Job summary
The post holder will be responsible for assessing and determining eligibility for people with complex health needs with a focus on clients with learning disabilities ,who are eligible for NHS funding for long term care and treatments under The National Framework for NHS Continuing Healthcare and NHS Funded Nursing Care, The Mental Health Act, Transforming Care and Neurological Rehabilitation pathways.
The post holder has responsibility to clinically plan and commission the care required, ensuring that the care is safe, effective and good quality. Communication and relationships with individuals and independent providers are a key part of this role as well as abilities to manage risks, problem solve influence and negotiate to ensure appropriate clinical commissioning case management of complex individuals.
Main duties of the job
- The post holder will act as Individualised Commissioning Nurse for a defined caseload of patients , with learning difficulties, whose care is either jointly or solely funded by NHS GM and the care is provided by the independent sector.
- Identify and case manage any clients in a nursing home who may be eligible for NHS funding, to chair and coordinate eligibility assessments and reviews. This includes representing NHS GM in the ratification of decisions for NHS Continuing Healthcare and NHS Funded Nursing care and on duty.
- Act as Commissioning Case Manager for all individualised commissioned placements, purchased by NHS GM.
- Conduct contractual monitoring ensuring that contracts in place for individual clients in receipt of NHS funding are being adhered to as well as supporting and enabling providers to improve the quality-of-care delivery.
- Provide expert advice to other professionals commissioned to provide care in relation to NHS Individualised Commissioning.
- Complete the restitution process for all claims which includes presentation of findings to NHS GM multi-agency funding panel and the NHS England Independent review panel.
- Jointly conduct contract performance visits to ensure contractual obligations and quality care standards are being met.
About us
NHS Greater Manchester Integrated Care
Integrated Care Systems (ICSs) are partnerships of health and care organisations that come together to plan and deliver joined up services and to improve the health and wellbeing of people who live and work in their area. Their purpose is to improve outcomes in population health and healthcare; tackle inequalities in outcomes, experience, and access; enhance productivity and value for money and support broader social and economic development in their area efficiency. This will be delivered in the neighbourhood, place, combinations of places and GM system.
Job description
Job responsibilities
KEY DUTIES AND RESPONSIBILITIES
- The post holder will act as Individualised Commissioning Nurse for a defined caseload of patients whose care is either jointly or solely funded by NHS GM and the care is provided by the independent sector.
- Identify and case manage any clients in a nursing home who may be eligible for NHS funding, to chair and coordinate eligibility assessments and reviews. This includes representing NHS GM in the ratification of decisions for NHS Continuing Healthcare and NHS Funded Nursing care and on duty.
- Act as Commissioning Case Manager for all individualised commissioned placements, purchased by NHS GM.
- Conduct contractual monitoring ensuring that contracts in place for individual clients in receipt of NHS funding are being adhered to as well as supporting and enabling providers to improve the quality-of-care delivery.
- Provide expert advice to other professionals commissioned to provide care in relation to NHS Individualised Commissioning.
- Complete the restitution process for all claims which includes presentation of findings to NHS GM multi-agency funding panel and the NHS England Independent review panel.
- Jointly conduct contract performance visits to ensure contractual obligations and quality care standards are being met.
COMMUNICATION
- Co-ordinate and lead multi-disciplinary meetings, including patients and family/representatives, requiring excellent verbal communication skills to ensure all appropriate information is obtained in order that appropriate decisions are made regarding eligibility for NHS Continuing Healthcare.
- Understand and communicate complex information, both patient and non-patient related.
- Manage complex, sensitive and often contentious situations on a frequent basis.
- Act and deal appropriately with potentially aggressive/antagonistic situations
- Complete concise and accurate reports including reports to be presented for Court of Protection cases.
- Communicate complex and often sensitive and distressing information on a regular basis.
- Nurture key relationships and maintain internally and externally.
- Attend and contribute effectively to various meetings including safeguarding and quality of care meetings.
- Establish partnerships and networks with adult social care teams, voluntary sector and other agencies to ensure patients with complex continuing healthcare need have access to all resources available.
- Act in an educational and advisory role to staff in provider and other partner organisations in order to promote and share knowledge concerning, continuing Healthcare, Funded Nursing Care and Personal Health budgets.
