About this role
Job summary
Lancashire and South Cumbria Integrated Care Board (ICB) has been selected to take part in one of four national Fit Note Reform Pilots commissioned by the Department for Work and Pensions, helping to test a new approach that aims to improve support for people whose health affects their ability to work. The pilot is designed to address a recognised challenge within the current system, where fit notes often focus on certifying sickness absence rather than providing practical support to help people remain in work or return to work safely.
MBPCC is delivering one of these pilots, taking fit note generation out of practices within the Barrow and Mid Furness PCN areas. Patients will be referred directly from general practice into a new service called Enable where they will be offered a personalised Workability Plan setting out what they can do, the adjustments that would help, and the support available to them to aid them return to work.
The Occupational Health Nurse is one of the senior clinical assessment resource within the Enable team. The post holder will undertake work and health assessments for patients referred into the pilot, form an occupational health judgement about functional capacity and fitness for work, and produce Workability Plans that are clinically defensible, practical for employers and genuinely useful to the patient.
This is a test-and-learn service. The post holder is expected not only to deliver assessments, but to help shape the clinical model itself
Main duties of the job
Clinical assessment and workability planning
Undertake structured work and health assessments with patients referred into the pilot, face to face, by telephone or by video, according to patient need and clinical appropriateness.
Assess the interaction between a persons health condition, their functional ability and the demands of their role, taking account of all appropriate physical, psychological, social and workplace factors.
Formulate and co-produce personalised Workability Plans focused on functional capability, phased return, adjustments and the practical support required to sustain work.
Exercise autonomous professional judgement in determining whether a period away from work is clinically appropriate, and articulate that judgement clearly, proportionately and defensibly.
Provide specialist advice on reasonable adjustments, graduated return to work, workplace modification and phased hours, informed by an understanding of the Equality Act 2010 and relevant health and safety legislation.
Review and update Workability Plans at agreed intervals, adjusting recommendations as recovery, circumstances or employer response change.
Recognise the limits of the pilot service and of personal professional competence and escalate promptly and appropriately
Please see full Job Description and Person Specification
About us
Morecambe Bay Primary Care Collaborative is the largest employer of Primary Care colleagues in South Cumbria, we are a not-for-profit Community Interest Company, and work to support, guide and underpin primary medical care across Lancashire and South Cumbria.
We deeply value education and learning, hosting the Lancashire and South Cumbria Training Hub. We have a great team on our board that guide our organisation, and you will be supported to excel in your role.
Job description Job responsibilities
Post: Occupational Health Nurse
Service: MBPCC Enable Service
Accountable to: Clinical Lead
Responsible to: Advanced Nurse Practitioner
Hours: 37.5 per week
Salary: £41,590 (30% enhanced hourly rate for Saturday working)
Contract Type Fixed term 12 months. Secondment applications welcome.
Base: Hybrid and flexible with home working occasional Barrow and Mid Furness PCN sites
2. SERVICE CONTEXT
The pilot operates across Barrow and Mid Furness Primary Care Networks and is delivered by Morecambe Bay Primary Care Collaborative on behalf of participating practices.
The service is multidisciplinary. The post holder works alongside the Clinical Lead, Advanced Nurse Practitioner, allied health professionals, administrative staff
Participation is voluntary for patients. The service operates within an agreed clinical governance framework, defined escalation routes back to general practice, and a Data Sharing Agreement covering all information flows.
The pilot is time limited and subject to independent national evaluation. Data capture, consistency of practice and adherence to agreed protocols are therefore integral to the role rather than administrative afterthoughts.
The post holder does not replace the patients GP and does not assume responsibility for the management of underlying clinical conditions. Where clinical need is identified, it is escalated to the registered practice through agreed pathways.
3. KEY WORKING RELATIONSHIPS
Internal
Service Lead day to day management, absence and sickness, appraisals
Clinical Lead, Advanced Nurse Practitioner, allied health professionals, Enable administrator
External
Referring GPs, practice managers and primary care teams across Barrow and Mid Furness.
