Hepatology Clinical Nurse Specialist

North Bristol NHS Trust
£43,742 to £50,056 a year pro-rata
Closing date
17 Dec 2023

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Band 7
Contract Type
Full Time
  • The Hepatology Clinical Nurse Specialist (CNS) role requires practice that is informed by higher levels of judgement, decision-making and discretion.
  • The Hepatology CNS will work as part of the multidisciplinary team, using clinical, communication and interpersonal skills to identify the needs of patients to ensure a co-ordinated quality service and will be actively involved in education, audit, and research.
  • The Hepatology CNS will work as an integral member of the hepatology team providing specialist nursing advice and support to patients and families from the time of diagnosis and throughout care.
  • The Hepatology CNS role involves demonstrating leadership, education, and management to ensure a seamless service for patients, carers, and staff.
  • The Hepatology CNS will be responsible for the duties of a clinical nurse specialist, including facilitating face-to-face and telephone clinics and remote surveillance of patients.
  • The Hepatology CNS will continue to develop, implement, monitor, and review standards/policies and guidelines.
  • The Hepatology CNS will aim to undertake paracentesis after appropriate training.

Main duties of the job

  • Run independent nurse led clinics for patients being assessed for liver transplantation and post-transplant surveillance.
  • Streamline the service to ensure transplant patients can access prompt imaging and follow-up, and ensure that imaging is coordinated such that transplant work up is achieved in a timely manner.
  • Co-ordinate and manage an independent nurse led clinic for the viral hepatitis B patient cohort using the existing model of FibroScan support.
  • Liaise with UBHW for the care of NBT patients with hepatitis C undertaking viral
  • Aim to complete a non-medical prescribing (NMP) course within the first year of CNS role.
  • Prescribe and review medication for therapeutic effectiveness, in accordance with evidence-based practice, national protocols, legislation (non-medical prescriber or under Patient Group Directions) and within scope of practice.
  • Undertake an IRMA course at NBT within 12 months of starting the post, to request relevant imaging.
  • To undertake FibroScans.
  • Demonstrate the pathways and data collection from clinics and innovations for audit and service development.
  • Participate in regional and national training and updates within their field and be an active participant in relevant associations such as BASL BLNS and BSG.
  • Outpatient paracentesis service: with support the CNS should aim to undertake paracentesis for outpatient patients with decompensated cirrhosis.

About us

NBT Cares. It's a very simple statement one which epitomises how everybody across our organisation goes the extra mile to ensure our patients get the best possible care.

NBT Cares is also an acronym, standing for caring, ambitious, r e spectful, and supportive - our organisational values.

And our NBT Cares values are underpinned by our positive behaviour's framework - a framework that provides clear guidance on how colleagues can work with one another in a constructive and supportive way.

Job description

Job responsibilities

  • The hepatology CNS will provide liaison between NBT, Kings College Hospital and other transplant centres. To coordinate the transplant assessment pathway, coordinating the necessary investigations in a timely and efficient manner. The successful applicant will work with the NBT MDT to identify potential liver transplant candidates and support the patient through the listing process up to the time of transplantation. Once listed the applicant will coordinate care both pre- and post-transplant.
  • The successful applicant will also act as a contact for all transplant patients known to the trust and where appropriate coordinate investigations, interventions and liaise with the appropriate transplant centre and NBT MDT.
  • Work with the Hepatology Team and Transplantation services to provide specialist advice to patients, their families, and carers before and after diagnosis, transplantation and during their disease pathway.
  • The successful applicant will also develop a robust and clear hepatitis B service, incorporating remote virtual and face-to-face review, working alongside, and supporting the FibroScan technician.
  • The successful applicant will also be expected to attend appropriate multi-disciplinary team meetings (MDT) to achieve a seamless approach to individualised patient centred care.
  • They will be responsible for attending their 1:1 with their matron and keeping up to date with relevant clinical guidelines and associations.
  • To provide specialist nursing advice, patient education and support to patients, their families, and carers from the time of diagnosis and throughout treatment and follow-up phases of treatment and care regarding:
  • The impact of diagnostic procedures.
  • Impact of treatment and side effects.
  • The disease processes.
  • Health promotion.
  • To develop guidelines, care, and referral pathways to streamline the patient pathway within Hepatology.
  • To lead the development, improvement, management, and promotion of the service ensuring the delivery of high-quality, cost-effective care.
  • To lead on the implementation and monitoring of adherence to relevant clinical guidelines.
  • To act as a resource in the care of patients with specialist care needs, ensuring an optimum level of service to patients and their carers.
  • To develop effective communication and support systems for patients and their families.
  • To embed patient and public involvement within the sphere of practice.
  • To ensure that all patients and families are aware of all treatment options, including clinical trials.
  • To function as a patients advocate to negotiate and mediate to work with the system to ensure optimum care to patients.
  • To establish nurse-led interventions to support services and manage patients needs and expectations.
  • To establish links with other organisations providing support and information and utilise these additional resources where necessary.
  • To adhere to infection control guidelines and procedures.
  • To act as a positive role model for nurses in the hospital through the demonstration of strong leadership skills.
  • Demonstrate specialist hepatology knowledge and skills.
  • Develop, maintain, and monitor high standards of evidence-based patient care for hepatology patients.
  • To provide support and advice in clinical areas, wards, and outpatients, to optimise quality improvement opportunities. This may involve working alongside nurses in the clinical areas.
  • Analyse and respond to complex clinical situations utilising specialist knowledge to assess a range of options to formulate solutions and recommendations.
  • To act as a change agent, using skills that will motivate and reassure staff through negotiation and training, to facilitate the change process.
  • Integrate the work of the clinical nurse specialist with the multi-disciplinary team through leadership and collaborative working practices to ensure that high clinical standards are achieved and maintained.
  • Liaise closely with other nursing and medical staff within the Hepatology Department as well as other relevant health and social care professionals within both primary and secondary care to achieve a seamless pattern of care for the individual patient.
  • Demonstrate excellent communication skills with patients, carers and staff ensuring the information is appropriate timely and delivered sensitively and based on individual need. Ensure that patients and their carers receive highly skilled physical and psychological assessment care / support information and advice as appropriate.
  • Provide clear and readily accessible education, information and support to patients and their carers from diagnosis through to treatment and follow up care, referring on to other services as appropriate.
  • Co-ordinate and run nurse-led clinics and practice in line with Trust Policy.