- Participate in pre and post registration training for staff from multi-professional backgrounds.
INFORMATION RESOURCES ANALYSIS AND DECISION MAKING
- Responsible for producing assessments and reports using appropriate information technology
- Maintain up-to-date, accurate records, inputting case management into the electronic patient system.
- Analyse information from providers in order to make informed decisions where there is a range of options.
- Collect, collate, evaluate and report clinical information to inform commissioning decisions.
- Provide information to assist in the production of statistical returns.
- Complete the ratification process for decisions for NHS Continuing Healthcare and approve recommendations for NHS Funded Nursing care and NHS Fast Track funding when acting in the role of duty nurse.
- Reporting all incidents, near misses and hazards in line with NHS GM reporting arrangements/system.
PLANNING & ORGANISATION
- Work autonomously, prioritising and managing own workload including triage of duty cases, ensuring both National and local timescales are met.
- Undertake duties in a timely matter whilst managing frequently competing demands on a daily basis.
- Ensure systems are in place for on-going review and assessment of care provision and delivery.
- Identify gaps in provision and act accordingly.
- Have the ability to work under pressure within an agreed time frame.
- Provide system expert knowledge to colleagues in relation to complex care providers in and out of area.
PATIENT/CLIENT CARE
- Work as a Nurse Commissioner within individualised Commissioning, providing expert advice in relation to NHS funding, support and care to a defined group of patients and liaise as appropriate with lead health and social care professionals.
- Undertake Continuing Healthcare assessments in accordance with the National Framework Use clinical knowledge and expertise to assess patients health care needs and determine care requirements.
- Have the ability to positively challenge and influence health and social care professionals to ensure that plans for patient care are appropriate and that the patient will be cared for on the most appropriate pathway where possible utilising the least restrictive options.
- Identify appropriate care providers and request provider assessments.
- Have the ability to analyse information from care providers and commission appropriately to meet clients outcomes whilst providing cost effective care.
- Ensure that patients are offered personal health budgets and undertake personal health budget activity in accordance with NHS GM Policy. Empower patients and their families through appropriate support and education. Facilitate the integration of patient goals for health, social care and future health needs into individualised support plans.
- Undertake reviews in accordance with the national framework for CHC ensuring that this includes a review of patient care, care records and care provision to ensure commissioned care is appropriate, of acceptable quality and meets the patients identified care needs. Whilst also considering the continued eligibility of NHS funded Care
- Act appropriately when there are requirements to re-consider care provision and the provision of interim solutions if required.
- Provide support to patients to resolve issues related to health care provision
POLICY & SERVICE DEVELOPMENT
- Work within Professional Codes of Practice and defined GMIC and National protocols/policies including those appertaining to NHS Continuing Healthcare and NHS Funded Nursing Care.
- Propose changes to local policy & procedure development and implement amendments to practice.
- Represents the clinical, quality and safeguarding directorate in giving clinical input to the wider locality.
- Engage in clinical supervision and self-reflection to develop own professional standards and working in practices.
FINANCIAL & PHYSICAL RESOURCES
- Has delegated authority, within identified NHS GM scheme of delegation limits, to agree care packages and placements for patients eligible for NHS Individualised Commissioning.
- Evaluate applications/costs for packages of care, evaluating the options available and ensuring cost effective quality services with an understanding of current market provision.
- Consider and monitor budgetary and resource issues when commissioning/procuring packages of care, working within available resources and in a fair and equitable manner.
- Accountable for the appropriate use NHS Resources
- Negotiate with care providers when commissioning individual care placements.
PEOPLE MANAGEMENT
- Maintain up to date knowledge and competence in line with professional and service requirements and demonstrate critical thinking, decision making and reflective skills to ensure own professional development.
- Provide expert advice and support on matters relating to Individualised Commissioning
- Contribute towards the effective running of the service and establish effective liaison with commissioning staff, supporting and deputising for colleagues as required.
- Undertaking a statutory duty of care for your own personal safety and that of others
- Line management responsibility for Nurse Assessors in the team.
- Provide assessor or supervisor support to student nurses on placement.
RESEARCH, DEVELOPMENT & AUDIT
- Participate in the audit and evaluation of processes regarding the implantation of the national framework for Continuing Healthcare and Funded Nursing Care.
