Job summary
**Indicative band 7 - subject to job evaluation**
As a member of the Specialist Neurorehabilitation Case Management team, the post holder will provide active support to case managers in the discharge planning process for patients within the "slow stream" care pathway. The post holder will also act as a Trusted Assessor for patient cohorts across all Greater Manchester (GM) localities either requiring slow stream rehabilitation or with an Acquired Brain Injury (ABI). Additionally, the post holder will also complete assessments under the Care Act on behalf of locality partners and will provide expert ongoing social care and signposting for patients and families as required.
Main duties of the job
Provide active support for specialist neurorehabilitation case managers in the discharge planning process for patients on a slow stream rehabilitation pathway.
Where agreed, act as a Trusted Assessor across the GM footprint for patients with an ABI or on a neurorehabilitation slow stream care pathway.
Provide expert ongoing social care for patients on the team's caseload, liaising with patients and their families as required.
Sign post patients and family members to the most appropriate services for their needs.
Act as a crucial link between the specialist neurorehabilitation case management team and local social services teams to ensure Social Worker allocation and assessment takes place in a timely manner. This will be crucial in ensuring that discharge takes place in as streamlined a way as possible.
Work collaboratively with other place-based services, including housing providers, to ensure successful discharge.
Support patients and carers in their transition from a complex rehabilitation environment to suitable placements or independent living in the community.
Attend multi-disciplinary team (MDT) meetings as required to support the management of patient assessments or potential discharges
About us
Our NHS People Promise
Our NHS People Promise -the promise we must all make to each other, to work together to improve the experience of working in the NHS for everyone. Like many other employers, NHS GM currently has evidence of unwarranted inequalities in the workforce, most notably in relation to minoritised ethnic, female and\or disabled staff and their intersectionality. As a result, we will use positive action measures to bring benefits to our organisation, including a wider pool of talented, skilled, and experienced people from which to recruit and a better understanding of the needs of a more diverse range of customers.
We are Compassionate
We are inclusive, actively promote equality and diversity, and challenge discrimination.
We are kind and treat people with compassion, courtesy, and respect.
We are Curious
We aim for the highest standards and seek to continually improve, harnessing our ingenuity.
We can be trusted to do what we promise.
We will develop our cultural proficiencies, ensuring we deliver well to all our diverse communities.
We are Collaborative
We collaborate, forming effective partnerships to achieve our common goals.
We celebrate success and support our people to be the best they can be.
Job description
Job responsibilities
Contribute to the identification of appropriate discharge pathways and support with the development and implementation of discharge plans.
Work with colleagues (both internal and external to the ICB) to unblock barriers encountered when trying to move patients into the most appropriate setting, including discharge to home.
Work collaboratively with others across organisational boundaries to ensure that patients are cared for in the most appropriate setting to meet their needs. This includes, but is not limited to, GM Local Authorities, NHS neurorehabilitation inpatient services, CHC teams, community neurorehabilitation teams (CNRT) and IS providers.
Ensure that data is captured as per local processes so that performance against identified key performance indicators (KPIs) identified can be monitored and reported against in line with agreed processes.
Contribute to the development of improvement plans and provide regular updates of progress against these where performance against KPIs falls below the agreed standard.
Work with both internal and external colleagues to minimise the risk of delayed transfers of care (DTOC), taking appropriate action to address these by facilitating discussions to resolve issues, escalating issues encountered appropriately.
Actively engage with the annual Performance Development Review (PDR) process and managerial and clinical supervision sessions to ensure the opportunity for personal development is maximised.
Job description
Job responsibilities
Contribute to the identification of appropriate discharge pathways and support with the development and implementation of discharge plans.
Work with colleagues (both internal and external to the ICB) to unblock barriers encountered when trying to move patients into the most appropriate setting, including discharge to home.
Work collaboratively with others across organisational boundaries to ensure that patients are cared for in the most appropriate setting to meet their needs. This includes, but is not limited to, GM Local Authorities, NHS neurorehabilitation inpatient services, CHC teams, community neurorehabilitation teams (CNRT) and IS providers.
Ensure that data is captured as per local processes so that performance against identified key performance indicators (KPIs) identified can be monitored and reported against in line with agreed processes.
Contribute to the development of improvement plans and provide regular updates of progress against these where performance against KPIs falls below the agreed standard.
Work with both internal and external colleagues to minimise the risk of delayed transfers of care (DTOC), taking appropriate action to address these by facilitating discussions to resolve issues, escalating issues encountered appropriately.
Actively engage with the annual Performance Development Review (PDR) process and managerial and clinical supervision sessions to ensure the opportunity for personal development is maximised.
Person Specification
Qualifications
Essential
- Degree or equivalent in Diploma in Social Work, or equivalent recognised by the Central Council for Education and Training in Social Work.
- Social Work England registration
Experience
Essential
- Experience of working within a multi-disciplinary team (MDT) and chairing MDT meetings or panels.
- Presenting complex and sensitive information to a range of recipients
- Demonstrate the ability to perform to a high level in a clinical setting, holding services to account and ensuring effective use of NHS resources.
Knowledge
Essential
- Detailed knowledge of the Care Act, Mental Capacity Act (MCA) and Mental Health Act (MHA) and a clear understanding of the interface between these.
- Detailed knowledge and understanding of the background to and aims of current health and care policy areas and the implications of this on commissioners, providers and key stakeholders.
Desirable
- Budget monitoring and working to Standard Financial Instructions.
Person Specification
Qualifications
Essential
- Degree or equivalent in Diploma in Social Work, or equivalent recognised by the Central Council for Education and Training in Social Work.
- Social Work England registration
Experience
Essential
- Experience of working within a multi-disciplinary team (MDT) and chairing MDT meetings or panels.
- Presenting complex and sensitive information to a range of recipients
- Demonstrate the ability to perform to a high level in a clinical setting, holding services to account and ensuring effective use of NHS resources.
Knowledge
Essential
- Detailed knowledge of the Care Act, Mental Capacity Act (MCA) and Mental Health Act (MHA) and a clear understanding of the interface between these.
- Detailed knowledge and understanding of the background to and aims of current health and care policy areas and the implications of this on commissioners, providers and key stakeholders.
Desirable
- Budget monitoring and working to Standard Financial Instructions.
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).
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.
UK Registration
Applicants must have current UK professional registration. For further information please see
NHS Careers website (opens in a new window).