Consultant Lead for CPMG Team

Job description

Job responsibilities

Objectives for the Complex Patient Management Group

Support GPs in the management of their most complex patients and provide advice, support, and education on how to do this in the community.

Advise on mitigation strategies in both medical and social care provision to prevent unplanned hospital admissions and promote wellness.

Advise on services to promote health and well-being via the health, social care and voluntary sectors for patients, families, and carers.

Complex Patient Management Group Services

Multidisciplinary review of patients referred to the service by a team composed of GP, Consultant Geriatrician, Nurse Case Manager and Care Navigator liaising with Social and Mental Health Services with triage for level of service and advice.

Provide Nurse Case Assessment and Management of Patient Needs.

Provide Advice on the Medical and Social Care management for referred patients.

Direct Advice & Support to a GP for specific issue

Review of care plans of difficult to manage patients.

Virtual Ward Round of patients on case load.

Face to Face Review of exceptionally complex patients medical needs (to be performed after virtual MDT review of the patient and decided by the team)

Provide Care Navigation for Social Services for patients.

CPMG is a Consulting Service for Support of Kilburn GPs not a Care Service

For the support and education of Kilburn GPs and Nurses to manage more complex patients with appropriate support from the PHC Team & Secondary care first and members of the CPMG second.

A consulting service with limited resources most patients will be assessed, a plan made, and care advice returned to the GP to action with specific support from the team as outlined in the plan.

Use of existing medical and social services to be advised not replaced by this service.

Face to face review of patients only for complex patients will be decided by the MDT.

Expected outcomes of CPMG

GPs to be provided with cohesive care plans for them to action concerning medical care with support from the Case Manager and Care Navigator as needed.

Clinical Responsibility to be retained by the GP, medical advice, and support to be given to the GP and ongoing review to be provided by the GP with open door for advice if the situation changes.

Once stable Case Manager will discharge back to GP with open door to provide advice or re-referral if change occurs.

Care navigator to provide and support links to services and discharge from case load once they have been actioned.

Person Specification

Experience

Essential

• Clinical Governance principles
• Awareness of current General Medical practices

Qualifications

Essential

• Full GMC Registration, MRCP
• MBBS or equivalent

Desirable

• Other degrees, e.g., BSc MSc, MD, PhD

SKILLS

Essential

• Ability to make decisions at consultant level.
• Sufficient leadership, organisational, communication, professional and personal skills to effectively undertake the role of consultant.
• Ability to inspire, lead and motivate team.
• Good team working skills.
• Computer-literate in clinical software and Microsoft Office applications (word processing, presentation, spreadsheet, and database analysis)
• Experience

PERSONALITY

Essential

• Caring with Compassion
• Respect and Dignity
• Striving to Excel

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

Kilburn Primary Care Co-Op Ltd

Address

Unit 11-12 The Tay Building 2a

Wrentham Avenue

London

NW10 3HA

Employer's website

https://www.kilburnprimarycare.co.uk (Opens in a new tab)