Acute-to-Community Care Transition Lead

Sussex Partnership Nhs Foundation Trust; Worthing; On-site; GBP 32,000 - 42,000; Full time

Job summary

Sussex Partnership NHS Foundation Trust in Worthing seeks a Band 6 Nurse, Social Worker or Occupational Therapist to join the Worthing Neighbourhood Mental Health Team as an Acute and Community Transition Practitioner. The role bridges acute and community services, ensuring smooth transitions for patients moving between settings.

Key duties include leading admissions to acute hospitals, coordinating with carers and external services, and overseeing complex discharge planning for up to 4–6 weeks

Qualifications

• Registered professionals in nursing, social work or occupational therapy.
• Experience coordinating acute-to-community transitions and discharge planning.
• Ability to liaise with carers, families and external services.

Responsibilities

• Attend acute and community meetings (Crisis Team MDT, ward huddles, discharge planning).
• Lead Practitioner for new admissions to acute hospitals and ECR beds for 4–6 weeks post-discharge.
• Coordinate with carers, families and external services (CGL, Social Care, Talking Therapies).
• Support inpatient services to achieve timely discharges and robust discharge planning.
• Maintain oversight of patients with complex needs and ensure safe pathways.

Skills

Discharge planning

Interdisciplinary teamwork

Communication

Leadership

Education

NMC registered nurse

Social worker qualification

OT qualification

Job description

Sussex Partnership NHS Foundation Trust in Worthing seeks a Band 6 Nurse, Social Worker or Occupational Therapist to join the Worthing Neighbourhood Mental Health Team as an Acute and Community Transition Practitioner. The role bridges acute and community services, ensuring smooth transitions for patients moving between settings.

Key duties include leading admissions to acute hospitals, coordinating with carers and external services, and overseeing complex discharge planning for up to 4–6 weeks