Palliative Care Discharge Support Nurse

Job summary

The Palliative Care Discharge Support Nurse will provide a high-quality, patient-centred service within Kingston and Richmond NHS Foundation Trust Specialist Palliative Care Team, supporting patients with complex palliative care needs regardless of diagnosis. As an integral member of the multidisciplinary team, the postholder will contribute to the coordination of specialist palliative care discharges across the Trust, ensuring seamless transitions between hospital, community, and primary care services.

Key responsibilities include coordinating multidisciplinary team (MDT) input to facilitate safe, timely, and holistic discharges; providing guidance and signposting to appropriate services for patients, families, and caregivers; and actively promoting and disseminating best practice through liaison with patients, carers, and MDTs. The role requires exceptional communication skills across diverse patient populations and the effective utilisation of multiple resources including IT systems, professional networks, and clinical guidance to ensure optimal discharge planning and continuity of care.

Main duties of the job

1. Expert Clinical Practice

• Liaise directly with key stakeholders across all health and social care settings to ensure continuity of patient care.
• Ensure patients and families/carers receive appropriate oral and written information regarding planned care.
• Work as an integral member of the multidisciplinary team to develop and improve service delivery.
• Build effective relationships with other departments, regional and national organisations to ensure coordinated care.
• Contribute to the development of integrated care pathways (ICP) in collaboration with the multidisciplinary team.
• Continuing Healthcare and Care Planning Responsibilities:
  • Take a lead on the assessment and completion of Fast Track Continuing Healthcare (CHC) applications for palliative and end of life care patients and liaise with CHC teams to secure funding and carers for patients.
  • Complete and update Universal Care Plans, ensuring documentation is accurate and up to date.

2. Education

• Ensure the health education needs of patients and their families/carers are met, escalating to MDT support if required.
• Develop personal knowledge, skills, and expertise to a higher academic and clinical standard.

3. Research and Audit

• Maintain awareness of the value of quality research in improving patient care.
• Use up-to-date research and evidence to inform patient care and disseminate knowledge across the MDT.
• Be aware of ongoing research within the specialist area.

About us

Development and staff wellbeing

Your growth and personal happiness matters to us. After all, we can't expect the best from you if we don't invest in your development and nurture your wellbeing. From the moment you join us, we're committed to fostering your professional and personal development with a supportive, empowering environment. Whether you're just starting your career or looking to advance further, we provide you with the tools and opportunities you need to succeed. We actively support colleagues to take part in research, quality improvement and innovation, whatever their role or level in the organisation.

To support your wellbeing, we offer an extensive range of resources, including on-site staff nursery at Kingston Hospital, wellbeing practitioners, regular wellbeing classes, dedicated staff physiotherapist, comprehensive occupational health services, 24/7 employee assistance programme, and a range of other support and activities.

We also take every opportunity to thank and recognise the work our teams do, through weekly "shoutouts" and patient feedback, monthly and staff awards.

Our Trust values

These words are important reminders, but it's our behaviours that tell people who we are. We expect all colleagues to bring values to life in their work.

• Compassionate
• Inclusive
• Collaborative
• Inspiring

Employer details

Employer name

Kingston and Richmond NHS Foundation Trust

Address

Kingston hospital

Galsworthy Road

Kingston upon Thames

KT2 7QB

Employer's website

https://www.kingstonandrichmond.nhs.uk/ (Opens in a new tab)

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Employer details

Employer name

Kingston and Richmond NHS Foundation Trust

Address

Kingston hospital

Galsworthy Road

Kingston upon Thames

KT2 7QB

Employer's website

https://www.kingstonandrichmond.nhs.uk/ (Opens in a new tab)

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