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Patients get the best of both worlds

Nicola Fenton and James Rushby are Advanced Clinical Practitioners (ACPs) at St Leonard’s. While the ACP role is widespread across the hospital sector, it is still fairly new to hospices.

Advanced clinical practice allows health professionals, including nurses, physiotherapists and occupational therapists, to work at a senior clinical level, effectively carrying out most of the duties of a doctor. This level of practice is designed to transform patient care as ACPs bring valuable skills from other clinical backgrounds.


Nicola’s story

 “As an ACP at St Leonard’s hospice I provide holistic care, demonstrating clinical expertise and evidence based practice in the management of palliative care patients. It’s an an area I feel passionate about and endeavour to promote autonomy and choice for the patients’’

Nicola has been a nurse since 1998. She started her career in the neurosurgery ward at Leeds General Infirmary (LGI) before moving to neurointensive care, where she worked for nearly 17 years. Nicola then became a critical care outreach nurse, supporting both LGI and St James’s Hospital, Leeds. She then moved back to neurosurgery at LGI as an ACP, where she completed her Master’s degree.

Nicola has always wanted to work in palliative care, so when the opportunity to join St Leonard’s came up, she jumped at the chance. “It was Christmas Eve when I came to look around. I knew automatically that this was where I wanted to be so I submitted my application immediately. I joined the team on 23 May 2022, and I haven’t looked back. I love the fact we are a small team committed to giving patients the best care. Everyone has been lovely and welcoming – I feel like I have worked here for years. The best thing is the quality time I spend with patients.”

She has already made a considerable impact leading on projects, including implementing a specialist palliative care triage tool for the in-patient unit and a patient acuity and dependency tool to enhance nursing satisfaction and patient experience.

“I feel incredibly well supported. I have many ideas, and it is great to be given the autonomy to implement them to benefit patients and colleagues. It is an absolute privilege to work here. I have many ambitions for the future, and it’s great to be in an environment where your development is so well supported.”


James’ story

 “Being able to bring together so many different facets, including medical, social care, emotional support and nursing, to make a difference to patients’ lives is incredible.”

For James, coming back to St Leonard’s last year was coming back to his roots. He first worked at the Hospice between 2012 and 2014 as a charge nurse. Since achieving his nursing degree in 2004 he has worked in oncology at The Christie Hospital, Manchester, as a district nurse and as a clinical nurse specialist. He also briefly worked in New Zealand.

Prior to his return to St Leonard’s last year, James was an ACP at one of York Hospital’s community rehabilitation units, caring for the elderly and supporting frailty. He is now back working in his specialist area, palliative care. “It is what I was trained to do and I’ve missed it. It’s great coming back as an ACP. While clinically I can prescribe like a doctor I am also able to use my nursing brain to give a holistic approach to care. It is the best of both worlds.”

During his career James has moved between clinical and managerial / strategic roles. Being an ACP allows him to combine both and he is actively getting involved in projects at the Hospice. He has already created an education programme for staff called 10 in 10 – a series of short training sessions to help people easily retain key information.

“It’s fantastic to be working in an environment where there’s the appetite and energy to innovate. You are encouraged to do things differently and you are respected for your skills and knowledge. I love being back here, working alongside amazing people I hugely respect.”