Oxleas NHS Foundation Trust

PICU Outreach Senior Practitioner

The closing date is 03 September 2025

Job summary

The PICU Outreach Senior Practitioner post is a newly established role in Oxleas; it has been set up with funding from the South East London MHLDA Quality Improvement Plan. The overall aim of this plan is to ensure that staff and service users in the inpatient services can be supported in the most effective way through a holistic and inclusive therapeutic care environment.

A PICU (Psychiatric Intensive Care Unit) is a specialised unit to manage and treat patients who are suffering from mental illness who present with challenging, aggressive, or other risk behaviours such as absconding, where the risk is too high to be managed on acute mental health wards.

The Tarn PICU is a 14 bedded unit, located in the Oxleas House Mental Health Unit in Woolwich. It is a male only unit that admits men between 18-65 years. It is the only PICU in Oxleas NHS Foundation Trust.

Female patients who require PICU admission or male patients who cannot be admitted to the TARN PICU are placed in other PICUs (called Out of Area or Private PICUs). The Tarn PICU receives referrals from services within Oxleas as well as outside Oxleas, such as prisons and other (non-Oxleas) hospitals.

The post holder will be providing expert clinical leadership, advanced assessment and intensive case management for all patients on the PICU pathway. They will act as the Trust's senior clinical resource for PICU-level care, ensuring safe, effective, and timely transitions into, through, and out of intensive care settings.

Main duties of the job

Provide highly specialised advice and clinical consultation both internally and externally on the management and care of patients with complex needs at risk of, or requiring, PICU admission.

To clinically lead the gatekeeping process for all PICU referrals, undertaking advanced assessments to ensure placements are necessary, appropriate and the least restrictive option available.

Collaborate closely with ward teams, multidisciplinary professionals, service users and carers to co-produce holistic, person-centred care plans aligned with assessed PICU needs.

Work collaboratively with PICU services to manage complex service users, developing and implementing individualised, person-centred care and risk management plans.

Actively drive patient flow across the care pathway, including proactive discharge planning and timely transfers between services.

Support the implementation and embedding of new clinical care pathways,working closely with the Matron to integrate updated practices into team operations.

Provide clinical consultation to ward teams on evidence-based strategies for managing acute behavioural disturbance to prevent PICU admission where possible.

Take a lead role in complex multi-agency and MDT meetings, including those with external providers and justice system partners, to formulate and review robust care and risk management plans.

Be flexible in travel across Oxleas sites.

Travel to external providers to conduct in-person assessments as required.

About us

Oxleas offers a wide range of NHS healthcare services to people in community and secure environment settings. Our services include community health care such as district nursing and speech and language therapy, care for people with learning disabilities and mental health care such as psychiatry, nursing and therapies. Our multidisciplinary teams look after people of all ages and we work in close partnership with other parts of the NHS, local councils and the voluntary sector and through our new provider collaboratives. Our 4,300 members of staff work in many different settings including hospitals, clinics, prisons, secure hospitals, children's centres, schools and people's homes.We have over 125 sites in a variety of locations in the South of England. In London we operate within the Boroughs of Bexley, Bromley Greenwich and into Kent. We manage hospital sites including Queen Mary's Hospital, Sidcup and Memorial Hospital, Woolwich, as well as the Bracton Centre, our medium secure unit for people with mental health needs. We are the largest NHS provider of prison health services providing healthcare to prisons within Devon, Dorset, Bristol, Wiltshire and Gloucestershire, Kent and South London. We are proud of the care we provide and our people.

Our purpose is to improve lives by providing the best possible care to our patients and their families. This is strengthened by our new values:

We're Kind
We're Fair
We Listen
We Care

Date posted

20 August 2025

Pay scheme

Agenda for change

Band

Band 7

Salary

£53,751 to £60,651 a year pa inc

Contract

Permanent

Working pattern

Full-time

Reference number

277-7404506-AAC

Job locations

Oxleas House, Queen Elizabeth Hospital

Stadium Road

London

SE18 4QH

Job description

Job responsibilities

Management responsibilities

Occasional cross-cover of same grade banded staff within the PICU expected.

Support recruitment processes as required.

Assist with the formal complaints process related to PICU care and transfers by supporting investigations and implementing appropriate actions.

Set standards of behaviour and performance in line with Trust objectives and KPIs.

Ensure efficient use of Oxleas resources within own area of responsibility, promoting value for money and service sustainability.

Act as an authorised signatory for approved departmental financial payments, responsible for the efficient procurement and management of essential physical assets and supplies, adhering to financial policies and procedures.

Actively contribute to monitoring expenditure against agreed budgets for out of area PICU placements, identifying opportunities for financial efficiencies or initiatives.

Leadership

Provide visible leadership and advanced clinical expertise in mental health, playing a key role in the direct delivery of care.

Act as a clinical leader and ambassador for the Trusts standards of care when liaising with external providers, ensuring quality and value for money in out-of-area placements.

Act as a clinical leader within the acute care setting supporting the development of evidence-based mental health practices in line with Trust policies, NICE guidance and PICU guidelines.

