Job summary
Complex Case Manager-Integrated Discharge Team
An exciting opportunity has arisen to work in the Integrated discharge team. Practising as an independent specialist clinical practitioner responsible for the management of a defined case load. The post holder will work in partnership with the multi-disciplinary team (MDT) to implement and improve the patient pathway.
You will play a vital role within hospital flow and be the escalation point to progress the patients journey reducing the number of non-valued added in-patient days and in turn facilitate a timely discharge on EDD.
They will be a main contact for patients and families to advise and guide them through the complex discharge process.
Main duties of the job
Post Holder will be based within hospital Complex Discharge Team.
The post holder will be practising as an independent specialist clinical practitioner responsible for the management of a defined case load.
The post holder will work in partnership with the multi-disciplinary team (MDT) to implement and improve the patient pathway.
You will play a vital role within hospital flow and be the escalation point to progress the patient's hospital journey reducing the number of non- valued added in-patient days and in turn facilitate a timely discharge on the EDD.
They will be a main contact for patients and families to advise and guide them through the complex discharge process.
About us
Northampton General Hospital is one of the largest employers in the area and we are on an exciting journey. All of our divisions are committed to doing things better, with more efficiency as we update, modernise, and advance. We have also entered into a Group Model with neighbouring Kettering General Hospital NHS Foundation Trust and become University Hospitals of Northamptonshire.
Our Excellence Values
Compassion
Accountability
Respect
Integrity
Courage
We want to recruit the best people to deliver our services across the University Hospitals of Northamptonshire and help to unleash everyone's full potential. As an organisation, we value how we communicate and promote our vacancies to all communities.
We are a Defence positive trust, supporting our reservists, veterans, spouses and partners.
The Hospital Group encourages applications from people who identify from all protected groups, especially those from BAME, Disabled and LGBTQ+ backgrounds as these are underrepresented in our hospitals.
We understand that we need to work with colleagues from diverse backgrounds and make sure the environment they work in is inclusive and collaborative.
We have active Networks that promote and support colleagues from all ensures everyone feels supported and has a sense of belonging working for Kettering and Northampton General Hospitals.
Job description
Job responsibilities
To actively facilitate effective and timely discharge of patients through liaison with appropriate departments, organisations, and professionals.
Attended the daily ward board rounds of patients on your case load to review patients needs related to discharge and update the ward MDT.
Provide Specialist Knowledge, support, and guidance to colleagues regarding discharge planning and mental capacity.
Demonstrable working knowledge and practical application of legislation relevant to discharge and transfer of care process including the Care Act.
Have extensive knowledge of health and social care services, roles and responsibilities and apply this to support patient discharges.
Liaise with Site Manager to ensure complex discharges are expedite on date of discharge.
To Coordinate / Participate in family, professional, and best interest meetings with multi-agencies to discuss Patients discharge arrangements.
Identify delays in the patient journey and act appropriately to challenge process.
Expert knowledge and understanding of the D2A model and pathways
Be the health lead in understanding the appropriate Discharge to Assess (D2A) pathway appropriate for patients and be ready to facilitate this pathway as soon as the patient is medically optimised.
Responsible for the integrated discharge hub and ensuring patient referrals are forwarded to relevant agencies in a timely manner
Responsible for updating Transfer of Care form (TOC) post IDT Hub with pertinent information identified to support Patients needs for a pathway to be agreed.
Work collaboratively with Specialist Teams internal and external to confirm clinical plans in place to reduce non valued added in-patient days and follow-on care post discharge.
Liaise with General Practitioners, community nurses, clinical support professionals and other agencies to facilitate a patient discharge.
Liaise with the community hospitals to ensure the continuity of patient care, when crossing healthcare boundaries.
Act as a focus for investigations and resolution of individual patient discharge problems, utilising the links with other professionals and an overall knowledge of available facilities and options for patient care within the community.
Support wards to diffuse and deal with conflict and delicate discharge situations to agree a discharge plan.
Please see the attached job description for full role responsibilities
Person Specification
Educations,Training and Qualifications
Essential
1. Degree level education or equivalent demonstrable experience.
2. Evidence of further education or study up to master's level or equivalent level of training or experience.
3. Recognised teaching or assessing qualification or equivalent demonstrable experience of teaching and assessment.
4. Health or Social Care professional registered with a nationally recognised regulatory body NMC, HCPC, Social Work England.
5. Evidence of proactive and continued professional development.
Knowledge and Experience
Essential
6. Mental and Emotional effort concentration levels - dealing with patients and relatives regarding sensitive issues concerning discharge, ability to defuse difficult situations, excellent persuasive skills to manage highly emotive situations and overcome barriers to understanding.
7. To have a clear working knowledge of the Hospital discharge service: policy and operating model.
8. Evidence of competence in CHC, safeguarding, MCA, DOL's.
9. Evidence of proactive and continued professional development.
10. Significant post registration experience in speciality.
11. Recent relevant experience at senior level band 6 or above.
12. Knowledge and understanding of the D2A pathways.
13. Ability to Assess, Plan and manage the care of a wide variety of patient conditions.
14. Experience of dealing with people who display inappropriate behaviours verbal aggression, insensitive and potentially hostile situations.
Desirable
15. Understanding of impact of high Stranded numbers.
16. Understanding of impact of delays in discharging patients.
Skills
Essential
17. Ability to prioritise and demonstrate time management and organisational skills.
18. Ability to work under pressure and change tasks daily to support Trust OPEL status or interject to ensure actions are followed up on request by Site Team, Senior Managers, Matrons.
19. Demonstrate the ability to obtain and evaluate information to aid decision making and to develop others in this area.
20. Highly developed communication skills, written, verbal and presentation, able to give constructive feedback.
21. Demonstrate a good understanding of wider health and social care systems.
22. Understanding of clinical governance and its application.
23. Ability to cope with a range of complex options, find solutions, analyse, compare, and decide appropriate course of action.
24. IT literate frequent use of VDU equipment, capable of using and interrogating IT data systems in support of the discharge role.