Breast Advanced Nurse Practitioner (Annex 21

Work as an autonomous and independent practitioner only seeking advice from senior medical colleagues where necessary.

Develop and promote advanced nursing practices to improve access to care, clinical care and patient experiences of care.

Act as an information resource for patients and family.

Participate in the development of Care Pathways and Guidelines written for use within the Breast unit.

Write new protocols developed for breast nurse practitioner  expert in knowledge and understanding of Breast Cancer and benign breast disorders, diagnoses and treatments.

Provide service for vetting of >100 new patient referrals per week which entails decisions around urgency and appropriateness of referrals forbreast services, clinical need of patient and planned radiological investigations.

Establish and maintain nurse led clinics within hospital and nurse led follow up care in the community ie family history clinic and breast cancer home visits.

Possess excellent interviewing and communication/counselling skills. This may include counselling in situations of bereavement or breaking badnews.

Enhance effective partnerships with a range of services in primary care and the voluntary sector to ensure continuity of care and optimum accessto support  expert in assessment of genetic risk associated with Breast Cancer. Collect familial information by questionnaire from patients. Use relevant knowledge of cancer inheritance theory and devise and analyse pedigree for all new patients to family history clinic.

Liaise with the Clinical Genetics department and attend joint clinics.

Record patients clinical history. Carry out clinical examination and patient assessment in order to establish a breast diagnosis. Arrange appropriate follow-up or discharge.

Assess the need for patients to undergo clinical investigations and order same in line with Trust protocols (and Nurse Practitioner protocols asabove)
Be responsible for the recording and interpretation of patients investigation results and discuss the results and their implications with the patient.

Perform complex invasive procedures ie core biopsies, FNA and punch biopsies according to nurse practitioner written  competent in seroma assessment and drainage.

Provide a nurse practitioner service in the following areas of breast disease:

Rapid diagnostic services to assess, diagnose, plan treatment and discharge patients, providing written resources where applicable.

Breast Follow-up services for benign and malignant conditions, discharging patients as per agreed breast unit protocols

Liverpool University Hospitals NHS Foundation Trust

St Helens and Knowsley Teaching Hospitals NHS Trust