Community Frailty Nurse

Hyde PCN

The closing date is 10 May 2025

Job summary

The Band 5 Community Frailty Nurse will work as part of a multidisciplinary team to provide high-quality, person-centred care to older adults living with frailty in the community and in care homes. The post holder will assess, plan, implement, and evaluate care needs, promoting independence and improving quality of life. This role involves close collaboration with GPs, social services, allied health professionals, and voluntary sector partners.

Main duties of the job

Key Responsibilities:

  • Deliver holistic nursing assessments and contribute to comprehensive geriatric assessments (CGA) in community settings (home visits, clinics, care homes).
  • Develop, implement, and review personalised care plans that meet the physical, emotional, and social needs of frail older adults.
  • Identify early signs of deterioration and implement proactive interventions to avoid hospital admissions where appropriate.
  • Promote self-management and independence in patients with long-term conditions.
  • Work collaboratively with the wider multidisciplinary team, including GPs, therapists, social workers, and support workers.
  • Support discharge planning and transitional care from acute settings back into the community.
  • Provide health education to patients, families, and carers.
  • Support in advanced care planning conversations where appropriate.
  • Maintain accurate and timely clinical records in accordance with local policies and NMC standards.
  • Participate in clinical supervision, audits, and service development initiatives.

About us

We are Healthy Hyde, who work with the 8 GP practices in Hyde. We are a Primary Care Network (PCN) supporting 72,000 patients in Tameside. We have a team of wellbeing practitioners, nurses, paramedics, mental health nurses, first contact physios and care co-ordinators who work with your community in multiple ways. These staff provide in excess of 5000 appointments every month.

Our priority is to support our practices in any way we can, to ensure the best possible healthcare & access to local services. We endeavour to make the best use of our resources to ensure that every one of our patients gets the help and support that they need and deserve.

Date posted

22 April 2025

Pay scheme

Other

Salary

£31,235.74 a year

Contract

Fixed term

Duration

1 years

Working pattern

Full-time

Reference number

A3778-25-0000

Job locations

Healthy Hyde PCN

Clarendon Mall

Hyde

Tameside

SK14 2QT


Job description

Job responsibilities

Job Specification: Band 5 Community Frailty Nurse

Job Title:Band 5 Community Frailty NurseDepartment:Hyde Primary Care NetworkLocation:HydeReports to:Community MatronSalary Band:Band 5Hours:Full Time/ 37.5 HoursContract Type:[Permanent]

Job Summary:

The Band 5 Community Frailty Nurse will work as part of a multidisciplinary team to provide high-quality, person-centred care to older adults living with frailty in the community and in care homes. The post holder will assess, plan, implement, and evaluate care needs, promoting independence and improving quality of life. This role involves close collaboration with GPs, social services, allied health professionals, and voluntary sector partners.

Key Responsibilities:

  • Deliver holistic nursing assessments and contribute to comprehensive geriatric assessments (CGA) in community settings (home visits, clinics, care homes).
  • Develop, implement, and review personalised care plans that meet the physical, emotional, and social needs of frail older adults.
  • Identify early signs of deterioration and implement proactive interventions to avoid hospital admissions where appropriate.
  • Promote self-management and independence in patients with long-term conditions.
  • Work collaboratively with the wider multidisciplinary team, including GPs, therapists, social workers, and support workers.
  • Support discharge planning and transitional care from acute settings back into the community.
  • Provide health education to patients, families, and carers.
  • Support in advanced care planning conversations where appropriate.
  • Maintain accurate and timely clinical records in accordance with local policies and NMC standards.
  • Participate in clinical supervision, audits, and service development initiatives.

Person Specification:

Qualifications and Training:

  • Registered Nurse (Adult) with current NMC registration
  • Evidence of continuing professional development
  • Relevant post-registration courses or willingness to undertake them (e.g. frailty, long-term conditions, or community nursing)

Experience:

  • Experience in a clinical nursing role (community or acute)
  • Community experience (Essential)
  • Experience working with older adults and/or individuals with complex needs (desirable)
  • Experience in multi-disciplinary or multi-agency working (desirable)

Knowledge and Skills:

  • Understanding of frailty, long-term conditions, and community-based care models
  • Ability to undertake clinical assessments and deliver evidence-based care
  • Strong communication, interpersonal, and organisational skills
  • IT literacy, including use of electronic patient records
  • Ability to work autonomously and as part of a team

