Job summary We have an exciting opportunity for a registered nurse to proactively case-manage identified patients with long-term conditions/frailty syndromes within the community frailty service, to avoid unplanned hospital admissions and facilitate independence/support within their own home. The successful post holder will assume responsibility for assessing, developing, planning, implementing and evaluating programmes of care in partnership with the patient, carer and family. The successful post holder will review and monitor allocated patients from the caseloads of Frailty Practitioners undertaking crisis intervention and secondary care in-reach duties. To successful post holder will work collaboratively with voluntary, statutory and independent sector agencies within the local health and social care economy, and promote self-management and health gain through education and health promotion activities. Main duties of the job We have an exciting opportunity for a registered nurse to proactively case-manage identified patients with long-term conditions/frailty syndromes within the community frailty service, to avoid unplanned hospital admissions and facilitate independence/support within their own home. To assume responsibility for assessing, developing, planning, implementing and evaluating programmes of care in partnership with the patient, carer and family. To review and monitor allocated patients from the caseloads of Frailty Practitioners undertaking crisis intervention and secondary care in-reach duties. To work collaboratively with voluntary, statutory and independent sector agencies within the local health and social care economy. To promote self-management and health gain through education and health promotion activity. About us Lancashire & South Cumbria NHS Foundation Trust provides a range of services including secondary mental health care across this area. Specialist provision comprises inpatient child and adolescent mental health services, perinatal mental health and forensic services including low and medium secure care.The Trust also provides a range of physical health and well-being services in the community alongside a range of partners in the Lancashire, Cumbria and Sefton area.Lancashire & South Cumbria Foundation Trust encourages flexible working, we believe that a positive work/life balance benefits NHS employees through improved health and wellbeing. We would consider working patterns such as; term time, part time, compressed hours, flexi-time and career breaks. We encourage applicants to state clearly on their application forms this request and discuss these options at interview.For more information please visit our website via Lancashire & South Cumbria NHS FT Date posted 12 March 2025 Pay scheme Agenda for change Band Band 6 Salary £37,338 to £44,962 a year Per Annum Contract Permanent Working pattern Part-time Reference number 351-CEN2240-MC Job locations Frailty Assessment Service (C) Leyland PR25 2TN Job description Job responsibilities Please see attached the job description and person specification for more information about this role. Job description Job responsibilities Please see attached the job description and person specification for more information about this role. Person Specification Qualifications Essential oGeneral registered nurse oDegree in appropriate subject or evidence of education to degree level Knowledge Essential oHigh level knowledge of Chronic Disease Management including current evidence-based practice oGood understanding of systems in health and social care that are wider than immediate role. oKnowledge and understanding of the principles of governance and its implications to their service area Experience Essential oProven experience of undertaking complex assessments using SAP oContinuing engagement in professional development and of reflective practice as evidenced in a professional portfolio oEvidence of clinical caseload management with complex cases in a range of clinical settings including community/primary care Person Specification Qualifications Essential oGeneral registered nurse oDegree in appropriate subject or evidence of education to degree level Knowledge Essential oHigh level knowledge of Chronic Disease Management including current evidence-based practice oGood understanding of systems in health and social care that are wider than immediate role. oKnowledge and understanding of the principles of governance and its implications to their service area Experience Essential oProven experience of undertaking complex assessments using SAP oContinuing engagement in professional development and of reflective practice as evidenced in a professional portfolio oEvidence of clinical caseload management with complex cases in a range of clinical settings including community/primary care 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. Employer details Employer name Lancashire & South Cumbria NHS Foundation Trust Address Frailty Assessment Service (C) Leyland PR25 2TN Employer's website https://www.lscft.nhs.uk/ (Opens in a new tab)