  • To participate in the planning and delivery of formal and informal education programmes for patients, carers, and all staff.
  • To participate in education forums locally, nationally, and internationally, representing the Trust.
  • To ensure that professional knowledge and practice is constantly updated.
  • Takes personal responsibility for life-long learning and personal development through clinical supervision, appraisal and Knowledge and Skills Framework.

  • To collate and record quantitative and qualitative data that provides evidence of productivity, outcomes, and quality, through audit and research.
  • To participate in clinical audit and research relevant to specialty and co-operate with other affiliated work.
  • To ensure that relevant research findings are translated into practice.
  • To promote a culture of evidence-based practice.
  • To work with the multidisciplinary team to develop standards of care and undertake evaluations to monitor the impact on patient care.
  • To be involved with health promotion related to the speciality.
  • Actively promote a culture of research-based improvement to achieve the highest quality of patient care.
  • Establish effective systems and mechanisms for the conduct of research activities ensuring these are clearly understood and adhered to by all clinicians and relevant staff.
  • Work closely with the Clinical Trials Team to explore possible areas for research and clinical trials within hepatology.
  • Be well-informed of research and development in the field of hepatology nationally and internationally and disseminating to others.
  • Develop, introduce, and apply research-based findings to nursing practice.
  • Lead and participate in relevant audit, research, and development activity, on a uni/multi professional basis.
  • Use critical appraisal skills within a multi-disciplinary forum to analyse current research and its implications for practice.

Professional responsibilities
  • Maintain own professional development and competencies through attending statutory study days as well as relevant courses to the service.
  • Attend regular clinical supervision sessions for personal and clinical support.
  • Attend and keep up to date with the Trusts mandatory training requirements.
  • Establish clinical supervision as an integral part of your clinical support.
  • Ensure Trust policies, procedures and guidelines/protocols are known and followed.
  • Attend and participate in departmental, directorate and Trust meetings as required.
  • Participate with other members of the team in preparation for annual peer review.
  • Participate in local and regional multidisciplinary meetings when required.
  • Participate in regional and national group meetings.
  • Maintain individual professional development in line with NMC requirements and revalidation.
  • Contribute and attend uro-oncology clinical governance meetings and audits.
  • Act as a specialist in the field by keeping up to date by reviewing latest research/literature and attending relevant conferences/courses.
  • Be an active member of the Trust Cancer Nurse Specialist Forum and undertaking activities to take cancer nursing forward in the Trust.
  • Behave in a manner that augments the security of NHS/NBT property and resources.
  • Always safeguard the confidentiality of information in relation to patients and staff.
  • Always follow risk management procedures.
  • Take personal responsibility for risk management in respect of self and colleagues and report any identified potential hazard to line manager.
  • Attend risk management training as required and directed.
  • Complete and submit the necessary documentation should an incident or hazard arise.

  • Demonstrate the ability to provide an initial response to complaints and queries and have a working awareness of the NBT NHS Trusts complaints procedure.
  • Maintain accurate and concise records that produce statistical data for the purpose of evaluation.
  • Maintain accurate and concise records that produce statistical data for the purpose of evaluation and development of the service.
  • Keep accurate and up to date patient records.
  • Serve on committees, working parties and project teams related to direct and indirect management of services as required.
  • Ensure all services delivered are correctly resourced and delivered. Work closely with the Matron to establish resourcing service developments.
  • Participate in strategic care and business planning for development of the service as required.
  • Participate in the development of evidence-based policies and procedures.
  • Facilitate the development of quality initiatives such as audit, evidence-based practice, and risk management within a culture of continuous quality improvements.
  • Initiate and participate in uni and multidisciplinary professional standards setting and audit.
  • Practice in accordance with current policies and procedures of NBT NHS Trust.
  • Participate in individual performance review annually.
  • Actively contribute to trust wide and divisional CNS work CNS away days, annual job plan reviews, and annual reports.

Person Specification



  • Advanced knowledge of the care and management of hepatology patients in the outpatient setting.
  • Up-to-date knowledge and understanding of national and local cancer issues and developments
  • Sound knowledge of liver car
    Any attachments will be accessible after you click to apply.


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