Job responsibilities

Please refer to the attached job description and person specification for full detailsand requirementsof the role.

Why join us?

• Be part of a major transformation of urgent community care services.
• Work within a supportive multi-disciplinary team.
• Flexible hybrid working across CAS Hub, UCR and urgent care services.
• Opportunities for teaching, leadership, service improvement and innovation.
• Help deliver safe alternatives to hospital admission and improve patient flow across the system.
• Help build the future of urgent community care.

Qualifications

Essential

• Fully qualified medical practitioner
• MRCGP or equivalent
• Full GMC registration with licence to practise in the UK
• GP register inclusion
• Evidence of continued professional development

Desirable

• Additional postgraduate qualification relevant to urgent care
• Formal leadership or management qualification

Experience

Essential

• Experience working as a GP
• Management of undifferentiated and complex patients
• Experience of multidisciplinary working
• Participation in governance, audit or quality improvement
• Experience supporting colleagues clinically

Desirable

• ACP / trainee supervision experience
• UTC, WIC, OOH or SDEC experience
• Community or intermediate care experience
• Service redesign and pathway development
• Formal education and teaching experience
• Formal leadership experience
• Educational leadership experience
• Practical quality improvement experience
• System development experience
• Quality improvement leadership experience

Knowledge and skills

Essential

• Excellent assessment and diagnostic skills
• Management of complex presentations
• Ability to support and lead clinicians
• Demonstrates evidence-based care
• Excellent verbal and written communication skills
• Ability to work across organisational boundaries
• Understanding of governance and patient safety
• Ability to teach and support colleagues
• Understanding of quality improvement methodology
• Use of clinical systems and digital technologies

Other

Essential

• Commitment to person-centred care
• Demonstrates integrity and professionalism
• Ability to adapt to changing service needs
• Collaborative approach
• Ability to motivate and influence others
• Commitment to innovation and improvement
• Commitment to equality, diversity and inclusion

Values

Essential

• Continuous improvement - committed to making improvements to our services for the benefit of all.
• Accountability - taking ownership to anticipate, develop and deliver high quality care.
• Respect - how we treat others in an inclusive and supportive way.
• Enthusiasm - demonstrate our passion and pride for what we do and how we do it.
• Support - actively supporting others with compassion and courage.

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

Certificate of Sponsorship

Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).

From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).

Job responsibilities

The post-holder is responsible for the ongoing assessment of care needs and the development, implementation, and evaluation of care. The post holder will carry out all relevant forms of care and will take responsibility for caseload holders in their absence. Professional/Ethical Practice

Ensuring that the community nurses within the team practice within a legal and ethical framework that adheres to The Code and local Trust Policies and Procedures.

Focusing resources to ensure equity of access for all individuals and groups within the locality.

Being personally accountable for professional and ethical actions and ensuring compliance with The Code.

Maintaining confidentiality, while communicating patient information, in such a way that preserves the dignity and privacy of the patient and family/carers.

Working in a non-judgmental anti-discriminatory way, with regard to cultural and religious beliefs of individuals and groups.

Ensuring that prior to any course of action involving individuals/groups has their informed consent.

Acting as an advocate for individuals and groups.

Bringing to the attention of team members when they are acting outside of the Code, Trust Policies and Procedures and identifying actions to rectify any professional issues. Patient Care Delivery/Communication

Developing, maintaining, and identifying problems with effective locality communication networks with other health professionals, statutory and voluntary agencies and helping to improve its effectiveness. To manage a caseload of patients with a broad range of complex and specialist needs, using evidence based and client centred principles to assess plan implement and evaluate interventions.

Accurately and timely recording of all care given to the patients and report any changes in the patients condition to the general practitioner or other members of the health/social care team and that may be used for investigations/serious incident reporting.

Attending and participate in staff meetings, MDTs and other meetings as required.

Ability to verbally explain complex issues in formal situations such as investigations.

Ability to formally present and discuss to individuals and groups ideas and issues pertinent to Community Nursing.

Identifying and allocating responsibility for the assessment of particular client groups.

Having responsibility for the health assessment of adults within the population as their needs arise.

Using the knowledge and skills necessary to assess individuals and groups, identifying the multiple needs of the patient, family/carer providing holistic care taking into consideration cultural differences.

Working within the Community Division as a member of the integrated community nursing team, participating in activities, which address the health needs of the general population.

Providing and maintaining a high standard of skilled nursing care for patients in their homes, health clinics and Care Homes using an evidence-based model of care, that is consistent with NICE guidelines, within own scope of practice and legislation.

Ensuring that nursing procedures are taught to relatives/carers so that the care of the patients may be continuous over 24 hours, and guidance is given on carrying out all treatments.

Ensuring the changing needs of individuals and groups are identified timely and adjustments to programmes of care are made.

Promoting and maintaining optimum health by identifying, planning, and undertaking specific health promotional activities with identified individuals and target groups.

Following Merseycare NHS Foundation Trust guidelines in all suspected and confirmed emotional, sexual, and physical abuse.

