Clinical Nurse Specialist

Guy’s and St Thomas’ is among the UK’s busiest and most successful NHS foundation trusts. We provide a full range of hospital and community services for people in south London and as well as specialist care for patients from further afield including cancer, renal, orthopaedic, respiratory and cardiovascular services.

Guy’s is home to the largest dental school in Europe and a £160 million Cancer Centre opened in 2016. As part of our commitment to provide care closer to home, in 2017 we also opened a cancer centre and a kidney treatment centre at Queen Mary’s Hospital in Sidcup. St Thomas’ has one of the largest critical care units in the UK and one of the busiest emergency departments in London. It is also home to Evelina London Children’s Hospital.

Evelina London cares for local children in Lambeth and Southwark and provides specialist services across south east England including cardiac, renal and critical care services. We lead a number of specialist service networks aiming to ensure children are treated locally where possible, but have access to specialist expertise when they need it. Our community services include health visiting, school nursing and support for families of children with long-term conditions.

Our adult community services teams deliver care at the heart of the local communities we serve, working in partnership with GPs, local authorities and other healthcare and voluntary sector organisations. Working with our partners in Lambeth and Southwark, we are focusing on new ways of working to improve care for local patients.

In February 2021 the Royal Brompton and Harefield joined Guy’s and St Thomas’ NHS Foundation Trust, bringing together world-leading expertise in the care and research of heart and lung disease. Our merger provides a once in a generation opportunity to build a lasting, world-renowned heart and lung centre, providing the highest quality care for patients and conducting world-leading research.

We have a reputation for clinical excellence and high quality teaching and research. We are part of King’s Health Partners, one of eight accredited UK academic health sciences centres. In partnership with King’s College London we have dedicated clinical research facilities including an MHRA accredited Phase I clinical trials unit.

Patients are at the heart of everything we do and we pride ourselves on ensuring the best possible patient experience as well as safe, high quality care. We are proud to have one of the lowest mortality rates in the NHS. Following a comprehensive Care Quality Commission (CQC) inspection in 2019 we maintained our overall rating of ‘good’. Our adult community services achieved a rating of ‘outstanding’.

The commitment of our 23,500 staff is key to our success. We are one of the largest local employers and we aim to develop and support all our staff so they are able to deliver high quality, safe and efficient care. The 2019 NHS staff survey results show that we have one of the most engaged and motivated workforces in the NHS. We know this has a positive impact on the care provided to our patients.

We have one of the most ambitious capital investment programmes anywhere in the NHS.

Job overview

Based within our busy Rapid Access Eye Clinic, you will play a key role in delivering high-quality, timely care to patients presenting with urgent eye conditions. The service operates Monday to Friday and accepts patients through walk-in attendance, referrals from local community services, and our dedicated telephone triage line.

As part of a well-established multidisciplinary team, you will work alongside experienced nurses, optometrists, and ophthalmic clinicians to assess, manage, and support patients requiring urgent ophthalmic care. The clinic sees approximately 17,000 patient attendances each year, providing a fast-paced and rewarding environment in which to develop and utilise advanced clinical skills.

This is an excellent opportunity for a motivated and experienced practitioner who is passionate about delivering outstanding patient care and contributing to the ongoing development of a dynamic urgent care service.

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The post holder will provide clinical and operational leadership within the Rapid Access Eye Clinic, working closely with the Clinical Lead to deliver a safe, effective, and patient-focused service. They will lead and support a team of experienced ophthalmic nurses and optometrists, promoting high standards of care, professional development, and continuous service improvement.

The role combines leadership with a significant clinical commitment, requiring the post holder to work across all areas of the service. Responsibilities include face-to-face and telephone triage, assessment and management of patients presenting with urgent ophthalmic conditions, and the autonomous treatment and discharge of patients within agreed protocols. Appropriate referral to medical colleagues and other services will be undertaken when necessary.

The post holder will support effective patient flow, workforce management, and service delivery to ensure patient needs are met efficiently. They will contribute to clinical governance, audit, quality improvement initiatives, and the implementation of evidence-based practice.

Working collaboratively within the multidisciplinary ophthalmology team, the post holder will act as an expert practitioner and professional role model. Ideally, they will be an Independent Non-Medical Prescriber, enabling the timely assessment, treatment, and management of a wide range of urgent eye conditions for the approximately 17,000 patients seen by the service each year.

Working for our organisation

We provide specialist surgical and medical ophthalmology services for our local communities and are the tertiary referral centre for many specialties within the clinical group. We are passionate about constantly improving our service and delivering high quality care to our patients. We have a significant focus on patient experience and want to improve further the engagement from patients to improve the service. We are looking for a committed individual with excellent organisational and interpersonal skills, who have a genuine interest in working within in our Rapid Access Eye Clinic. We are dedicated to training and developing our staff, so the successful candidate will get the opportunity to work alongside a well-established team in nurse led services. Ophthalmology has over 200 colleagues who all work closely with one another to ensure the smooth day to day running of the service and engage in transformation projects to improve patient and staff experience. We have a number of social events throughout the year to bring everyone together and celebrate our diverse team.