Personal Attributes:

  • Empathetic and patient-focused
  • Flexible, adaptable, and responsive to change
  • Committed to promoting dignity, respect, and independence
  • Full UK driving licence and access to a vehicle (or ability to travel efficiently across the locality)

Other Requirements:

  • Enhanced DBS check required
  • Willingness to work flexibly across service hours

Job Types: Full-time, Permanent

Pay: £31,235.74 per year

Benefits:

  • Company pension
  • Cycle to work scheme
  • Free flu jabs
  • On-site parking

Schedule:

  • Monday to Friday

Work Location: In person

Job description

Job responsibilities

Job Specification: Band 5 Community Frailty Nurse

Job Title:Band 5 Community Frailty NurseDepartment:Hyde Primary Care NetworkLocation:HydeReports to:Community MatronSalary Band:Band 5Hours:Full Time/ 37.5 HoursContract Type:[Permanent]

Job Summary:

The Band 5 Community Frailty Nurse will work as part of a multidisciplinary team to provide high-quality, person-centred care to older adults living with frailty in the community and in care homes. The post holder will assess, plan, implement, and evaluate care needs, promoting independence and improving quality of life. This role involves close collaboration with GPs, social services, allied health professionals, and voluntary sector partners.

Key Responsibilities:

  • Deliver holistic nursing assessments and contribute to comprehensive geriatric assessments (CGA) in community settings (home visits, clinics, care homes).
  • Develop, implement, and review personalised care plans that meet the physical, emotional, and social needs of frail older adults.
  • Identify early signs of deterioration and implement proactive interventions to avoid hospital admissions where appropriate.
  • Promote self-management and independence in patients with long-term conditions.
  • Work collaboratively with the wider multidisciplinary team, including GPs, therapists, social workers, and support workers.
  • Support discharge planning and transitional care from acute settings back into the community.
  • Provide health education to patients, families, and carers.
  • Support in advanced care planning conversations where appropriate.
  • Maintain accurate and timely clinical records in accordance with local policies and NMC standards.
  • Participate in clinical supervision, audits, and service development initiatives.

Person Specification:

Qualifications and Training:

  • Registered Nurse (Adult) with current NMC registration
  • Evidence of continuing professional development
  • Relevant post-registration courses or willingness to undertake them (e.g. frailty, long-term conditions, or community nursing)

Experience:

  • Experience in a clinical nursing role (community or acute)
  • Community experience (Essential)
  • Experience working with older adults and/or individuals with complex needs (desirable)
  • Experience in multi-disciplinary or multi-agency working (desirable)

Knowledge and Skills:

  • Understanding of frailty, long-term conditions, and community-based care models
  • Ability to undertake clinical assessments and deliver evidence-based care
  • Strong communication, interpersonal, and organisational skills
  • IT literacy, including use of electronic patient records
  • Ability to work autonomously and as part of a team

Personal Attributes:

  • Empathetic and patient-focused
  • Flexible, adaptable, and responsive to change
  • Committed to promoting dignity, respect, and independence
  • Full UK driving licence and access to a vehicle (or ability to travel efficiently across the locality)

Other Requirements:

  • Enhanced DBS check required
  • Willingness to work flexibly across service hours

Job Types: Full-time, Permanent

Pay: £31,235.74 per year

Benefits:

  • Company pension
  • Cycle to work scheme
  • Free flu jabs
  • On-site parking

Schedule:

  • Monday to Friday

Work Location: In person

Person Specification

Qualifications

Essential

  • Qualifications and Training:
  • Registered Nurse (Adult) with current NMC registration
  • Evidence of continuing professional development
  • Relevant post-registration courses or willingness to undertake them (e.g. frailty, long-term conditions, or community nursing)
  • Experience:
  • Experience in a clinical nursing role (community or acute)
  • Community experience (Essential)
  • Experience working with older adults and/or individuals with complex needs (desirable)
  • Experience in multi-disciplinary or multi-agency working (desirable)
  • Knowledge and Skills:
  • Understanding of frailty, long-term conditions, and community-based care models
  • Ability to undertake clinical assessments and deliver evidence-based care
  • Strong communication, interpersonal, and organisational skills
  • IT literacy, including use of electronic patient records
  • Ability to work autonomously and as part of a team
  • Personal Attributes:
  • Empathetic and patient-focused
  • Flexible, adaptable, and responsive to change
  • Committed to promoting dignity, respect, and independence
  • Full UK driving licence and access to a vehicle (or ability to travel efficiently across the locality)
  • Other Requirements:
  • Enhanced DBS check required
  • Willingness to work flexibly across service hours