- Critically appraise available/current research and apply this knowledge to current practice.
- Maintain registration under NMC.
- Work across health and social care boundaries to obtain specialist evidence and ensure a co-ordinated, multi-disciplinary, multi-agency approach is adopted to assessments.
- Liaise with a wide range of stakeholders providing specialist advice and guidance on all matters relating to the National Framework for NHS Continuing Healthcare and Funded Nursing Care.
- Contribute to service development within the NHS GM and partner organisations.
Job description
Job responsibilities
KEY DUTIES AND RESPONSIBILITIES
- The post holder will act as Individualised Commissioning Nurse for a defined caseload of patients whose care is either jointly or solely funded by NHS GM and the care is provided by the independent sector.
- Identify and case manage any clients in a nursing home who may be eligible for NHS funding, to chair and coordinate eligibility assessments and reviews. This includes representing NHS GM in the ratification of decisions for NHS Continuing Healthcare and NHS Funded Nursing care and on duty.
- Act as Commissioning Case Manager for all individualised commissioned placements, purchased by NHS GM.
- Conduct contractual monitoring ensuring that contracts in place for individual clients in receipt of NHS funding are being adhered to as well as supporting and enabling providers to improve the quality-of-care delivery.
- Provide expert advice to other professionals commissioned to provide care in relation to NHS Individualised Commissioning.
- Complete the restitution process for all claims which includes presentation of findings to NHS GM multi-agency funding panel and the NHS England Independent review panel.
- Jointly conduct contract performance visits to ensure contractual obligations and quality care standards are being met.
COMMUNICATION
- Co-ordinate and lead multi-disciplinary meetings, including patients and family/representatives, requiring excellent verbal communication skills to ensure all appropriate information is obtained in order that appropriate decisions are made regarding eligibility for NHS Continuing Healthcare.
- Understand and communicate complex information, both patient and non-patient related.
- Manage complex, sensitive and often contentious situations on a frequent basis.
- Act and deal appropriately with potentially aggressive/antagonistic situations
- Complete concise and accurate reports including reports to be presented for Court of Protection cases.
- Communicate complex and often sensitive and distressing information on a regular basis.
- Nurture key relationships and maintain internally and externally.
- Attend and contribute effectively to various meetings including safeguarding and quality of care meetings.
- Establish partnerships and networks with adult social care teams, voluntary sector and other agencies to ensure patients with complex continuing healthcare need have access to all resources available.
- Act in an educational and advisory role to staff in provider and other partner organisations in order to promote and share knowledge concerning, continuing Healthcare, Funded Nursing Care and Personal Health budgets.
- Participate in pre and post registration training for staff from multi-professional backgrounds.
INFORMATION RESOURCES ANALYSIS AND DECISION MAKING
- Responsible for producing assessments and reports using appropriate information technology
- Maintain up-to-date, accurate records, inputting case management into the electronic patient system.
- Analyse information from providers in order to make informed decisions where there is a range of options.
- Collect, collate, evaluate and report clinical information to inform commissioning decisions.
- Provide information to assist in the production of statistical returns.
- Complete the ratification process for decisions for NHS Continuing Healthcare and approve recommendations for NHS Funded Nursing care and NHS Fast Track funding when acting in the role of duty nurse.
- Reporting all incidents, near misses and hazards in line with NHS GM reporting arrangements/system.
PLANNING & ORGANISATION
- Work autonomously, prioritising and managing own workload including triage of duty cases, ensuring both National and local timescales are met.
- Undertake duties in a timely matter whilst managing frequently competing demands on a daily basis.
- Ensure systems are in place for on-going review and assessment of care provision and delivery.
- Identify gaps in provision and act accordingly.
- Have the ability to work under pressure within an agreed time frame.
- Provide system expert knowledge to colleagues in relation to complex care providers in and out of area.
PATIENT/CLIENT CARE
- Work as a Nurse Commissioner within individualised Commissioning, providing expert advice in relation to NHS funding, support and care to a defined group of patients and liaise as appropriate with lead health and social care professionals.
- Undertake Continuing Healthcare assessments in accordance with the National Framework Use clinical knowledge and expertise to assess patients health care needs and determine care requirements.