Patients and, with consent, their employers, line managers, HR
Local employers, Jobcentre Plus, VCSE [Voluntary, Community, and Social Enterprise] partners, therapy and mental health services, and other statutory agencies
4. MAIN DUTIES AND RESPONSIBILITIES
Clinical assessment and workability planning
Undertake structured work and health assessments with patients referred into the pilot, face to face, by telephone or by video, according to patient need and clinical appropriateness.
Assess the interaction between a persons health condition, their functional ability and the demands of their role, taking account of all appropriate physical, psychological, social and workplace factors.
Formulate and co-produce personalised Workability Plans focused on functional capability, phased return, adjustments and the practical support required to sustain work.
Exercise autonomous professional judgement in determining whether a period away from work is clinically appropriate, and articulate that judgement clearly, proportionately and defensibly.
Provide specialist advice on reasonable adjustments, graduated return to work, workplace modification and phased hours, informed by an understanding of the Equality Act 2010 and relevant health and safety legislation.
Review and update Workability Plans at agreed intervals, adjusting recommendations as recovery, circumstances or employer response change.
Recognise the limits of the pilot service and of personal professional competence and escalate promptly and appropriately.
Triage, caseload and pathway management
Contribute to the triage of incoming referrals, applying agreed criteria to determine the appropriate assessment route, practitioner and priority.
Manage a personal caseload, prioritising effectively against service standards and pilot appointment targets.
Identify patients whose needs fall outside the pilot model including those requiring urgent clinical assessment, safeguarding intervention or mental health crisis support and escalate through agreed routes without delay.
Refer and signpost to wider support, including WorkWell coaching, therapy services, musculoskeletal pathways, social prescribing, debt and housing advice and employment support.
Support colleagues in the wider team with clinical advice on complex or borderline cases, within scope of practice.
Employer and stakeholder liaison
With patient consent, participate in three way conversations between the patient, their employer and the service to agree practical adjustments and maintain workplace connection from day one of absence.
Produce clear, objective written advice for employers and managers that answers the question asked, respects medical confidentiality and avoids unnecessary clinical detail.
Communicate sensitively with employers who may hold differing views, using negotiation and persuasion to reach workable outcomes for the patient.
Build constructive relationships with referring practices, providing feedback that supports referral quality and confidence in the pilot model.
Clinical governance, safety and record keeping
Practice at all times within the NMC Code, professional standards, pilot protocols and standard operating procedures.
Maintain accurate, contemporaneous and legible records in the approved clinical system, in line with the Data Sharing Agreement and information governance requirements.
Obtain and record valid informed consent for assessment, for information sharing and for any contact with employers or third parties.
Discharge safeguarding responsibilities for children and adults at risk, escalating concerns in accordance with agreed policy.
Report incidents, near misses, complaints and risks through the pilot governance framework, and contribute to learning from them.
Participate in clinical supervision, case review and multidisciplinary discussion, including reflective review of complex or contested cases.
Maintain professional indemnity and NMC registration and comply with revalidation requirements.
Service design, data and evaluation
Contribute to the development and refinement of assessment templates, triage criteria, escalation thresholds, business rules and standard operating procedures as the pilot matures.
Capture the agreed management information and evaluation data set accurately and at the point of care, understanding that incomplete data weakens the national evidence base.
Participate in audit, service evaluation, quality improvement and test-and-learn cycles, and act on the findings.
Support the independent national evaluation, including interviews, case note review and data collection, within the limits of patient confidentiality.
Education, promotion and professional development
Promote the pilot to practices, patients, employers and partners in a positive way
Provide informal supervision, coaching and clinical advice to non-clinical members of the team.
Maintain and extend personal expertise in occupational health, work and health policy and fitness for work assessment; undertake training identified as necessary for the role, including any pilot specific training.
Participate in appraisal, personal development planning and mandatory training.
5. WORKING ARRANGEMENTS
This is a fixed term post for 12 months, funded through the national pilot. Continuation beyond the pilot period cannot be guaranteed and is subject to national decisions on the future of the model.
