examination, and diagnostic tests where appropriate, to inform professional clinical reasoning and formulate a differential diagnosis.
• Devise, monitor and review evidence-based treatment plans and advice, which ensure safe management of patients. Autonomously formulate appropriate management plans for patients which ensure optimum physical and psychological needs are met and are ethically based. Make appropriate follow up referral as needed and/or ensure the patient has instructions on action to take if not improving.
• Where appropriate to help inform the management of an individual, request and interpret appropriate laboratory and radiological investigations (bloods, X-Rays, MRI, ultrasound and Nerve Conduction Studies) in line with Gloucestershire Health Community G-care guidelines and maintain competency as a referrer.
• Demonstrate a critical understanding of the indications, limitations and ability to interpret reported findings of diagnostic tools used in the assessment of MSK conditions e.g. imaging, blood tests and neurophysiology; using a shared decision-making approach.
• Competently carry out a wide variety of procedures and interventions which require advanced levels of knowledge and skills requiring dexterity and accuracy.
• If an independent prescriber, transcribe, prescribe and review medication for therapeutic effectiveness appropriate to patient need and in accordance with best/evidence-based practice and national and local protocols and within the role’s scope of practice and legal framework.
• Utilise advanced listening, probing and facilitative skills across a diverse range of consultations, some of which are highly challenging due to emotive circumstances.
• Demonstrate a critical understanding of broadened level of responsibility and autonomy and the limits of own competence and professional scope of practice, including working with uncertainty and complexity, risk and incomplete information.
• Act on professional judgement about when to seek help, demonstrating critical reflection on your own practice, self- awareness, emotional intelligence, and openness to change.
• Work in partnership with individuals, families and carers, using a range of assessment methods as appropriate i.e., history taking, holistic assessment, identifying risk factors in mental health assessments, requesting and correlating reports from diagnostic tests, including radiology requests. Apply critical analysis to the synthesis of complex information during the care process to provide accurate advice and health information to patients to empower them to act upon the advice given.
• Support the safeguarding of individuals, utilising acquired skills in mental health, child protection, medication and other areas of healthcare as required for the role, ensuring policies and legislation are followed.
• Demonstrate effective communication styles supporting challenging and sensitive conversations. Provide accurate, unambiguous, relevant and timely communications to colleagues as required during handover and referral. These must be supported by written information which is consistent with verbal or electronic information.
• Critically appraise and apply person-centred consultation styles, to actively involve patients, carers and families in shared-decision making by exploring patient expectations and preferences alongside risks, benefits and consequences of available assessment and management options.
• Utilise critical thinking to inform assessment, diagnosis and decision-making skills to inform clinical reasoning approaches when dealing with differentiated and undifferentiated individual presentations and complex situations synthesising information from multiple sources to make appropriate evidence-based judgements and diagnoses.
• Demonstrate integration of advanced knowledge and clinical reasoning to critically evaluate all clinical information to consider the potential for MSK symptoms to be features of non-MSK conditions (e.g., infection, metabolic, oncological, inflammatory/autoimmune, neurological or vascular).
• Demonstrate critical and evaluative understanding of pharmacotherapy and its potential risk and benefits including when to seek appropriate support or onward referral Recognise the opportunity for and provide health education to patients during the consultation process, referring to appropriate health care professionals as required.
• Demonstrate critical and evaluative understanding of the role of joint and soft tissue injections, informed by the evidence base in MSK practice, and the ability to communicate this information effectively to patients to help them make informed decisions about their care.
• Where the post holder holds a Masters level module, and associated Trust competence in Injection Therapy, be able to demonstrate critical and evaluative practice in soft tissue and joint injection under the legislative framework of a PGD and as per Trust Policy.
• Where the post holder holds a qualification in diagnostic ultrasound/POCUS and associated Trust competence, act under professional guidelines of the appropriate professional body.
• Work collaboratively with an appropriate range of MDT and interprofessional resources, developing, maintaining and evaluating links to manage risk and issues across organisations and settings.
• Maintain clear, accurate, comprehensive and contemporaneous clinical records using the Systm One electronic patient record, in line with service and professional standards including outcome measures and the writing of patient reports and letters.