Ensuring that concerns and identified potential risks are referred to the appropriate General Practitioner (GP)/Multidisciplinary team immediately.Care/Caseload Management

Responsibility for the co-ordination in monitoring the care of patients with long term conditions, disease management and supporting clinical staff ensuring continuity and continuing care

Being responsible for the development of an annual caseload profile to identify the health needs and necessary resources to meet service needs, using the information to inform other professionals and to direct development of services.

Responsible for the setting of team objectives in conjunction with the Operational Lead.

Ensuring that all Human Resources policies are adhered to including the recruitment and employment of staff, the management of sickness absence.

Using own expertise and experience to present recommendations for service development.

Responsible for ensuring that all data relating to the patient activity of the team is input onto the information system accurately and on time as required by Trust policy.

Having delegated responsibility for budget management operating with constraints identified by management, and acts as an authorise signatory for goods and services.

Allocating work to make best use of the knowledge and skills of team members.

Having responsibility for ensuring that appraisals and PDPs are carried out within the team and the information collated.

Co-operating with Trust management and others in meeting statutory and local requirements of the Health and Safety Policy.

Identifying strategies aimed at minimising risks to staff, patients, clients, and others that use the health service.

Having the responsibility for accident/incident reporting.

Developing systems and processes that engage with users of the service ensuring services are designed to meet need.

Valuing the contribution that users of the service can make in shaping services.

Leading by example to inspire others with the values and vision for the present and future of Community Nurses nursing patients with long term conditions/acute disease management highlighting to individuals, the team, and the Trust the benefits of new ways of working

Having the ability to constructively challenge current working practices and overcome barriers during times of change.

District Nurse Team Leader Role:

To promote the attainment and maintenance of optimum health of patients who have long term conditions and acute disease management through predictive and proactive case management of an identified caseload of patients.

To formulate care plans that address the expressed health, social and cultural needs of the patient as an individual through working in partnership with the patient, the GP, specialist nurses and other stakeholder providers.

To promote patient centred care by integrating and co-ordinating the activities of the patient, relatives and carers, the individual practitioners, and teams in the provision of an efficacious management strategy for managing an individuals long-term condition.

To ensure that appropriate information regarding the condition of the patient is known to the GP and other appropriate stakeholder providers, by the development and maintenance of effective systems of inter-agency, inter-disciplinary communications.

In liaison with Integrated Community Nursing Teams, Social Services and GPs, provide clinical leadership to nursing teams to enable them to develop approaches that address the needs of patients with complex long-term conditions and acute disease.

Support pathways for smooth transition between primary, secondary, and tertiary care for patients, particularly those who are newly diagnosed or whose symptoms are poorly controlled, by liaison with specialists within primary and secondary care. Making direct referral of patients for medical assessment and diagnostic procedures using the care pathways approach.

Inform the development of policies and procedures relevant to the care of people with long term conditions and acute diseases by co-operating and assisting in research programmes relating to the client group. Valuing the contributions that users of the service can make in reshaping services by developing systems and processes that engage those users meaningfully to ensure services are designed to meet expressed need.

Ensure services are delivered and sustained in line with NICE guidelines/local targets and understand principles of disease management by leading, motivating, educating, and developing colleagues and others.

Promote admission avoidance and early discharge by effective liaison with internal and external stakeholders. Personal/Professional Development

Participating in the setting of personal objectives with the Operational Lead through the job appraisal and clinical supervision processes.

Giving advice on professional issues relating to community nursing.

Managing changes to ensure the smooth transition of new ways of working.

Identifying and investigating poor quality practices within the team and suggesting and agreeing actions to rectify practice.

Complying with and fulfilling the objectives of the Community Division.

Maintaining and continually updating professional knowledge and skills.

Undertaking yearly appraisals with team members, identifying their training, educational and development needs.

Assisting in the induction programme for new staff to the Merseycare NHS Foundation Trust as appropriate.

Using own knowledge and skills to inform the future development of policies and procedures relevant to Primary/Community care and district nursing in particular.

Ensuring the competencies relating to the nurse prescribing competency framework are maintained and developed.

Qualifications

Essential

• First level Registered Nurse
• First level qualification in District Nursing / specialist Practitioners qualification in District Nursing
• Nurse Prescriber V150/300
• Evidence of Post registration education in related areas

Desirable

• Practice Teacher/Supervisor and assessor experience
• Previous management course/qualification

Experience

Essential

• Evidence of leadership & management qualities
• Experience at Band 6 level in community nursing setting
• Demonstrable contribution to practice developments in community care /chronic disease management/long term conditions/palliative, end of life care
• Evidence of collaborative working with multi-professional colleagues
• Evidence of effective communication across all levels of the organisation and with all stakeholders