- Have the ability to positively challenge and influence health and social care professionals to ensure that plans for patient care are appropriate and that the patient will be cared for on the most appropriate pathway where possible utilising the least restrictive options.
- Identify appropriate care providers and request provider assessments.
- Have the ability to analyse information from care providers and commission appropriately to meet clients outcomes whilst providing cost effective care.
- Ensure that patients are offered personal health budgets and undertake personal health budget activity in accordance with NHS GM Policy. Empower patients and their families through appropriate support and education. Facilitate the integration of patient goals for health, social care and future health needs into individualised support plans.
- Undertake reviews in accordance with the national framework for CHC ensuring that this includes a review of patient care, care records and care provision to ensure commissioned care is appropriate, of acceptable quality and meets the patients identified care needs. Whilst also considering the continued eligibility of NHS funded Care
- Act appropriately when there are requirements to re-consider care provision and the provision of interim solutions if required.
- Provide support to patients to resolve issues related to health care provision
POLICY & SERVICE DEVELOPMENT
- Work within Professional Codes of Practice and defined GMIC and National protocols/policies including those appertaining to NHS Continuing Healthcare and NHS Funded Nursing Care.
- Propose changes to local policy & procedure development and implement amendments to practice.
- Represents the clinical, quality and safeguarding directorate in giving clinical input to the wider locality.
- Engage in clinical supervision and self-reflection to develop own professional standards and working in practices.
FINANCIAL & PHYSICAL RESOURCES
- Has delegated authority, within identified NHS GM scheme of delegation limits, to agree care packages and placements for patients eligible for NHS Individualised Commissioning.
- Evaluate applications/costs for packages of care, evaluating the options available and ensuring cost effective quality services with an understanding of current market provision.
- Consider and monitor budgetary and resource issues when commissioning/procuring packages of care, working within available resources and in a fair and equitable manner.
- Accountable for the appropriate use NHS Resources
- Negotiate with care providers when commissioning individual care placements.
PEOPLE MANAGEMENT
- Maintain up to date knowledge and competence in line with professional and service requirements and demonstrate critical thinking, decision making and reflective skills to ensure own professional development.
- Provide expert advice and support on matters relating to Individualised Commissioning
- Contribute towards the effective running of the service and establish effective liaison with commissioning staff, supporting and deputising for colleagues as required.
- Undertaking a statutory duty of care for your own personal safety and that of others
- Line management responsibility for Nurse Assessors in the team.
- Provide assessor or supervisor support to student nurses on placement.
RESEARCH, DEVELOPMENT & AUDIT
- Participate in the audit and evaluation of processes regarding the implantation of the national framework for Continuing Healthcare and Funded Nursing Care.
- Critically appraise available/current research and apply this knowledge to current practice.
- Maintain registration under NMC.
- Work across health and social care boundaries to obtain specialist evidence and ensure a co-ordinated, multi-disciplinary, multi-agency approach is adopted to assessments.
- Liaise with a wide range of stakeholders providing specialist advice and guidance on all matters relating to the National Framework for NHS Continuing Healthcare and Funded Nursing Care.
- Contribute to service development within the NHS GM and partner organisations.
Person Specification
evidenced in application
Essential
- Experience of working with people with LD
- experience at senior nurse level
- experience of MH Law
- experience of NSF
- The ability to lead multi professional MDT's
- Master's degree Or relevant experience
Desirable
- line manager experience
- Experience of investigating and acting in a role of safeguarding Adult manager
- Knowledge of retrospective reviews
- Experience of working with Older People with Mental Health difficulties and with the Independent Care Sector
registration requirement
Essential
- professional registration
Person Specification
evidenced in application
Essential
- Experience of working with people with LD
- experience at senior nurse level
- experience of MH Law
- experience of NSF
- The ability to lead multi professional MDT's
- Master's degree Or relevant experience
Desirable
- line manager experience
- Experience of investigating and acting in a role of safeguarding Adult manager
- Knowledge of retrospective reviews
- Experience of working with Older People with Mental Health difficulties and with the Independent Care Sector
registration requirement
Essential
- professional registration
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.
Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).
From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).
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.
Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).
From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).
UK Registration
Applicants must have current UK professional registration. For further information please see
NHS Careers website (opens in a new window).