The post holder willundertake the role of Registered Nurse to work as a core member of the Proactive Care Service MACCT alongside Community Matron within a multi-disciplinary borough-wide core team including; Social Workers, Physiotherapists, Mental Health Practitioners, Pharmacists, Navigators, and Administrators) providing holistic joint assessments, planning, and care co-ordination service to complex Adult (18 +) patients in Haringey who have been identified as at high risk of unplanned hospital admission/high-intensity users of services (GP / A&E) and at risk of their health deteriorating and care needs increasing. They will contribute to the delivery of the case management and coordination of care for identified moderate and high-risk patients; actively supporting them to work towards self-management of their condition. Act as a link for the MACC Team with GPs, other community-based nurses, LAS, Social Services, and other relevant professional areas and organisations as the post
holder will work as part of the multidisciplinary team, working within and across professional and organisational boundaries. Liaising with GPs, other professionals, and statutory and voluntary agencies will complete holistic assessments and deliver individualised care to patients. To ensure the provision of a high standard of nursing care to patients and their families in the community To ensure that practice is always delivered in line with the NMC code
Main duties of the job
Use the standardized initial assessment tool used by all MACCT professionals to gain a holistic overview of health and social care needs.
Will contribute to the development of Proactive Care Service services for patients within Haringey, develop patient pathways and new ways of working across primary and secondary care (with a particular focus on anticipatory care/frailty and building working relationships with localities and intermediate care services).
You will receive a thorough induction, regular operational and clinical supervision From MACCT Community Matron & Joint operational support from colleagues & Proactive Care Service Team Managers. Benefits include career development, flexible working, and well-being.
To be the named nurse for clients of the proactive care service and coordinate care outside of the traditional nursing role when required.
Ensure that all discharges from the caseload are discussed and agreed with the patient and Line Manager.
To be involved in care/case management under the supervision of the Community Matrons, GP, and MACCT Managers, including clients with continuing care needs
Whittington Health serves a richly diverse population and works hard to ensure that all our services are fair and equally accessible to everyone. Nowhere is this more obvious than in the way we look after our staff. We aim to employ a workforce which is as representative as possible of this population, so we are open to the value of differences in age, disability, gender, marital status, pregnancy and maternity, race, sexual orientation, and religion or belief. The Trust believes that as a public sector organisation we have an obligation to have recruitment, training, promotion and other formal employment policies and procedures that are sensitive to these differences. We think that by doing so, we are better able to treat our patients as well as being a better place to work.