Desirable

• Research & Development experience
• Experience of managing complaints

Skills

Essential

• Ability to communicate highly complex information where there may be barriers to understanding
• Ability to exercise critical thinking skills
• Ability to analyse date and present information to various audiences
• Ability to implement programmes or work streams leading to service changes
• Demonstrates up to date evidence based clinical knowledge in relation to community nursing
• Forward thinking able to identify opportunities for improvement in service development
• Motivated - able to motivate self and others to deliver a quality service
• Operational planning and delivery of care for complex caseloads including chronic disease management/Long term conditions/palliative care
• Computer literate - ability to use software programmes designed to maximise the contribution to the post
• Must have access to a vehicle & be able to commute to meet the demands of the role and remain flexible - to meet the demands of the service

Knowledge

Essential

• Awareness of current initiatives within the local & National health economy and of applicable guidelines, protocols, and frameworks
• Knowledge and experience of budget management
• Up to date knowledge of current Government and Local agendas and how these translate into local practice
• Research & Development experience
• Experience of managing complaints
• Evidence of providing professional/clinical leadership at postgraduate level
• Good working knowledge of the clinical governance agenda/National & Local priorities

Desirable

• Research & Development experience
• Experience of managing complaints

Values

Essential

• Continuous Improvement
• Accountability
• Respectfulness
• Enthusiasm
• Support
• High professional standards
• Responsive to service users
• Engaging leadership style
• Strong customer service belief
• Transparency and honesty
• Discreet
• Change oriented

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).

Job responsibilities

The model of care is broadly as below:

- New referrals to the team (if accepted) are offered a new patient assessment with an ANP or medic. A CT head may be requested following this assessment if one has not already been requested by the GP.

- A follow up appointment will then be planned for the purpose of confirming the diagnosis, if appropriate, and once any pending CT scan is completed

- If suitable for treatment then this will be commenced by the team and the patient is monitored by the titration team nurses who will review the response to any medication changes and, once stable, a further review is completed at 6 months. Subsequently a shared care request is sent to the GP.

- Once a shared care agreement is in place then the patient is reviewed by an assistant practitioner every 6-12 months

- If a patient is in a care home then ongoing follow up would be completed by the care home liaison team for 6-12 month review

In the case of more complex memory referrals with higher level of risk or unsettled presentations then the process would be the same as above but the patient would be allocated a CPN. The CPN would then complete the follow up reviews for titration of memory medications and regular outpatient clinic appointment reviews with a medic would be offered.

For functional referrals, patients tend to be seen by medics and then followed up via outpatient clinic for as long as treatment and monitoring is required. Patients may also be allocated a CPN and can be discharged back to primary care if remaining settled on maintenance treatment.

Post diagnostic support is currently commissioned to be provided locally by the Alzheimers Society.

The post holder would be expected to work on Rio which is the Trusts electronic health record system, training for this will be provided on induction. The post holder would be required to record clinical activity accurately and comprehensively in a timely fashion. The post holder would undertake an annual appraisal, CPD and maintain professional registration with General Medical Council and abide by its professional codes of conduct. It is essential that the post holder has Mental Health Act Section 12(2) status which is integral to having Approved Clinician status. The post holder would participate in annual job plan review with the Clinical Director taking into account servicer configuration and delivery associated with modernisation. The post holder would work with local colleagues and managers ensuring efficient running of the services and also comply with the Trusts agreed policies, procedures, standing orders and financial instructions.

Please see job description for further details.

Registration

Essential

• Full registration with General Medical Council
• Inclusion on or eligible for inclusion on the Specialist Register of the General Medical Council or within 6 months of CCST/CCT or equivalent in Old age Psychiatry at date of interview
• Section 12 (2) Approval which is integral to Approved Clinician Status or demonstrated ability to gain approval

Desirable

• In good standing with GMC with respect to warning and conditions on practice

Qualifications and Training

Essential

• MbChb, MBBS or equivalent

Desirable

• Qualification or higher degree in medical education, clinical research or management
• Additional Qualifications
• Membership of the Royal College of Psychiatrists or equivalent, 3 years higher professional training in Old age psychiatry
• Undertaken 'Train the Trainer' and 'Equality and Diversity' Training

Transport

Essential

• Holds valid UK driving licence and will use own car for work related travel OR provides evidence of proposed alternative

Clinical Skills, Knowledge and Experience

Essential

• Excellent clinical knowledge in specialty
• Excellent clinical skills using bio-psycho-social perspective and wide medical knowledge
• Excellent oral and written communication skills in English Able to manage clinical complexity and uncertainty
• Makes decisions based on evidence and experience including the contribution of others Able to meet duties under MHA and MCA

Desirable

• Experience in working previously in similar roles at a relevant level
• Training or worked as a DoLs assessor
• Experience in management and service development Knowledge and use of IT systems

Academic Skills and Lifelong Learning

Essential

• Able to deliver undergraduate or postgraduate teaching and training
• Participated in continuous professional development
• Participated in research or service evaluation
• Able to use and appraise clinical evidence
• Has actively participated in clinical audit

Desirable

• Able to plan and deliver teaching and training relevant to this post
• Reflected on purpose of CPD undertaken
• Experienced in clinical research and / or service evaluation
• Has led clinical audits leading to service change

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

Certificate of Sponsorship

Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).

From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).