Skip to main content

This job has expired

Advanced Nurse Practitioner for High Cost Drugs

Oxford University Hospitals NHS Foundation Trust
£43,742 to £50,056 per annum pro rata
Closing date
1 May 2024

View more

This post has been created in response to NICE approved use of High Cost Drugs for moderate rheumatoid arthritis and for high risk fractures. This is a newly introduced role within Rheumatology and Fracture Prevention Nursing teams to help manage patients who require long term therapies for their condition. The post holder will be working in a small team of specialist nurses, pharmacists, consultants and administrative staff. As the demand grows, with the eligible patients being offered high cost drug treatment, the team will expand accordingly.

Main duties of the job

Advanced practitioners will be able to
  • Decide on and carry out treatment, which may include the prescribing of medicines, or referring patients to an appropriate specialist.
  • Assess individuals, families and populations holistically using a range of different methods, some of which may not be usually exercised by nurses such as physical assessment and history taking, ordering and interpreting diagnostic tests or advanced health needs assessments.
  • Ensure the provision of continuity of care.
  • Use their expert knowledge and clinical judgement to decide upon & request further investigations, including DXA and laboratory tests, referrals, diagnoses and treatment decisions, including benefits of introducing biologics or targeted synthetic agents and balancing potential cardiovascular risks.
  • Identifying patients who are potentially eligible for biologics or targeted synthetic agents ensuring all patients are fully informed of their on-going care.
  • Assess and evaluate, with patients and /or carers, the effectiveness of the treatment and care provided and make changes as needed.
  • Work autonomously within a wider health care team and as a lone practitioner. Remaining accountable for own acts or omissions.
  • Work across professional, organisational and system boundaries and proactively develop and sustain new partnerships and networks to influence and improve health, outcomes and healthcare delivery systems.

About us

Oxford University Hospitals NHS Foundation Trustis one of the largest NHS teaching trusts in the country. It provides a wide range of general and specialist clinical services and is a base for medical education, training and research.

The Trust comprises four hospitals - the John Radcliffe Hospital, Churchill Hospital and Nuffield Orthopaedic Centre in Headington and the Horton General Hospital in Banbury.

Our values, standards and behaviours define the quality of clinical care we offer and the professional relationships we make with our patients, colleagues and the wider community.We call thisDelivering Compassionate Excellenceand its focus is on our values of compassion, respect, learning, delivery, improvement and excellence.These values put patients at the heart of what we do and underpin the quality healthcare we would like for ourselves or a member of our family. Watch how we set out to deliver compassionate excellence via theOUH YouTube channel.

Job description

Job responsibilities

Clinical Practice:

Rheumatology advanced nurse practitioners will be able to
  • Work at an advanced level practice autonomously as well as within a multi-disciplinary team and are self directed.
  • Work clinically to optimize health and wellbeing, demonstrate autonomous decision making related to comprehensive history taking and physical assessment of patients.
  • Work at an advanced level drawing on a diverse range of knowledge in complex decision making to determine evidence-based therapeutic interventions, which may include prescribing medication.
  • Plan and manage complete episodes of care, working in partnership with others, delegating and referring as appropriate to optimize health outcomes and resource use, providing direct support to patients and clients.
  • Use professional judgement in managing complete and unpredictable care events.
  • Draw upon an appropriate range of multi-agency and inter-professional resources in their practice.
  • Appropriately define boundaries in practice.
  • Promote a high standard of advanced specialist nursing by initiating and co-ordinating the assessment, planning, delivery and evaluation of the holistic needs of patients/families through evidence based practice following agreed policies, protocols and guidelines.
  • Practice a high standard of communication including highly sensitive and complex information to develop and sustain partnership working with individuals, groups, communities and agencies. Utilise evidence based information through a variety of communication media.
  • Maintain adequate patient documentation to NMC requirements for all patients seen and advice given in any practice setting and contribute to clinical activity/data collection as required.
  • Work in an extended role utilising skills that you have competency in, which may include ultrasound scanning and intra-articular joint injections.
  • Identify, triage and manage patients who are eligible for treatment amongst patients with moderate RA or the very high fracture risk group ensuring patients are fully informed of their on-going care in line with NICE (TAs 676, 744, 715 and 791), BOB ICS and local guidance including using QRISK3 for cardiovascular risk assessment.
  • Lead in the co-ordination and preparation of service audits, and be responsible for disseminating results to team members and inter-professional agencies.
  • Lead in the handover of the osteoporosis cohort to the subsequently appointed band 6 nurse in the team and coordinate the sharing of the moderate RA cohort with the subsequently appointed band 7 nurse


