About this role
Job summary
Central Norwich Primary Care Network and Norwich Health CIC are seeking an experienced, compassionate and highly motivated GP to lead an innovative specialist neighbourhood palliative and end-of-life care service.
This is an exciting opportunity to develop a proactive, responsive and patient-centred model of care across Central Norwich. The service will support patients approaching the end of life, as well as those living with a terminal diagnosis who may benefit from earlier intervention, advance care planning and greater continuity before deterioration.
The successful applicant will manage a defined caseload, providing proactive and autonomous medical care in patients homes, care settings and other community locations. They will work closely with general practices, community palliative care teams, hospices, community nursing, care homes and wider health and social care professionals.
The postholder will provide clinical leadership, advice, supervision and support to Advanced Nurse Practitioners, Paramedic Practitioners and other colleagues, supported by dedicated care coordinators.
This is initially a six-month pilot, with the potential for extension. The postholder will help develop, evaluate and demonstrate the impact of the model.
We welcome applications from GPs seeking four to eight sessions per week. Flexible and non-standard working patterns, including school-hours working, can be considered.
Main duties of the job
The postholder will:
Provide proactive, compassionate and personalised medical care to patients with palliative and end-of-life care needs across Central Norwich.
Manage a defined caseload, maintaining oversight and responsibility of patients with complex or changing needs.
Support patients from the point of a terminal diagnosis, including earlier intervention, advance care planning and continuity of care.
Build trusted relationships with patients, families and carers.
Undertake holistic assessments and develop appropriate treatment and care plans.
Anticipate deterioration and ensure suitable plans, medication and support are in place.
Review patients following discharge, deterioration, treatment changes or concerns raised by patients, families or professionals.
Undertake home, residential and nursing care visits where appropriate.
Work closely with patients registered GP practices, avoiding duplication and maintaining clear clinical responsibility.
Liaise with specialist palliative care teams, hospices, community nursing, secondary care, social care and voluntary organisations.
Provide clinical leadership, supervision and advice to Advanced Nurse Practitioners, Paramedic Practitioners and other team members.
Support multidisciplinary working and relevant palliative care meetings.
Help patients and families navigate services with dignity, empathy and shared decision-making.
Contribute to the development, evaluation and improvement of the pilot service.
About us
Central Norwich Primary Care Network brings together five GP practices serving a diverse population of approximately 70,000 people across central Norwich. The PCN works collaboratively to improve access, strengthen continuity of care and develop services that respond to local population need.
Norwich Health CIC is a not-for-profit organisation established by local general practice to support the delivery of high-quality, integrated services at neighbourhood level. It works closely with member practices, community providers, voluntary organisations and wider NHS partners to develop practical, locally led solutions that improve patient care.
Together, Central Norwich PCN and Norwich Health CIC have developed a strong record of collaborative working, including home visiting, enhanced care home support, training, cancer surveillance and other neighbourhood services. Their approach is transparent, clinically led and focused on keeping decision-making close to patients and practices.
The organisations are committed to innovation, partnership working and reducing fragmentation across health and care. This specialist neighbourhood palliative care pilot reflects that ambition by providing earlier, more coordinated and compassionate support for patients and families across Central Norwich.
Job description Job responsibilities
The successful applicant will manage a defined caseload of patients, providing proactive and autonomous medical care in patients homes, care settings and other appropriate community locations. They will work closely with general practices, community palliative care services, hospices, community nursing teams, care homes and other health and social care professionals.
The postholder will provide clinical leadership, advice, supervision and support to junior and advanced clinical colleagues, including Advanced Nurse Practitioners and Paramedic Practitioners. They will also be supported by dedicated care coordinators who will assist with caseload management, communication and coordination of care.
This is initially a six-month pilot service. The postholder will play an important role in developing, evaluating and demonstrating the impact of the model, with the potential for the service and post to be extended.
We welcome applications from GPs seeking between four and eight sessions per week. We are committed to flexible working and are able to consider non-standard working patterns, including sessions structured around school hours.
