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Central London Community Healthcare (CLCH) is one of the largest community healthcare organisations in London and Hertfordshire, providing our services to diverse communities/boroughs in 11 London Boroughs - Barnet, Brent, Ealing, Hammersmith & Fulham, Harrow, Hounslow, Kensington and Chelsea, Merton, Richmond, Wandsworth, Westminster - and Hertfordshire.
We are rated Good by the Care Quality Commission and are ranked among top NHS employers. Community healthcare is our focus and our passion. We champion the role of community health professionals to make sure our patients get great care closer to home.
Job overview
Mon - Fri 9-5
The Case Manager will work within an integrated neighbourhood/care team (ICT/INT) to proactively undertake case finding, manage, co-ordinate and support patients with multiple complex long-term conditions using the whole systems integrated care (WSICS) dashboards. The post holder will ensure all health and social care needs are met for risk stratification and managing frailty patient populations registered in the Primary Care Networks (PCNs) aligned to the ICT/INT. The post holder will also support the health inequalities agenda through engagement of patients in the most deprived areas of the West London borough and work with key stakeholders on the wider determinants of health to improve outcomes, functional status and quality of life.
Main duties of the job
1. The post holder will work as a minimum, 80% of their time in direct patient care, supporting caseload allocation, providing practice development and education and competence support to the Case Managers and Health and Social Prescribing Coordinators.
2. Work with the Primary Care Networks to identify patients at high risk for acute hospital admission and ensure those identified are assessed and have care planned appropriately.
3. Empower patients and carers through appropriate support and education, ensuring care provided is in line with National Service Framework, NICE Guidelines, Trust policies and procedures.
4. Work with Community Practitioners on the promotion of patient self-management programmes within the local community.
5. Have clinical responsibility for practice caseloads including aspects of care delivery and co-ordination in line with service operating procedures.
6. Support safer caseloads across the ICT/INT, minimising service risk in relation to workflow and productivity.
Working for our organisation
We provide community health services to more than two million people across eleven London boroughs and Hertfordshire. Every day, our professionals provide high-quality healthcare in people's homes and local clinics, helping them to stay well, manage their own health with the right support, and avoid unnecessary trips to, or long stays in, hospital.
Detailed job description and main responsibilities
1. Operational support and management for the Case Managers and Health and Social Prescribing Coordinators.
2. Working with other Case Managers to provide cover for GP practices during periods of absence.
3. Leading and developing others through role modelling improved and evidence-based practice.
4. Providing supportive and facilitative clinical leadership in ICT/INT forums.
5. Manage the day to day delivery and development of the service that is responsive and high quality.
6. Responsible for monitoring service delivery metrics and performance activity reports.
Person specification
Education/Qualification
Essential criteria
* Registered Adult/Mental Health Nurse
* Educated to Degree/Masters level or equivalent postgraduate experience
* Clinical Supervision Training
* Teaching and Mentoring
Desirable criteria
* Dual Registered Nurse
* V300 Non-Medical Prescriber
* Advance Clinical Practitioner or willing to undertake
Experience
Essential criteria
* Extensive work experience at a Band 7 or above in a community/hospital/primary care setting
* Experience of presenting cases at large multi-disciplinary teams
* Experience of Frailty Populations, Long Term Conditions, Palliative Care, Respiratory, Cardiovascular Disease, Dementia
* Experience of working with stakeholders and collaborative negotiating
Desirable criteria
* Experience of managing and investigating complaints
* Experience of managing and investigating serious incidents.
Skills & Knowledge
Essential criteria
* Line management of clinical staff in line with trust HR Process.
* Goal setting with patients, coaching techniques to self-care and empowerment.
* Knowledge of CHC, Fast track EoL Assessments
Due to the high number of applications that are received for some posts we may close this vacancy before the advertised closing date. Therefore please apply for this post as soon as you can, if you are interested and you meet the requirements of the Person Specification.
Only those candidates who clearly demonstrate how they meet the person specification will be shortlisted for this job.
Interview arrangements will be communicated via email so please check your email regularly following the closing date.
At CLCH we appreciate and are proud of the diversity in the communities we serve and the workforce we employ. Applications are open and welcome to anyone, regardless of your age, sexual orientation, gender identity and expression, ethnicity, religion, and disability.
This post is subject to the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (Amendment) (England and Wales) Order 2020 and it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service.
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