Detailed job description and main responsibilities

The post holder will provide visible clinical and operational leadership within the Rapid Access Eye Clinic, ensuring the delivery of a safe, effective, responsive, and patient-centred service. Working closely with the Rapid Access Eye Clinic Clinical Lead, the post holder will support the strategic development, day-to-day management, and continuous improvement of the service to meet the needs of patients presenting with urgent ophthalmic conditions.

Clinical Responsibilities

• Undertake autonomous assessment, diagnosis, treatment, and discharge of patients presenting with acute ophthalmic conditions.
• Provide expert clinical decision-making and management of patients attending the Rapid Access Eye Clinic
• Perform face-to-face triage to determine clinical urgency and appropriate patient pathways.
• Deliver telephone triage and advice services, ensuring patients receive timely and appropriate care.
• Order, interpret, and act upon relevant ophthalmic investigations within scope of practice.
• Initiate treatment plans, monitor patient outcomes, and arrange appropriate follow-up where required.
• Refer patients appropriately to ophthalmology consultants, subspecialty services, primary care, emergency departments, or other healthcare professionals as indicated.
• Act as an independent prescriber where qualified, prescribing medicines safely and effectively in accordance with local and national guidance.
• Ensure accurate and contemporaneous documentation of all patient assessments, interventions, and outcomes.

Leadership and Management Responsibilities

• Provide leadership and day-to-day management of a team of experienced ophthalmic nurses and optometrists.
• Support staff development through supervision, mentoring, coaching, and appraisal processes.
• Foster a positive team culture that promotes collaboration, professional development, and high-quality patient care.
• Assist with workforce planning, rota management, and allocation of clinical resources to ensure service efficiency.
• Support the recruitment, induction, and retention of staff within the service.
• Act as a senior clinical resource, providing advice and guidance to colleagues and other healthcare professionals.
• Deputise for the Clinical Lead in their absence as required.

Service Development and Quality Improvement

• Contribute to the ongoing development and modernisation of the Rapid Access Eye Clinic
• Identify opportunities to improve patient pathways, patient experience, and service efficiency.
• Lead and participate in clinical audits, quality improvement projects, and service evaluations.
• Ensure clinical practice is evidence-based and aligned with national standards, professional guidance, and Trust policies.
• Monitor and review service activity, outcomes, and performance indicators to support continuous improvement.
• Participate in the development and implementation of clinical guidelines, protocols, and standard operating procedures.

Governance and Risk Management

• Promote and maintain high standards of clinical governance and patient safety.
• Ensure compliance with Trust policies, professional standards, and statutory requirements.
• Report, investigate, and learn from incidents, complaints, and near misses within the service.
• Identify and manage clinical risks, escalating concerns appropriately.
• Support infection prevention and control measures and ensure compliance with safeguarding policies.

Education and Professional Development

• Act as a role model for advanced clinical practice and professional behaviour.
• Support the education and training of nursing, optometry, medical, and allied health professional staff.
• Participate in delivering teaching sessions and clinical competency assessments.
• Maintain and develop specialist ophthalmic knowledge and skills through continuing professional development.
• Promote a culture of lifelong learning, reflective practice, and evidence-based care.

Research and Innovation

• Support participation in research, audit, and innovation initiatives within ophthalmology services.
• Contribute to the implementation of new evidence, technologies, and pathways that enhance patient care and service delivery.

The post holder will be expected to maintain a significant clinical presence within the Rapid Access Eye Clinic while providing leadership and operational oversight, ensuring that the service continues to deliver high-quality care to approximately 17,000 patients accessing urgent ophthalmic services each year.

Guy’s and St Thomas’ celebrates, respects and values the diversity of its staff and patients. We review our policies, procedures and practices to ensure that all employees, patients and carers are treated equitable according to their needs. We are actively committed to ensuring that no one who applies for a job, works or study’s at the Trust, or accesses our services is discriminated against on the grounds of race, ethnicity, nationality, disability, religion or belief, age, gender identity , gender reassignment, sexual orientation, pregnancy and maternity/paternity, or marital/civil partnership.

Applications are welcomed from applicants with a disability. We can make reasonable adjustments and offer support and advice in a variety of ways throughout the application process. Equality of opportunity is our policy.

As an organisation we are committed to developing our services in ways that best suit the needs of our patients. This means that some staff groups will increasingly be asked to work a more flexible shift pattern so that we can offer services in the evenings or at weekends.

Flexible working

We are committed to supporting all employees to achieve a healthy work life balance and to work in a way that is best for them and our patients. We will consider all requests to work flexibly, taking in to account the individual’s personal circumstances as well the needs of the service. We encourage all prospective applicants to discuss their individual circumstances with the recruiting manager as part of the on-boarding process.

Due to recent changes in the UK immigration rules which affect Skilled Worker Visas, Global Business Mobility, Higher Skill Level and Increased Salary Thresholds, please ensure that you are able to meet the requirements to live and work in the UK before applying. Further information about eligibility is available on the UK Government website.

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