Work with colleagues in the frailty team to identify patients who would benefit from proactive review. Work with colleagues to undertake patient reviews in a holistic way using the what matters to me model. Work with patients, carers, and families to provide specialist, personalised Occupation focussed interventions. Plan and prioritise a caseload of patients with complex needs, using highly specialist occupational therapy skill. Work alongside GPs and nursing home staff to ensure patients safety, wellbeing and independence are maintained. Work alongside a multidisciplinary team to ensure comprehensive and cohesive patient care. Provide Specialist Occupational Therapy advice and guidance to GP practice staff and the wider MDT in supporting patient care. Liaise with community partners such as district nursing, palliative care teams, voluntary sector organisations, the integrated care therapy team to improve patient and carer outcomes.