About this role
Job summary
The aim of this post is to provide complex case management for the mental health and learning disability caseload of the Continuing Healthcare team.
As a registered mental health nurse, the post holder will provide relevant mental health expertise to the continuing health care team, as well as specifically manage mental health and learning disability patient caseload. Case management will ensure that the commissioned package of care is appropriate and meets the needs of the patient. In addition, as case manager, you will ensure that the quality of care provided by commissioned providers meets the required standards
Main duties of the job
This role requires a subject matter expert in Mental Health and Learning Disabilities. This includes the clinical knowledge to challenge care providers.
The post is responsible for providing professional expertise for mental health to the outcome of commissioning business processes for the Department or Directorate.
The post-holder will solely be responsible for the commissioning of complex mental health and learning disability care packages for patients for whom GMICB holds a commissioning responsibility under S.117 and act as complex case lead for all intensive rehabilitation placements, secure placements and Psychiatric Intensive Care Unit (PICU) placements commissioned by the ICS.
The post holder will be responsible for negotiation the commissioning of joint packages of care under S.117 with the relevant local authorities, where GMICB is the responsible commissioner. This includes resolving disputes regarding who is the responsible commissioner and negotiating funding splits between multiple organizations both within arbitration and legal settings. This responsibility is supervised and supported by the Deputy Director for CHC
About us
NHS GM plans and delivers joined-up services to improve the health and wellbeing of the population residing in Greater Manchester. Its's goals include improving population health and healthcare outcomes, tackling inequalities, enhancing productivity and value for money, and supporting broader social and economic development.
This will be achieved at various levels, including neighbourhood, place, combinations of places, and the Greater Manchester system.
Job description Job responsibilities
COMMUNICATION
The post holder will be required to:
Co-ordinate and manage MDT processes in regard to NHS Continuing Healthcare and NHS funded Nursing Care and Sec 117 processes for patients who are subject to Mental Health Act legislation.
Be responsible for presenting appropriate cases to GMICB funding panels.
Manage challenge and conflict in regard to NHS Continuing Healthcare processes and decision making.
Ensure GMICB is represented appropriately to service users, their relatives/power of attorney.
Work collaboratively and act as a specialist resource to all stakeholders in both an advisory and directional capacity.
Be influential within a complex and challenging environment.
Provide and receive complex, sensitive information relating to patients care, home circumstances, diagnosis and clinical condition.
INFORMATION RESOURCES, ANALYSIS AND DECISION MAKING
Ability to critique and analyse clinical and social information regarding person centred assessment and sound decision making.
Analysing complex facts or situations such as clinical need, treatment and care options, diagnosis and safety of care package, patient health and social circumstances and ability to manage independently.
Knowledge of budgetary management.
They will manage confidential information provided to the GM ICS to support patient care, ensuring that the requirements of the Data Protection Act and the GDPR are met.
To reference the areas of health inequality identified through the Joint Strategic Needs Assessment (JSNA).
Support the analysis, interpretation, and production of reports regarding S.117 packages of care for the Mental Health Investment Standard providing expertise in Mental Health and Learning Disability via Analysis, interpretation and presenting complex data related to patient needs. There may be conflicting information (such as public safety, least restrictive practice, conflicting guidance, opposing patient wishes and Court of Protection orders where judgement is required regarding unique situations which do not have obvious solutions) to highlight issues, risks and support decision making where there are a range of options to committees, ICP and other budget holders as required
This includes analysing written evidence that may be emotionally distressing information, including child sexual abuse and violent criminality such as murder and manslaughter which the individual may have been victim, perpetrator, or both, in order to make commissioning decisions
PLANNING & ORGANISATION
Able to work under pressure within an agreed time frame.
Ensure that all statutory reviews of patients on the ICS Mental Health and Learning Disability caseload are completed in line with national guidance.
In accordance with the Health and Safety at Work Act 1974 and subsequent legislation the post holder is required to undertake a proactive role in the management of risks in all their actions. This includes:
Undertaking risk assessments in line with GM ICS risk assessment process.
Reporting all incidents, near misses and hazards in line with GM ICS reporting arrangements/system.
Undertaking a statutory duty of care for your own personal safety and that of others
Attending all statutory and mandatory health and safety training, appropriate to the role.
Ability to work effectively to meet post requirements and re-prioritise workload as the situation demands.
They will act as advocate for the patient and will provide complex case management for the mental health and learning disability patient caseload.
They will liaise with the wider multi-disciplinary team to ensure that the commissioned package of care in the community setting meets the patients needs and is good value for money.
They will support the funding panel process through the provision of evidence- based case information and robust care planning to enable decision making
They will respond to day-to-day enquiries from patients, providers and stakeholders.
Plan and organise complex activities such as multidisciplinary and clinical meetings regarding patients care planning and strategic planning for mental health and complex care services.