Provide clinical supervision, mentorship and support to junior staff, contributing to their professional development and promoting a culture of continuous learning, across Adult PICU and inpatient settings in the Acute & Crisis Directorate.

Attend and contribute to key handovers, leading complex case discussions related to PICU service users, including their risks, needs, and care planning.

Lead MDT discussions relating to allocation of appropriate pathways for patients with complex needs entering and exiting the PICU pathway.

Act as a clinical role model, mentor and educator, providing supervision, support and guidance to healthcare team members in Adult Acute and PICU settings to promote excellence in clinical practice.

Facilitate clinical debriefings and clinical supervision sessions relating to PICU patients as needed.

Deliver local induction programmes to newly recruited nurses across Adult Inpatient/PICU settings.

Act as a role model and take the lead in restrictive practice interventions when working within the clinical environment.

Participate in the planning, organisation and delivery of specific and education programmes for the multi-disciplinary healthcare teams within the acute mental health services.

Play an active and constructive role in service improvement initiatives, delivering agreed actions within set timeframes and supporting colleagues effectively through periods of change.

Ensure clinical environment is conducive to supporting the education and learning of all staff and students.

Clinical

Autonomously conduct advanced clinical assessments, including comprehensive reviews of patient records and face-to-face assessments (often in external or challenging environments), to formulate and direct care plans.

Proactively develop, implement, and evaluate safe, person-centred care strategies in partnership with service users and carers to support recovery journeys.

Autonomously promote and deliver evidence-based care for patients presenting with complex mental health symptoms within relevant statutory frameworks.

Ensure ongoing competence assurance through regular skills assessments and targeted training.

Engage effectively with patients experiencing acute distress or hostility, utilising de-escalation and therapeutic engagement techniques.

Able to conduct comprehensive assessments including thorough reviews of patient records and face to face assessments and prepare a professional summary including care plans.

Apply advanced clinical knowledge to recommend adjustments to treatment plans where appropriate including pharmacological and psychosocial interventions, and act as a patient advocate to ensure their needs and preferences are central to care decisions.

Support the multidisciplinary team in empowering service users and their carers to make informed choices that enhance health and wellbeing.

Adhere to all relevant Trust policies, procedures and the NMC Code of Conduct, seeking senior advice when faced with non-routine clinical challenges.

Maintain and promote a safe and therapeutic environment, ensuring adherence to infection prevention protocols and promptly reporting potential risks or hazards.
Lead the clinical response to challenging behaviours associated with acute mental illness during transitions of care, utilising de-escalation and therapeutic engagement techniques.
Manage and respond to challenging behaviours associated with acute mental illness.

To be PMVA trained and competent in the use of restraint techniques.

Work effectively under pressure and manage competing priorities.

Take responsibility for assessing complex care needs, developing and evaluating collaborative care plans, including Positive Behaviour Support plans, and setting high standards of care to ensure service quality.

Demonstrate adaptability and professionalism in a challenging and varied environment, providing compassionate and high-quality care while upholding the Trusts values across all areas of practice.

Research

Interpret and analyse relevant national policies related to PICU, providing expert guidance on their implications for the service, and leading on the implementation and evaluation of changes in collaboration with the multidisciplinary team.

Demonstrate a clear understanding of internal and external factors influencing services and the rationale behind ongoing improvements.

Evaluate the impact of service development initiatives and identify further actions to support progress toward strategic goals.

To design and lead on audits of the PICU care pathway, including referral criteria, out-of-area placement duration, and patient outcomes, to drive quality improvement and service development.

Participate in audits, research and quality improvement projects aimed at enhancing care and outcomes in PICU and other inpatient settings.

Collaborate closely with Lived Experience Practitioners to ensure that hard-to-reach groups are actively involved in improvement projects across the Acute & Crisis directorate.

Communication

Apply highly developed communication skills to ensure high-quality service delivery in complex and high-pressure environments.

Facilitate continuity of care for service users with PICU needs by strengthening collaboration and communication between acute services and community teams.

Respond promptly and effectively to concerns raised by service users or carers.

Liaise with other agencies/teams, including police, forensic services, private PICU and Patient Flow Team, to ensure coordinated and effective care pathways.

Clearly document all aspects of assessment, formulation and management plans using electronic record systems.

Compile reports based on key performance indicators to contribute to development and improvement of services.

Utilise the SBAR tool to effectively communicate clinical concerns and sensitive information with colleagues, including the Consultant Psychiatrist, Community Mental Health Team, Ward MDT and Safeguarding teams.

Communicate complex information to patients and carers with clarity, adapting communication methods to meet individual needs.

Maintain effective and professional communication with all service users, carers and healthcare team members, including attending multidisciplinary handovers and CPA (Care Programme Approach) reviews.

Act as an advocate for patients and colleagues, ensuring their voices are heard and respected in care planning and decision-making.

Be knowledgeable about guidance and support services (e.g. PALS) and provide accessible information to patients, referring appropriately when challenges are identified.

On Call/Unsocial Hours

Not applicable for this post.