A flexible and agile approach to working is expected. The service operates a blended model of face to face clinics, remote consultation and home working, and the balance between these will vary with service demand and patient need.
Home working is supported for remote assessment, report writing and administrative activity, subject to a suitable, confidential home working environment and compliance with information governance requirements. Home working is an operational arrangement, not a contractual entitlement, and does not remove the requirement to attend sites.
Regular travel across Barrow and Mid Furness is required. Access to a vehicle and a full UK driving licence is necessary.
Some flexibility over working hours may be needed to accommodate patients who are in work and employers who are only available outside core hours such as Saturday working
The post holder will be expected to work in a rapidly evolving service where processes, systems and documentation change during the pilot period.
6. GENERAL RESPONSIBILITIES
Mandatory Training & Compliance
The post holder will be required to complete and remain compliant with all mandatory training as defined by the organisation.
Evidence of current training may be requested prior to commencement, and refresher training must be completed within specified timeframes.
MBPCC will consider the ability to passport training records if post holder has evidence of completion from other relevant employment
Additional Information
This role includes being partly home-based, which requires a high level of self-management.
Candidates must ensure a secure working environment in line with data protection policies.
Person Specification
Qualifications Essential
-Registered Nurse on the NMC register, Part 1 (Adult, Mental Health or Learning Disability) or Registered Midwife, with a current unrestricted registration. -Evidence of continuing professional development and compliance with NMC revalidation. -Willingness to undertake pilot specific training in workability assessment, fit note practice and work and health conversations.
Desirable
-Specialist Community Public Health Nurse (Occupational Health) registration, or an occupational health degree, diploma or certificate. -Degree or postgraduate study in occupational health, public health or a related field. -Training in fit note completion or DWP work and health assessment. -Teaching, assessing or mentoring qualifications. -Motivational interviewing, health coaching or case management training.
Experience Essential
-Significant post registration experience as an autonomous practitioner. -Experience of undertaking structured clinical assessments and formulating advice or recommendations independently. -Experience of managing a personal caseload and prioritising competing demands without close supervision. -Experience of producing clear written reports or care records for a non-clinical audience. -Experience of working within a multidisciplinary team.
Desirable
-Experience in occupational health, or a demonstrable interest in occupational health and the work and health agenda. -Practical experience of issuing, advising on or contributing to fit notes. -Experience of management referral or case management consultations. -Experience of sickness absence management, rehabilitation or return to work planning. -Experience of liaising directly with employers, HR or line managers. -Experience of working in primary care, community services or a WorkWell or vocational rehabilitation service. -Experience of contributing to service design, pilots, audit or quality improvement. -Experience of remote or telephone consultation.
Knowledge and skills Essential
-Ability to assess functional capacity and to relate health conditions to the demands of work. -Understanding of the principles of fitness for work assessment and the health benefits of good work. -Excellent verbal and written communication skills, including the ability to convey complex clinical information clearly and sensitively to patients, employers and non-clinical colleagues. -Negotiation, motivational and de-escalation skills, including where professional opinions differ. -Sound understanding of consent, confidentiality, information governance and the boundaries of disclosure to third parties. -Knowledge of safeguarding responsibilities for children and adults at risk. -Competent use of clinical record systems and Microsoft 365, including Teams for virtual consultation and meetings. -Ability to record data accurately and consistently for reporting and evaluation purposes.
Desirable
-Knowledge of the Equality Act 2010 as it applies to reasonable adjustments in the workplace. -Knowledge of relevant health and safety legislation. -Understanding of the national fit note reform policy context and the Workability Plan model. -Familiarity with EMIS or occupational health information systems -Understanding of audit and quality improvement methodology. -Knowledge of local employment support, WorkWell and VCFSE provision.
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 Morecambe Bay Primary Care Collaborative
Address The Strand
Barrow in Furness
Cumbria
LA14 2HG
United Kingdom
Employer's website https://mbpcc.co.uk/ (Opens in a new tab)