About this role
Job summary
We are seeking a compassionate, motivated and skilled Senior Healthcare Assistant / Nursing Associate to join our Frailty and Community Outreach Team within East & Central Brighton Primary Care Network.
Working as part of an integrated multidisciplinary team, the postholder will primarily support our Long-Term Conditions (LTC) workstream, delivering structured LTC reviews and routine clinical monitoring to housebound patients. The role will also contribute to the wider team's delivery of proactive, person-centred care to adults living with frailty, multiple long-term conditions and complex health or social needs.
This is an exciting opportunity to take on a varied and rewarding clinical role, working with a degree of autonomy within agreed competencies and under the guidance of registered clinicians. The postholder will undertake delegated clinical assessments, routine health monitoring and follow-up interventions, supporting the early identification of deterioration and helping patients remain safe and independent at home.
Working closely with GPs, nurses, allied health professionals and wider community services, the postholder will contribute to coordinated, preventative care, helping to improve health outcomes, reduce avoidable hospital admissions and address health inequalities.
Please note that this role is not eligible for Skilled Worker visa sponsorship. Applicants must have an existing right to work in the UK.
Main duties of the job
- Support structured long-term condition (LTC) reviews for housebound patients, ensuring access to routine assessment, monitoring and preventative healthcare.
- Undertake delegated assessments for patients with diabetes, hypertension, cardiovascular disease, chronic kidney disease and respiratory conditions, including clinical observations, phlebotomy and lifestyle assessments.
- Support Quality and Outcomes Framework (QOF) targets by completing relevant clinical monitoring, investigations and accurate documentation.
- Manage a delegated caseload, undertaking planned home visits within agreed competencies, identifying deterioration and escalating clinical concerns appropriately.
- Promote patient independence and self-management through health education, lifestyle advice and identifying barriers to treatment adherence.
- Support the PCN Health Hub for one session per week, providing reception support, initial enquiry triage, care navigation and signposting.
- Work collaboratively with GPs, nurses, pharmacists and the wider multidisciplinary team to coordinate care, improve health outcomes and reduce health inequalities.
About us
East & Central Brighton Primary Care Network (PCN) is a collaborative network of nine GP practices, serving over 70,000 patients across some of Brighton's most diverse communities. As a Community Interest Company, we are committed to improving population health, reducing health inequalities and delivering accessible, high-quality care to those who need it most.
Our multidisciplinary teams bring together nurses, pharmacists, physiotherapists, occupational therapists, mental health practitioners and social prescribing professionals to provide proactive, personalised and coordinated care. We work closely with primary care, community services and voluntary organisations to address both the clinical and wider social factors affecting health.
Our Frailty and Outreach Team supports adults living with frailty, multiple long-term conditions and complex health needs, with a particular focus on housebound patients and those who experience barriers to accessing healthcare. Through comprehensive assessment, long-term condition management and early intervention, we aim to prevent avoidable deterioration, promote independence and support people to remain well in their own homes.
We are an innovative and community-focused organisation, committed to developing services that respond to the needs of our local population. Our East Brighton Health Hub is one example of this approach, bringing health, wellbeing and community support together in an accessible setting.
Job description
Job responsibilities
Long Term Condition Reviews
- Support the delivery of structured long-term condition (LTC) reviews, primarily for housebound patients, in accordance with local clinical protocols and Quality and Outcomes Framework (QOF) requirements.
- Undertake delegated assessments and monitoring for patients with diabetes, hypertension, cardiovascular disease, chronic kidney disease, COPD, asthma and other long-term conditions.
- Carry out clinical observations and investigations, including blood pressure monitoring, phlebotomy, blood glucose monitoring, urinalysis and other relevant assessments within agreed competencies.
- Gather and document relevant information about patients' symptoms, medication adherence, lifestyle, wellbeing and general health to support comprehensive clinical reviews.
- Contribute to QOF achievement through accurate monitoring, clinical coding, identification of outstanding investigations and appropriate follow-up.
- Recognise changes in patients' conditions, abnormal findings and signs of deterioration, ensuring timely communication and escalation to the appropriate clinician.
- Promote health education, preventative care and supported self-management, empowering patients to make informed decisions about their health.
Community Working and Patient Support
- Undertake planned home visits across the PCN, delivering accessible healthcare to patients who are unable to attend their GP practice.
- Organise and manage a delegated caseload, prioritising visits and follow-up care while working with a degree of autonomy within agreed competencies.
- Support patients living with frailty, dementia, multiple long-term conditions and complex health or social needs, recognising the impact these may have on their independence and wellbeing.
- Identify and respond to concerns relating to falls, nutrition, hydration, mobility, functional decline, self-neglect and home safety.
- Follow lone-working procedures, home visit risk assessments and relevant health and safety policies.
