East and Central Brighton Primary Care Network
* To work, primarily, with a cohort of frail, housebound or high-risk patients, providing holistic assessments, chronic disease management, identifying needs, providing advice, completing onward referrals and signposting, enabling proactive management of patients, aiming to prevent deterioration and the need for secondary healthcare.
* Be a highly specialist practitioner providing clinical expertise in care, advice and support within East and Central Brighton, managing a caseload within this community of GP practices.
* Lead on improving population and public health and wellbeing outcomes within local communities.
* Work within the multi-disciplinary PCN frailty team to ensure a coordinated approach to safe, effective, person & family centred care across the ECB area, and make timely onward referral to other professionals and agencies.
Main duties of the job
* Lead in providing a person-centred holistic approach to assess the mental, physical, psychological and social wellbeing abilities and needs of the person, their families and carers.
* Act as a specialist expert resource on nursing within the PCN team.
* Liaise closely with directorate and other Trust colleagues, general practitioners and a range of other statutory, independent and voluntary agencies to maximise the independence of patients and clients and prevent unnecessary hospital admissions.
* Lead as a key member of the multidisciplinary team across all aspects of care both internal and external to the organisation to achieve an optimum level of service/care for persons, their families and carers.
About us
East and Central Brighton Primary Care Network supports 9 GP practices in the city centre and beyond. We have a population of over 70,000 patients and our GP practices support some of the most deprived communities in our city. At present, the PCN team consists of pharmacists, social prescribers, care co-ordinators, patient engagement workers, mental health practitioners/support workers and paramedics, staffing several multi-disciplinary teams. The Frailty and Community Outreach teams consist of nursing, nursing associates, occupational therapists, and a physiotherapist allowing for seamless and comprehensive care in the community.
The PCN is innovative and creative and constantly thinking about how we can contribute to improving the health and wellbeing of our population. We work with a number of charities and are just beginning to think about how we can embed ourselves in community centres.
The PCN team is currently based in an office at central Brighton but individual staff members establish working patterns that meet the requirements of role, working at home, in GP practices or in the community as appropriate.
Job responsibilities
* Use local population health information and develop health improvement plans to address priority areas, proactively working with the multidisciplinary team, as well as individuals, their families, carers and voluntary agencies.
* Lead on the delivery and promotion of evidence-based practice in line with local, regional and national guidelines.
* Demonstrate appropriate care values including: compassion, respect, empathy, treating people with dignity, integrity, courage, responsibility and adaptability.
* Facilitate the supervision and assessment of junior clinical staff.
To recognise the importance of safeguarding procedures within the project, and to ensure that any concerns, disclosures or allegations of abuse are immediately and correctly reported.
To embed equality, diversity and inclusion best practice into all aspects of work.
To work to the requirements of the organisations quality standards, and other service-specific quality accreditations as required, abiding by organisational ethos and principles.
Contribute to the development of clinical guidelines, agreed policies protocols and procedures ensuring these are embedded within the service and communicated to relevant personnel.
Flexible to work out-of-hours as required according to service needs and demands.
To attend and participate in regular supervision, appraisals, training and other internal meetings.
Undertake additional duties as requested by the PCN executive board appropriate to the stated job purpose and skills. The above list of main tasks in this job description should, therefore, not be regarded as exclusive or exhaustive.
Build, sustain and maintain multidisciplinary relationships, through effective links with the key professional groups concerned with the provision of PCN services.
Person Specification
Knowledge
* Knowledge of the current professional trends and issues within community nursing and knowledge of current trends within Health and Personal Social Services including community care act and commissioning process.
* Demonstrates accountability for delivering professional expertise and direct service provision.
* Exercise a critical understanding of personal scope of practice and to identify when a patient needs referring on and where there are opportunities for developing the scope and competence of the wider MDT to meet patient care needs.
* Thorough patient assessment and working in partnership with patients and their carers, make decisions about the best pathway of care, informed by the urgency and severity of patient need, patient acuity and dependency, and the most appropriate deployment of resources.
* To be able to work effectively as an autonomous practitioner in the community and to be accountable for own professional actions.
* To carry out treatments in the community in occasional unpleasant and distressing conditions.
* Ensure appropriate risk assessments (including lone worker) are carried out as part of own clinical assessments and support for the team.
* To use appropriate manual handling knowledge and skills in order to provide relevant moving and handling equipment and plans and delegate safe practice to support staff as appropriate.
* Involves patients in decision making and supporting adherence as per NICE guidance.
* Sound knowledge and experience of safeguarding pathways and management of risk in a community setting.
Working Relationships
* Operate as a full member of the primary care team, including contributing to leadership, service evaluation/improvement and research activity.
* Manage and co-ordinate the care that individual patients receive, including through liaising with other members of the MDT and with patients' carers.
* Lead primary care activity, with a strong emphasis on prevention and early intervention, including through the delivery of public health advice (e.g. relating to physical activity, weight management and smoking cessation).
* Contribute to the development of primary care teams, including through contributing to others' learning.
Qualifications
* Registered Nurse: first level, on the live NMC register.
* Non-medical prescribing or working towards advanced clinical practice.
Experience
* Experience of safeguarding pathways and management of risk in a community setting.
Skills & Abilities
* Ability to relate to local people with positive and non-judgemental approach.
* Ability to reflect and critically appraise own performance.
* Demonstrates self-development through continuous professional development activity.
* Communication and ICT skills.
* Ability to travel within the requirements of the role driving license essential.
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.
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