Rheumatology advanced practitioners will be able to
  • Collaborate with the multiprofessional team to develop a shared vision of the service.
  • Act as a role model and resource in expert clinical evidence based practice.
  • Work collaboratively with colleagues to develop effective documentation, pathways, protocols and guidelines for care. Demonstrate a commitment to share expertise and disseminate information.
  • Participate in implementing national standards and frameworks at a local level.
  • Network locally, regionally, nationally and internationally and seek opportunities to develop the ANP role.
  • Provide workplace evidence in the delivery of service / e-rosters.
  • Have an understanding of budgetary constraints and may be required to manage budgets.
  • Use effective change management skills to initiate and implement service and practice development, making the best use of resources to improve practice and health outcomes.
  • Participate in the selection, interviewing, appraisal and professional development of team members.
  • Maintain involvement and active input in multidisciplinary meetings and appropriate local bodies / forums to contribute to practice and service development.
  • Work alongside operational leads to ensure compliance with all emergency/ elective access targets and specialist pathways within the service.
  • Implementation of best practice and support existing good areas of practice in line with national guidelines.
  • Deliver the required number of helpline, day unit and outpatient sessions as defined by the local standards within the service.


Rheumatology advanced nurse practitioners will be able to
  • Maintain, advance and develop personal theoretical knowledge, high standards of clinical competence and professional development through ongoing self education and attendance at relevant courses of study.
  • Develop and maintain a peer network of support, information and learning with other nurse specialists at a local and National level.
  • Maintain own professional portfolio.
  • Contribute to the development of specialist nursing knowledge and skills to enhance and extend the practice of other nurses and health care professionals within the service.
  • Identify and address the educational needs of patients, families, carers and staff involved in the delivery of this service.
  • Contribute to the teaching and support of students from the multi professional team within relevant educational programmes.
  • Provide an appropriate learning environment, including mentorship, coaching and preceptorship.
  • Organise and contribute to relevant educational programmes and in house study days.
  • Develop and maintain a peer network of support, information and learning with other nurse specialists at a local and National level.

Improving quality and developing practice:

Rheumatology advanced practitioners will be able to
  • Coordinate and participate in ongoing service review and evaluation, including monitoring of patient experience including the co-ordination of an annual patient satisfaction audit for patients with moderate RA and very high fracture risk, identify and act on the recommendations from this.
  • Participate in research / audit to generate new evidence in area of speciality.
  • Evaluate clinical practice in relation to its evidence base and clinical effectiveness.
  • Identify areas of risk and poor quality, and address these through appropriate governance structures and forums.
  • Participate and actively seek peer review in practice.
  • Have responsibility to ensure annual appraisal, agree objectives which reflect local and national service needs and develop personal development plans.
  • Develop personal and professional knowledge through critical self appraisal, clinical supervision and networking with other health care professionals locally, nationally and internationally. .
  • Advocate and contribute to a working environment that promotes continuous learning and development, evidence based practice and succession planning, as well as identifying learning opportunities at local and national levels.
  • Have a high level of communication skills to enable the participation in the dissemination of practice through conferences and professional publications.
  • Ensure statutory and mandatory training updates, as well as role /speciality updates are completed and necessary records maintained.
  • To undertake any other duties as required by the Deputy Operational Services Manager/Matron.
  • Take a lead in the on-going commissioning process including reporting for both cohorts (moderate RA and very high risk fracture).
  • Lead and support the team to ensure that quarterly KPI metrics are submitted to directorate and commissioners as appropriate for both cohorts.
  • Contribute and lead the development of the team and the services to continuously improve the quality and efficiency of patient care.
  • Participate in implementing national standards and frameworks at a local level e.g. NICE guidance.
  • Network locally, regionally, nationally and internationally and seek opportunities to develop the specialist role.
  • Lead in the selection, interviewing, appraisal and professional development of team members.
  • Line manage members of the team where appropriate in association with the lead rheumatology nurse
  • Maintain involvement and active input in multidisciplinary meetings and appropriate local bodies / forums to contribute to practice and service development including leading and delivering cycles of QI within the service.

This job description is intended as a guide and may be revised and updated with the post-holder as appropriate to meet changes and demands within the service

Person Specification



  • Registered Nurse
  • Evidence of working across clinical boundaries
  • Non-medical prescriber


  • Master qualification in Advanced Nursing practice, or working towards one
  • Experience in Rheumatology
  • Teaching and assessing qualification

Employer details

Employer name

Oxford University Hospitals NHS Foundation Trust


Nuffield Orthopaedic Centre

Windmill Road



Any attachments will be accessible after you click to apply.


Get job alerts

Create a job alert and receive personalised job recommendations straight to your inbox.

Create alert