Senior Clinical Case Reviewer/Assessor, NHS CHC Appeals
NHS Lancashire and South Cumbria Integrated Care Board (125)
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Job summary
Previous applicants within the last 9 months need not apply.
The post holder will have a lead and managerial role with respect to NHS Continuing Healthcare (CHC) appeals and retrospective reviews. The role will involve scrutinising and analysing the appropriate health and social care information, meeting with representatives to attempt to resolve the dispute locally, considering and examining representative comments and helping to prepare final reports. The post holder will have line manager responsibilities and take a leading role in relation to NHS England's Independent Review Panel hearings.
Main duties of the job
- Provide clinical expertise for CHC Appeals, and retrospective reviews.
- Ensure the National Framework and local processes have been robustly applied within the dispute and retrospective review process, with evidence to support CHC eligibility recommendations and decision making.
- Co-ordinate and Chair both local resolution and retrospective claim meetings and provide the expert clinical CHC advice at the meetings where patients/families have disputed decisions or requested back dated reviews of eligibility.
- Line manage and support clinicians and administrators working in the appeal/retrospective team
- Work to timescales in line with National Framework guidance in respect of CHC disputes and previously unassessed periods of care assessments.
- Support Line Manager to review CHC appeals and retrospective review processes to identify any opportunities to improve pathways as appropriate to enhance quality and effectiveness.
- Meet with patients/representatives in potentially highly contentious situations and provide responses to complex CHC disputes.
- Provide timely relevant correspondence to patients/families/representatives ensuring they are kept informed of developments
- Ensure the relevant documentation including Health and Social care records are provided in a timely manner to NHS England as part of the independent review panel appeal process
- Provide 1:1 support, supervision, development reviews and appraisals to band 6 clinicians and administration staff.
About us
- Adhere to and uphold the ICB's vision and values
- Observe the provisions of and adhere to all ICB policies and procedures
- Complete ICB Statutory and Mandatory training as required and any other training courses relevant to the post
- Abide by the ICB's commitment that all staff will be treated with respect by management, colleagues, patients and visitors and equally staff will treat management, colleagues, patients and visitors with the same level of respect. Staff will be supported to challenge any discriminatory behaviour that may be based on differences in race, disability, language, culture, religion, sexuality, age, and gender or employment status.
- Adhere to relevant Code of Practice of Professional body (if appropriate)
The post holder must be flexible in the duties performed and it is expected that similar duties, not specifically listed above, will be carried out as required and may be cross site.
Not to reapply if have done in the last 12 months.
Date posted
13 March 2024
Pay scheme
Agenda for change
Band
Band 7
Salary
£43,742 to £50,056 a year per annum
Contract
Permanent
Working pattern
Full-time, Part-time, Job share
Reference number
125-ICB007-24-A
Job locations
County Hall
Fishergate Hill
Preston
PR1 8XB
Employer details
Employer name
NHS Lancashire and South Cumbria Integrated Care Board (125)
Address
County Hall
Fishergate Hill
Preston
PR1 8XB
Employer's website
https://www.lancashireandsouthcumbria.icb.nhs.uk/ (Opens in a new tab)
For questions about the job, contact:
Supporting documents
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