About this role
Job summary
Hours: up to 30 hours per a week
Salary dependant on experience
An exciting opportunity has arisen to join our expanding Frailty Team. We are growing our service to enhance the care we provide to our local community, and were looking for a dedicated professional to become part of this forward-thinking team.
Our established Frailty Team currently includes a Community Frailty Practitioner, a Community Frailty Paramedic, and a Care Coordinator. A Non-Medical Prescribing qualification is essential for this role, and applicants must have successfully completed this qualification.
The PCN Frailty Team plays a key role in supporting our practices by conducting weekly ward rounds, monitoring new care home residents, and providing high-quality long-term condition management.
In addition, the team delivers a non-urgent housebound service, offering vital support for patients who are unable to attend the surgery but require ongoing management of their long-term conditions.
This is a fantastic chance to be part of a dynamic, compassionate team dedicated to improving frailty care across our community.
Main duties of the job
We are looking for an experienced & motivated clinical practitioner to join our supportive & forward-thinking team, delivering high-quality care to housebound patients & residents within care homes.
This is a rewarding & varied role where you will work autonomously within your professional boundaries, undertaking history taking, clinical assessment, diagnosis, treatment, & evaluation of care for vulnerable patients.
You will play a key role in leading long-term condition management for elderly, frail, & housebound patients, helping to improve outcomes & quality of life within the community. A key part of the role will involve leading & participating in regular care home ward rounds, working proactively with care home staff & the wider multidisciplinary team to provide coordinated, person-centred care.
The successful candidate will demonstrate safe clinical decision-making, using advanced assessment & diagnostic skills within general practice. You will prioritise & triage patient needs effectively, arranging investigations, referrals, & onward care when required.
Working closely within a supportive multidisciplinary team, you will collaborate with GPs, nurses, care homes, & wider healthcare professionals to deliver holistic care.
This is an exciting opportunity to develop within a dynamic role, with strong clinical support, mentorship, & opportunities for professional growth. The workload will include home visits, care home visits, ward rounds, & telephone consultations.
About us
Severnvale PCN (Primary Care Network) comprises four GP practices in South Gloucestershire delivering services to a population of circa 34,000 patients which includes 10 care homes. We are an enthusiastic, dynamic, and friendly PCN who constantly strive to improve patient pathways and health care outcomes.
The PCN team includes a Clinical Director, a PCN Manager, 2 Community Frailty Practitioner, a Care Co-ordinator, 4 Clinical Pharmacists, a Pharmacy Technician, 7 Care Coordinator Prescription Clerks, 2 dedicated Social Prescribing Link Workers and First Contact Physiotherapists.
Job description Job responsibilities
Job responsibilities,
To work as part of a multi-disciplinary team across the PCN to care for our housebound and care home patients, including proactive assessment, diagnosis and treatment of individuals using a holistic approach.To undertake care home weekly ward rounds.
To assess, diagnose, investigate, treat, refer or signpost patients/service users within the community with undifferentiated or undiagnosed condition relating to minor illness, minor injury or urgent problems.
The post holder will use advanced clinical skills to provide education to service users, promoting self-care and empowering them to make informed choices about their treatment.
The post holder must have access to a vehicle for home visits with mileage expenses remunerated by submission of a monthly mileage form. (Please note it is the postholders responsibility to ensure that their car insurance is covered for business use).
Visiting patients who are frail/have co morbidity in their homes or in a care home. Undertake care home ward rounds with the support of the PCNs Community Frailty Practitioner, Community Frailty Paramedic and Care Coordinator Prescribe/issue medications as appropriate following policy, patient group directives and local pathways. Independent Prescriber qualifications is essential. May be required to help with the Avoiding Unplanned Admission reviews Consult with patients, take medical histories, perform physical examinations, analyse, diagnose and explain medical problems during consultations and home visits. Recommend and explain appropriate diagnostic tests and treatment. Formulate differential diagnoses and develop and deliver appropriate treatment and management plans. Request and interpret results of laboratory investigations when necessary. Advanced end of life care planning to include ReSPECT discussions and development of Personalised Care and Support Plans. Advise patients on general health care and minor ailments, with referral to other members of the primary and secondary health care team as necessary. Undertake assessment for patients within their place of residence using diagnostic skills, initiation of investigations and feeding back to the patients GP where appropriate. To help manage/support patients with their long term condition. Support quality improvement and assurance initiatives within the PCN. Promote public health and screening programs, including immunisations and cervical screening. Integrate population health management approaches to reduce health inequalities. Work collaboratively with the wider practice team to enhance patient care. Work with local and national evidenced based policies and procedures. To communicate at all levels within the team ensuring an effective service is delivered. Ensure evidenced-based care is delivered at the highest standards ensuring delivery of high-quality patient care.
Person Specification
Experience Essential
Experience of working to protocols or guidelines. Experience in frailty care, chronic disease management, and care planning in community or primary care settings CDM Management Ongoing evidence of CPD
Desirable
Experience of offering mentorship and supervision to other nursing staff. Experience of developing and implementing training programs. Experience of working in care homes
Other Essential
Meets DBS reference standards and criminal record checks Willingness to work flexible hours when required to meet work demands Access to own transport and ability to travel across the locality to visit people in their own homes. Awareness of data protection (GDPR) and confidentiality issues particularly within a healthcare setting.
Qualifications Essential
Batchelor Degree in Life Science/Biomedical/Nursing or Allied Health Science or equivalent Health & Care Professions Council (HCPC) registration. Able to operate at an advanced level of clinical practice, using Level 7 capabilities as defined by (NHE/I GP DES, ARRS funding) and HEE guidance. Undergraduate attainment at minimum of Framework for Higher Education Qualification (FHEQ) Dip.HE. In a relevant subject. Non-medical prescribing qualification Full UK driving license and access to vehicle (for home visits as required
Desirable
Minimum 3 years post-registration experience.
Specialist knowledge/skills Essential
IT literate / proficient in the use of the computer Excellent interpersonal and organisational skills Good problem solving and decision-making skills Ability to manage workload effectively A high standard of clinical skills and experience of using these skills in different situations. Willingness to always work towards the best interest of the patient. Team player / ability to liaise effectively with colleagues and other members of the multi-disciplinary team. Ability to write comprehensive, accurate clinical notes, implement and evaluate care plans.
Desirable
Understand own scope of practice, the context of continual learning and the need to develop constantly to ensure safe, competent and confident practice. Evidence of success in efficient and effective project and program management
Personal attributes & abilities Essential
Ability to co-ordinate and prioritise workloads able to multi-task as well as be self-disciplined and highly motivated. High degree of personal credibility, emotional intelligence, patience, and flexibility Ability to cope with unpredictable situations.
Desirable
Confident in facilitating and challenging others Demonstrates a flexible approach to ensure patient care is delivered.
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 Severnvale PCN
Address Eastland Road
Thornbury
Bristol
BS35 1DP
United Kingdom