PATIENT/CLIENT CARE
Responsible for monitoring and ensuring that the standards of care are meeting the expectations of the ICS, in both hospitals, care home, supported accommodation, patients own homes and specialist placements settings in line with Better Standards for Health, and Mental Capacity Act 2005.
To practice competencies developed within the scope of professional practice.
Provide Specialist advice in relation to patient care such as advice concerning care packages, appropriate placements for care, standards of care and treatment to the CHC Team, local authority and NHS Trusts as required.
Critical analysis of available information, including but not limited to medical and nursing notes to establish critical history of the service users relevant needs to produce a specialist nursing assessment.
Ensure appropriate continuity of care by appropriate transfer of information to ensure high standards of care.
Provide a range of highly complex skills, to assess and make sound clinical decisions regarding the establishment of care plans to support suitable placements in a timely manner.
Identify service users whose care needs could be met in a more appropriate setting.
Carry out joint assessments with Social Services colleagues to ensure appropriate placement of service users.
Be proactive in quality assurance and identifying deficits in patient care, reporting these into the ICS quality mechanisms.
Assist in training of students and multi-agency training development, as required.
Promoting discharge to the service users own home when feasible, with direct knowledge of community care provision.
The case management includes patients with individual packages of care commissioned by the ICS (as they are not all on the caseload of Continuing and complex care)
Maintain commissioning case management of highly complex commissioned packages of care.
The post holder is responsible for ensuring the effective case management of mental health patients and for people with learning disabilities. This includes attending, overseeing and influencing CPA and other patient meetings, completing Safe and Well checks, within the boundaries of the role and with support from senior colleagues, acting as respondent to legal cases involving the judicial system and instructing solicitors and providing clinical supervision to other professionals.
The post holder will be responsible for the scrutiny of Out of Area placements to deliver improved quality, patient experience and value for money. This is done in a context of quality governance, taking advice from colleagues who are experts in quality and safeguarding. This ensures people are placed closer to home.
Reviewing the use of 1:1 observations that GMICB part or wholly funds, inclusive of CHC, S.117 and other health funding streams, and providing support to the relevant case managers to ensure that packages of care are meeting patient needs in a least restrictive manner.
POLICY & SERVICE DEVELOPMENT
Providing specialist knowledge and expertise to ensure that appropriate case management informs the commissioning process and commissioning decisions.
Can be required to impart distressing information to families regarding placement and future care.
Advise and influence resolution with any parties involved in conflict regarding the assessed outcome of care.
Participate and lead, as necessary, in professional/multi-professional meetings and conferences as required.
Implements practices and procedures that impact beyond own work area such as complex care protocols, funding protocols and assessment pathways for mental health or complex patients including processes relevant to the national implementation of the Transforming Care Program.
Working with the Mental Health Commissioning lead, undertake contract negotiations for Learning Disability, Community and inpatient Eating Disorder services and third sector contract and grant agreements commissioned solely or jointly by GM ICB. This may involve having highly complex discussions where at times there may be disagreements.
Work in conjunction with Local Authority peers to support and implement the effective integration of commissioning and care within GMICB that is being led by the ICB and LA Executive Teams.
With the lead commissioner for mental health and LD, the post holder will lead the implementation, delivery and review of processes in support of the Transforming Care agenda within locality but also where appropriate to support Greater Manchester commissioning initiatives.
The post holder will support current processes, facilitate discussions and advise colleagues as to how best practice might be adopted in the definition of future processes, document those processes as they are agreed and oversee their delivery.
Hold Transforming Care commissioning responsibilities by chairing and drawing recommendations from Care and Treatment Reviews and maintaining oversight of the implementation of these recommendations.
Highlight exceptions and risks ensuring mitigating action can be taken to keep the programme on track.
Person Specification
Professional registration Essential
NMC Registration
Qualifications Essential
Educated to masters level or equivalent level of experience of working at a senior level in specialist area. Evidence of an in date Registered Mental Nurse Nursing and midwifery registration. Evidence of post qualifying and continuing professional development
Experience Essential
Knowledge of Continuing and Complex health and specialist knowledge in a range of health care settings including mental health
Experience Essential
Must understand the background to and strategic aims of CHC and budgetary impact
Experience Essential
Should have an appreciation of the relationship between the Department of Health, NHS England and individual provider and commissioning organisations
Experience Essential
Experience of managing risks and reporting through governance processes.
Knowledge Essential
Experience of identifying and interpreting National policy and of researching best practice, interpreting its relevance and processes/ practices which could be implemented successfully to reform the service Evidence of planning and delivering work and projects and services on time.
Competencies Essential
Ability to work without supervision, providing specialist advice to the organisation, working to tight and often changing timescales Interpreting national policy for implementation. Experience of managing a complex case load.
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 NHS Greater Manchester Integrated Care
Address Unity House, Salford Civic Centre
Chorley Road
Swinton
M27 5AW
United Kingdom
Employer's website https://www.gmsharedservices.nhs.uk/ (Opens in a new tab)