Job summary
An opportunity has arisen in the
Integrated Care Team (ICT) in North East Hampshire (namely Aldershot,
Farnborough and Fleet localities) among a well-established and effective
multidisciplinary team.
This is a highly rewarding role,
where clinicians can dedicate quality time to understanding their patients and
what matters to them.
The integrated approach ensures
patients who require a bespoke level of care and support in the community are
looked after by the right team and will only need to tell their story once.
Patients under the care of the ICT have the peace of mind that the teams
supporting them do so with a joined-up and patient centred approach.
The ICT Nurse will assess
patients in the community setting and work among wider multidisciplinary team
colleagues to form innovative care plans to support identified needs. In
addition, the Nurse will participate in a rota of clinical triage in our vibrant
Community Services Referral Hub and the completion of proactive frailty
assessments providing variety and balance to the working week.
Main duties of the job
Holistic bespoke assessment of patients in
their own homes, establishing a baseline overview of health, clinical, mental
health, and environmental needs, guided by clinical templates
Support and input to care planning and
collaborative decision making alongside community service colleagues
including Community Nurses, Mental Health Practitioners, Specialist Nurses,
Community-Based Therapy Teams, Social
Prescribers, Adult Social Care, Hospice Services and Home Visiting Paramedic
Practitioners
Leads and participates in multidisciplinary
care team meetings
Clinical Triage, supported by robust protocol
and clinical templates, in our Community Single Point of Access (CSPA)
Proactive assessment of patients in their own
homes, to identify the increasingly frail patient in an attempt to input
support prior to any further decline in health, social and care needs.
Subsequent participation and coordination of a dynamic Consultant-Led
multidisciplinary meeting to agree care plans of action.
About us
Salus
is a GP Federation which was formed by the local GP practices within North
East Hampshire and Farnham. This
Includes practices located in Aldershot, Farnborough, Fleet, Farnham &
Yateley. We hold several contracts
supporting primary care to deliver services on behalf of those practices,
helping them work better together and with other healthcare providers leading
to improved patient services and developing new ones due to constant changes
in the Primary Care environment.
By
engaging with the public, we also help ensure that services are designed and
developed with patient and public involvement.
The
staff at Salus Medical Services have a wealth of experience working in
general practice and therefore a good understanding of the opportunities and
challenges faced.
The Salus ICT is made up of 7
trained Nurses, 3 Clinical Associates, a Care Coordinator, and a team of 5
effective administrators. We are a welcoming, friendly and responsive team.
Our vision is to provide a
service which supports and guide patients through complex and challenging
circumstances, in true collaboration with our valued partner organisations.
Staff wellbeing and a positive working
environment is instrumental to what we do. It is our belief that our approach
to patient care is only enhanced when our staff feel happy, healthy and safe.
Job description
Job responsibilities
The
following are the core responsibilities of the ICT Nurse. There may be, on occasion, a
requirement to carry out other tasks; this will be dependent upon factors
such as workload and staffing levels.
This role will be split across two divisions
of our service:
o
Undertaking of the triaging of referrals
into the Integrated Care Team via the
Community Single Point of Access.
o
The post holder will work as part of the
Integrated Care Team which will involve separate aspects as below
The post holder will undertake Integrated
Care Team assessments within the community setting focusing specifically on
those patients proactively identified as requiring Proactive Care/Frailty.
The post holder will demonstrate the ability
to complete a comprehensive assessment and understand frailty as a recognised
syndrome.
The postholder will partake in both the
Integrated Care Team Meetings and Proactive Care Meeting and demonstrate an
ability to communicate effectively with wider members of the
Multidisciplinary Team and service users.
The
post holder will be responsible for completing onward referrals within both
health and social care settings and liaising as required with services.
The post holder will hold responsibility for
the day-to-day management of the ICT caseload alongside other members of the
Integrated Care Team.
Liaise with relatives, carers, and health
care professionals to prevent and minimise the risk of acute hospital
admission where appropriate, working in partnership with secondary care
discharge co-ordinating services.
Must be autonomous in practice
Ensure resources are utilised in a
cost-effective manner
Ensure all professional/clinical practices
are in line with Salus policies
Ensure appropriate and accurate records are
maintained
Be accountable for own professional actions
according to NMC Code of Professional Code
Maintain your Continuous Professional
Development according to NMC Code of Professional Code and Revalidation
requirements
Job description
Job responsibilities
The
following are the core responsibilities of the ICT Nurse. There may be, on occasion, a
requirement to carry out other tasks; this will be dependent upon factors
such as workload and staffing levels.
This role will be split across two divisions
of our service:
o
Undertaking of the triaging of referrals
into the Integrated Care Team via the
Community Single Point of Access.
o
The post holder will work as part of the
Integrated Care Team which will involve separate aspects as below
The post holder will undertake Integrated
Care Team assessments within the community setting focusing specifically on
those patients proactively identified as requiring Proactive Care/Frailty.
The post holder will demonstrate the ability
to complete a comprehensive assessment and understand frailty as a recognised
syndrome.
The postholder will partake in both the
Integrated Care Team Meetings and Proactive Care Meeting and demonstrate an
ability to communicate effectively with wider members of the
Multidisciplinary Team and service users.
The
post holder will be responsible for completing onward referrals within both
health and social care settings and liaising as required with services.
The post holder will hold responsibility for
the day-to-day management of the ICT caseload alongside other members of the
Integrated Care Team.
Liaise with relatives, carers, and health
care professionals to prevent and minimise the risk of acute hospital
admission where appropriate, working in partnership with secondary care
discharge co-ordinating services.
Must be autonomous in practice
Ensure resources are utilised in a
cost-effective manner
Ensure all professional/clinical practices
are in line with Salus policies
Ensure appropriate and accurate records are
maintained
Be accountable for own professional actions
according to NMC Code of Professional Code
Maintain your Continuous Professional
Development according to NMC Code of Professional Code and Revalidation
requirements
Person Specification
Qualifications
Essential
Person Specification
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).
