Job responsibilities
Summary:
Exeter City
PCN (ECPCN) has developed a same day service to support our patients and GPs
in providing care for med- low risk patients who present to the practice for on
the day support and advice alongside some routine follow up work.
The post
holder will work as part of a multi-disciplinary team and within their clinical
competencies to provide expertise in mental health management using their
clinical skills to manage patients safely mainly over the telephone with some in person support, and prescribe
accordingly if able and required.
This role is
pivotal to improving the quality of mental health care for patients across the
PCN who contact the surgeries with on the day queries and requests. You will
also be able to support and signpost or refer patients to other appropriate
services or colleagues within the well-established Mental Health and Wellbeing
Team. The team comprises of 2 Health Coaches, a Social Prescriber, Assessment
and Brief Intervention Worker (ABI), Mental Health Nurse Prescriber.
The post
holder role is part of DEVON ICB and Exeter City PCN joint pilot to evaluate
the role of non-GP interventions in increasing capacity in general practice.
The post holder may be asked to contribute to data collections and support
review of the service.
Scope and Purpose of the role
The post holder will be responsible
for the ongoing development and delivery of these processes within the PCN, including:
Working with the PCN Same Day Service
Team to provide support to patients with urgent mental health needs, queries or
concerns. This includes providing telephone and online support as well as occasional in person support..
Supporting patients to make best use
of alternative services such as community based voluntary services as well as
formal NHS support pathways.
Working with the SDS Team to ensure
that clinically med - low risk patients feel listened to and can access advice
for mental health concerns and brief assessments for urgent interventions.
Assessment of risk and detailed actions for
colleagues to review and follow up.
Work within own professional boundaries and support
team members to provide a holistic service to patients, and ensuring any issues
identified during the review are acted upon in a timely fashion.
Using specialist knowledge of
barriers, both real and perceived, in accessing care, adherence to medication,
multi-morbidity, frailty and communication skills across a range of physical
and cognitive limitations, to formulate solutions for individual patients
issues, and support patients to make best use of the support available to them.
KEY RESPONSIBILITIES:
Provide comprehensive assessment, care and
safety planning for patients referred through the PCN practices for on the day
support.
Provide appropriate prescribing within
scope of own practice if appropriate.
Provide purposeful interventions and
signposting that promotes recovery and enables patients to self-select
appropriate pathways available to them.
Ensure accurate and timely clinical
documentation in line with your professional Code and PCN policy.
Develop and maintain specialist clinical
skills and expertise in the assessment and treatment of people with mental
health needs.
Offer advice on management of patients with
mental health issues to other health care professionals, advocating for best
practice in line with PCN and national guidance.
Assess, investigate, treat, or refer
patients to other services or colleagues within guidelines and the scope of
practice.
Ensure that patients requiring further
assessment and help are referred on appropriately.
Identify and implement effective joint care
planning for people who repeatedly contact the service for assessment.
Arrange admission to the mental health
services in conjunction with the patient's own GP where appropriate.
Liaise effectively with staff in local
systems and maintain accurate patient records that provide assessment reports
to GPs and other allied agencies.
To provide advice and monitor the use and
provision of the Mental Health/Capacity Act (1983/2005) and other relevant
legislation.
To provide clinical advice/expertise health
education, consultation and staff support to other health professionals.
Have knowledge of how to access appropriate
services and develop effective networks and channels of communication.
To actively participate in the achievement
of clinical outcome measures and accreditations for the service
Managerial:
Provide clinical supervision for junior
team members (wellbeing coaches).
Support the Clinical Lead in ensuring the
effective provision of care, service developments of the Same Day Service Team
Ensure that referral, assessment, and
workload allocation happens in a timely, flexible and responsive manner.
Participate in team meetings, initiating
and discussing new methods/models of care using QI methodology and contribute to
the Devon ICB and Exeter City PCN joint pilot.
Participate in the multi-disciplinary and
multi-agency decision-making process through team meetings and team building
when required.
Undertake duties as assigned by senior
staff to ensure that all agreed patient quality, safety and operational
performance outcomes are delivered within the area of responsibility.
Provide specialist advice, support, and
consultation to staff within the team, outside teams and other agencies.
The post holder will support the
introduction of outcome measures, to measure patient experience.
Contribute towards team education and
development providing opportunities for exchange of ideas, experience,
techniques and interventions.
A holistic approach to care is required
that encompasses physical health, mental health and social care.
Take part in service development and
review.
Responsibility for Patient/Client Care:
Develop and maintain effective
individualised care by ensuring the following areas are proactively undertaken
at all times:
Triage and assessment of client mental,
physical and social care needs.
Planning, implementation and evaluation of
clinical interventions
Clear, accurate and concise documentation
of individualised patient care and reflect the changing needs of the patients.
Ensure risk assessment and management is an
integral part of everyday practice.
All work will be undertaken within the
post holders clinical competence, ensuring that patients are referred to the
appropriate clinician as necessary.
Working
with the PCN Same Day Service Team, PCN Teams, GPs and practice teams to
further develop and participate in the service to all patients within the PCN.
Effectively communicating integrated patient centred-care through
appropriate working with the wider health and social care team.
Liaising with hospital and community providers where
specialist expertise is needed above that provided by our PCN teams.
Signposting patients and promoting
self-care as appropriate.
Supervision and Training
An Induction programme will be
provided.
Monthly meetings with the PCN Clinical
Director will be provided for more formal supervision.
Day-to-day clinical supervision: will always
have access to a GP where appropriate in each practice.
Clinical supervision provision to be monitored
by PCN Clinical Director.
Quality:
The post-holder will:
Alert other team members to issues of quality
and risk, reporting Significant Events as they arise and participating in the review
and learning of incidents.
Assess own performance and take accountability
for own actions, either directly or under supervision.
Contribute to the effectiveness of the team by
reflecting on own and team activities and making suggestions on ways to improve
and enhance the teams performance.
Work effectively with individuals in other
agencies to meet patients needs.
Effectively manage own time, workload and
resources.
Participate in audit, where appropriate
Personal & Professional Development:
The post-holder will:
Participate in the lead practices mandatory
training programme and an annual individual performance review, including
taking responsibility for maintaining a record of own personal and/or
professional development.
Take responsibility for own development,
learning and performance and demonstrating skills and activities to others who
are undertaking similar work.