Main duties of the job
The postholder will:
Provide proactive, compassionate and personalised medical care to patients with palliative and end-of-life care needs across Central Norwich.Hold and manage a defined clinical caseload, maintaining oversight of patients whose needs are complex or changing.Support patients from the point of a terminal diagnosis, rather than limiting involvement to the final days or weeks of life.Develop trusted and continuous relationships with patients, their families and carers.Undertake holistic clinical assessments and formulate appropriate treatment and care plans.Lead advance care planning and discussions concerning patients wishes, priorities and preferred place of care.Anticipate potential deterioration and ensure that appropriate plans, medication and support are in place.Review patients following hospital discharge, deterioration, changes in treatment or concerns raised by patients, families or professionals.Undertake home visits and visits to residential and nursing care settings where clinically appropriate.Work closely with patients registered GP practices while avoiding duplication and maintaining clear clinical responsibility.Liaise with community specialist palliative care teams, hospices, community nursing services, secondary care teams, social care and voluntary-sector organisations.Provide clinical leadership, supervision and advice to Advanced Nurse Practitioners, Paramedic Practitioners and other members of the neighbourhood team.Support effective multidisciplinary working and contribute to relevant palliative care and end-of-life care meetings.Help patients and families navigate health and care services during what can be an exceptionally difficult and distressing period.Promote high standards of continuity, communication, dignity, compassion and shared decision-making.Contribute to the development, evaluation and continuous improvement of the pilot service.Key responsibilitiesClinical careAssess, diagnose and manage patients with palliative and end-of-life care needs.Develop individualised care plans that reflect the patients clinical needs, personal priorities and family circumstances.Provide appropriate symptom control and prescribing within the postholders competence.Review and rationalise medication where appropriate, taking account of symptom burden, prognosis and patient preferences.Ensure anticipatory medication is considered and prescribed where clinically appropriate.Identify and respond to physical, psychological, social and spiritual needs.Recognise clinical deterioration and coordinate an appropriate response.Support treatment-escalation planning, advance care planning and decisions regarding emergency care.Work sensitively with patients and families where there may be uncertainty, changing expectations or differing views.Support timely access to specialist advice, hospice care, community services or hospital assessment where required.Ensure that the patients usual general practice remains informed and involved in their care.Maintain clear, accurate and contemporaneous clinical records within the relevant clinical systems.Proactive caseload managementMaintain oversight of a defined neighbourhood palliative care caseload.Identify patients who may benefit from earlier palliative care intervention.Work with practices and care coordinators to identify patients at risk of deterioration or unplanned hospital admission.Ensure that patients receive regular and proportionate review according to their clinical needs.Follow up patients after significant changes, hospital admissions or discharge.Support coordinated care across normal working hours, urgent care and community services.Help reduce avoidable crisis presentations and hospital admissions through anticipatory and coordinated care.Support for patients, families and carersCommunicate clearly, honestly and compassionately with patients and those important to them.Provide patients and families with the opportunity to discuss diagnosis, prognosis, treatment options and future care.Recognise and respond appropriately to carer stress and changing family circumstances.Ensure patients and families understand who to contact if their condition changes.Support bereavement-related communication and signposting where appropriate.Respect cultural, religious, spiritual and individual differences in approaches to illness, dying and death.Clinical leadership and supervisionAct as the senior clinical lead for the neighbourhood palliative care team.Provide accessible clinical advice and support to Advanced Nurse Practitioners, Paramedic Practitioners, care coordinators and other colleagues.Provide appropriate clinical supervision, case review and professional support.Promote safe autonomous practice within clearly defined scopes of competence.Identify learning and development needs within the team.Support reflective practice and a positive culture of learning, openness and professional curiosity.Escalate clinical, professional or operational concerns appropriately.Partnership and multidisciplinary workingDevelop effective working relationships with all Central Norwich PCN practices.Work collaboratively with community specialist palliative care services, hospices and community nursing teams.Liaise with secondary care clinicians, care homes, social care services, ambulance services and voluntary organisations.Participate in multidisciplinary meetings and complex case discussions.Promote clear allocation of responsibilities between professionals and organisations.Support timely information-sharing in accordance with confidentiality and information-governance requirements.Represent the service positively and professionally at relevant neighbourhood and system meetings.Clinical governanceWork in accordance with GMC standards and relevant professional guidance.Maintain appropriate registration, appraisal, revalidation, indemnity and mandatory training.Practise within personal competence and seek advice where appropriate.Comply with safeguarding, infection prevention, medicines management, information governance and health and safety requirements.Identify and report incidents, risks, concerns and near misses.Participate in clinical governance meetings and service reviews as required.Maintain confidentiality and handle sensitive information appropriately.Work within the policies and procedures of Norwich Health CIC, Central Norwich PCN and participating practices.What we can offerA genuinely flexible working pattern of between four and eight sessions per week.Consideration of non-standard sessions and school-hours working.The opportunity to shape and lead an innovative neighbourhood service.A defined caseload supported by Advanced Nurse Practitioners, Paramedic Practitioners and care coordinators.Strong links with general practices and community services across Central Norwich.The opportunity to provide high-quality, relationship-based care with genuine continuity.Supportive clinical leadership and multidisciplinary working.The opportunity to influence the future development of neighbourhood palliative care in Norwich.
Person Specification
Qualifications Essential
Primary medical qualification recognised by the GMC. Full GMC registration with a licence to practise. Certificate of Completion of Training in General Practice or equivalent. Inclusion on the NHS England Medical Performers List. Evidence of current appraisal and participation in revalidation. Appropriate medical indemnity covering the responsibilities of the role. Evidence of relevant continuing professional development.
Desirable
Diploma, postgraduate certificate or other recognised qualification in palliative medicine or palliative and end-of-life care. Qualification or recognised training in clinical supervision, education or leadership. Advanced communication-skills training relevant to serious illness and end-of-life care.
Experience Essential
Substantial experience as a practising GP. Experience of managing patients with complex palliative and end-of-life care needs. Experience of working autonomously and making complex clinical decisions. Experience of advance care planning and sensitive discussions with patients and families. Experience of multidisciplinary working across organisational boundaries. Experience of supporting or supervising other clinicians. Experience of providing care in patients homes, care homes or community settings. Evidence of effective management of clinical risk and uncertainty.
Desirable
Experience of working within specialist palliative care, hospice or community palliative care services. Experience as a GP with an Extended Role or Special Interest in palliative care. Experience of leading a clinical service or multidisciplinary team. Experience of developing or evaluating a new service or pilot. Experience of quality improvement, clinical audit or service redesign. Experience of working within a Primary Care Network or integrated neighbourhood team.
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.
UK Registration
Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).
Employer details Employer name Castle Partnership
Address Gurney Surgery
40 Fishergate
Norwich
Norfolk
NR3 1SE
United Kingdom
Employer's website https://www.castle-partnership.co.uk/ (Opens in a new tab)