Desirable

  • Qualifications and Training:
  • Registered Nurse (Adult) with current NMC registration
  • Evidence of continuing professional development
  • Relevant post-registration courses or willingness to undertake them (e.g. frailty, long-term conditions, or community nursing)
  • Experience:
  • Experience in a clinical nursing role (community or acute)
  • Community experience (Essential)
  • Experience working with older adults and/or individuals with complex needs (desirable)
  • Experience in multi-disciplinary or multi-agency working (desirable)
  • Knowledge and Skills:
  • Understanding of frailty, long-term conditions, and community-based care models
  • Ability to undertake clinical assessments and deliver evidence-based care
  • Strong communication, interpersonal, and organisational skills
  • IT literacy, including use of electronic patient records
  • Ability to work autonomously and as part of a team
  • Personal Attributes:
  • Empathetic and patient-focused
  • Flexible, adaptable, and responsive to change
  • Committed to promoting dignity, respect, and independence
  • Full UK driving licence and access to a vehicle (or ability to travel efficiently across the locality)
  • Other Requirements:
  • Enhanced DBS check required
  • Willingness to work flexibly across service hours
Person Specification

Qualifications

Essential

  • Qualifications and Training:
  • Registered Nurse (Adult) with current NMC registration
  • Evidence of continuing professional development
  • Relevant post-registration courses or willingness to undertake them (e.g. frailty, long-term conditions, or community nursing)
  • Experience:
  • Experience in a clinical nursing role (community or acute)
  • Community experience (Essential)
  • Experience working with older adults and/or individuals with complex needs (desirable)
  • Experience in multi-disciplinary or multi-agency working (desirable)
  • Knowledge and Skills:
  • Understanding of frailty, long-term conditions, and community-based care models
  • Ability to undertake clinical assessments and deliver evidence-based care
  • Strong communication, interpersonal, and organisational skills
  • IT literacy, including use of electronic patient records
  • Ability to work autonomously and as part of a team
  • Personal Attributes:
  • Empathetic and patient-focused
  • Flexible, adaptable, and responsive to change
  • Committed to promoting dignity, respect, and independence
  • Full UK driving licence and access to a vehicle (or ability to travel efficiently across the locality)
  • Other Requirements:
  • Enhanced DBS check required
  • Willingness to work flexibly across service hours

Desirable

  • Qualifications and Training:
  • Registered Nurse (Adult) with current NMC registration
  • Evidence of continuing professional development
  • Relevant post-registration courses or willingness to undertake them (e.g. frailty, long-term conditions, or community nursing)
  • Experience:
  • Experience in a clinical nursing role (community or acute)
  • Community experience (Essential)
  • Experience working with older adults and/or individuals with complex needs (desirable)
  • Experience in multi-disciplinary or multi-agency working (desirable)
  • Knowledge and Skills:
  • Understanding of frailty, long-term conditions, and community-based care models
  • Ability to undertake clinical assessments and deliver evidence-based care
  • Strong communication, interpersonal, and organisational skills
  • IT literacy, including use of electronic patient records
  • Ability to work autonomously and as part of a team
  • Personal Attributes:
  • Empathetic and patient-focused
  • Flexible, adaptable, and responsive to change
  • Committed to promoting dignity, respect, and independence
  • Full UK driving licence and access to a vehicle (or ability to travel efficiently across the locality)
  • Other Requirements:
  • Enhanced DBS check required
  • Willingness to work flexibly across service hours

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).

Additional information

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).

Employer details

Employer name

Hyde PCN

Address

Healthy Hyde PCN

Clarendon Mall

Hyde

Tameside

SK14 2QT

Employer details

Employer name

Hyde PCN

Address

Healthy Hyde PCN

Clarendon Mall

Hyde

Tameside

SK14 2QT

For questions about the job, contact:

Community Matron

Jodie Macleod

01613685426

Date posted

22 April 2025

Pay scheme

Other

Salary

£31,235.74 a year

Contract

Fixed term

Duration

1 years

Working pattern

Full-time

Reference number

A3778-25-0000

Job locations

Healthy Hyde PCN

Clarendon Mall

Hyde

Tameside

SK14 2QT


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