- Develop positive, professional relationships with patients and carers, delivering compassionate and individualised care.
Health Hub Support
- Provide planned patient-facing reception support at the PCN Health Hub on Fridays, alongside the role's primary clinical responsibilities.
- Welcome patients, respond to enquiries and undertake initial screening, care navigation and signposting in accordance with agreed protocols.
- Work collaboratively with Health Hub colleagues to support the smooth and effective delivery of services.
Multidisciplinary Working and Care Coordination
- Work collaboratively with GPs, nurses, pharmacists, allied health professionals and wider community services to support coordinated, person-centred care.
- Communicate clinical findings and patient concerns clearly, ensuring appropriate follow-up and continuity of care.
- Support the coordination of investigations, appointments, referrals and onward signposting to relevant services.
- Contribute to multidisciplinary discussions and wider team activities, sharing relevant information to support patient care.
Clinical Governance, Safeguarding and Documentation
- Maintain accurate, timely and comprehensive clinical records using SystmOne, EMIS and other relevant systems, ensuring appropriate clinical coding and documentation.
- Recognise and respond to safeguarding concerns involving adults at risk, following local policies and escalation procedures.
- Work within professional boundaries, agreed competencies and delegated responsibilities, seeking support when required.
- Adhere to infection prevention and control, confidentiality, information governance, health and safety and lone-working requirements.
- Maintain clinical skills and competencies through training, supervision and continuing professional development.
General Expectations
As a member of East & Central Brighton PCN, the postholder will be expected to demonstrate professionalism, compassion and a commitment to delivering high-quality, equitable care.
The role requires a flexible and proactive approach, with the ability to manage competing priorities, work independently where appropriate and contribute positively to a supportive multidisciplinary team.
The postholder will be encouraged to participate in service development, quality improvement and new ways of working that enhance patient experience and improve access to healthcare.
Registered Nursing Associates must maintain active NMC registration and practise in accordance with the NMC Code.
Person Specification
Qualifications
Essential
- NVQ Level 3 in Health and Social Care or equivalent relevant healthcare qualification, with substantial clinical experience appropriate to a Senior Healthcare Assistant role; OR
- Foundation Degree in Nursing Associate Practice (Level 5) or equivalent NMC-approved qualification, with current NMC registration as a Nursing Associate.
- Competence in venepuncture/phlebotomy, or willingness to undertake training and competency assessment.
- Full UK driving licence and access to a vehicle for community visits.
Desirable
- Additional qualifications or training in long-term condition management, including diabetes, cardiovascular or respiratory care.
- Training in clinical assessment, frailty, dementia care or health promotion.
- Additional clinical competencies relevant to primary care and community nursing.
Experience
Essential
- Experience working as a Senior Healthcare Assistant, Nursing Associate or in a comparable clinical role.
- Experience undertaking clinical observations, routine health assessments and patient monitoring.
- Experience supporting patients with long-term conditions or complex health needs.
- Experience undertaking delegated clinical interventions within agreed competencies.
- Experience recognising changes in a patient's condition and escalating concerns appropriately.
- Experience working with registered clinicians and multidisciplinary teams.
- Experience maintaining accurate clinical records and communicating effectively with patients and healthcare professionals.
Desirable
- Experience supporting structured long-term condition reviews, including QOF monitoring.
- Experience working in primary care, a GP practice or community nursing service.
- Experience undertaking home visits or providing care to housebound patients.
- Experience supporting patients with frailty, dementia or multiple long-term conditions.
- Experience undertaking phlebotomy and other relevant clinical procedures.
- Experience using SystmOne or EMIS.
- Experience providing health promotion advice and supporting patient self-management.
Knowledge, Skills and Attributes
Essential
- Excellent communication and interpersonal skills, with a compassionate and person-centred approach.
- Good understanding of common long-term conditions and routine clinical monitoring.
- Ability to recognise clinical deterioration and escalate concerns appropriately.
- Understanding of safeguarding principles and professional responsibilities.
- Ability to work independently within agreed competencies and recognise professional limitations.
- Good organisational and time management skills, including the ability to prioritise a delegated workload.
- Ability to communicate effectively with patients, carers and multidisciplinary teams.
- Good IT skills, including the ability to use electronic clinical record systems.
- Flexible and adaptable approach to working across community and primary care settings.
Desirable
- Knowledge of QOF requirements and structured long-term condition reviews.
- Understanding of frailty, multimorbidity and the needs of housebound patients.
- Awareness of health inequalities and barriers to accessing healthcare.
- Knowledge of health promotion, preventative care and supported self-management.
- Interest in continued professional development and service improvement.
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
East and Central Brighton Primary Care Network
Address
East & Central Brighton Primary Care Network
Fourth Floor, Freedom Works, Barts House, Black Lion St,
Brighton
East Sussex
BN1 1ND
United Kingdom