Advanced Occupational Therapist

Central and North West London NHS Foundation Trust; Uxbridge; On-site; GBP 42,000 - 50,000; Full time

Job summary

Central and North West London NHS Foundation Trust is seeking a Band 7 Advanced Occupational Therapist to lead OT clinical practice within the Hospital at Home and Urgent Community Response pathways across Hillingdon. You will deliver autonomous assessments, discharge planning, and complex case management in patients' homes, supported by a multidisciplinary team.

The role requires HCPC registration, RCOT membership, and substantial post-graduate CPD, with experience in frailty, geriatrics, and

Qualifications

• Diploma or Degree in Occupational Therapy and HCPC registration.
• RCOT membership and postgraduate CPD portfolio.
• Extensive post-qualification experience in community/acute care.
• Experience in frailty, geriatrics, and complex caseload management.
• Ability to supervise staff and lead OT teams in a multidisciplinary setting.

Responsibilities

• Be clinically and legally accountable for full OT management within H@H/UCR pathways.
• Undertake advanced OT assessments, discharge planning and goal-directed treatment.
• Apply clinical reasoning to analyze complex information from multiple sources.
• Deliver OT treatment plans using CGA components and functional strategies.
• Ensure informed consent and uphold Mental Capacity Act 2005 and DoLS requirements.
• Discharge readiness decisions in collaboration with MDT and daily review processes.

Skills

Clinical reasoning

Autonomous practice

Team leadership

Supervision

Education

Diploma or Degree in Occupational Therapy

HCPC registration

RCOT membership

Postgraduate CPD portfolio

Tools

SystmOne

EMIS

Job description

Job Overview The Hospital at Home (H@H) service is an adjunct pathway to Urgent Community Response (UCR), delivering hospital-level monitoring and clinical intervention to acutely unwell adults in their own homes across the London Borough of Hillingdon. Operating 08:00–20:00, seven days per week, H@H provides an integrated step-up (admission avoidance) and step-down (early supported discharge) model in accordance with the NHS England Virtual Wards Operational Framework and the Hillingdon Health and Care Partnership Borough-wide Reactive Care Service.

Job Overview The Hospital at Home (H@H) service is an adjunct pathway to Urgent Community Response (UCR), delivering hospital-level monitoring and clinical intervention to acutely unwell adults in their own homes across the London Borough of Hillingdon. Operating 08:00–20:00, seven days per week, H@H provides an integrated step-up (admission avoidance) and step-down (early supported discharge) model in accordance with the NHS England Virtual Wards Operational Framework and the Hillingdon Health and Care Partnership Borough-wide Reactive Care Service. The Band 7 Advanced Occupational Therapist is a senior clinical role at the heart of the UCR and H@H MDT. As the most senior therapy clinician on the H@H establishment, the post holder is the primary OT lead for the service, providing expert occupational therapy assessment, intervention, clinical reasoning, and discharge planning for complex, frail, and acutely unwell patients in their own homes. The role encompasses autonomous clinical practice, H@H Initial Visits, clerking of step-up patients, caseload prioritisation, and senior clinical oversight of therapy delivery within the team. The post holder must be able to work flexibly over a 7-day week including weekday and weekend shifts and will frequently work as a lone practitioner in community settings.

Main duties of the job

• Be professionally and legally accountable for all aspects of own clinical work, managing an autonomous and complex caseload of UCR and H@H patients in accordance with HCPC standards and the RCOT Code of Ethics and Professional Conduct. Ensure a high standard of care and support more junior staff to do likewise.
• Perform the UCR / H@H Initial Visit for patients stepped up to H@H following the 48-hour C2R review, within 4 hours of the MDT decision - including OT-specific components of the clinical clerking, functional status, environmental risk, equipment, and advancing goal setting.
• Conduct advanced occupational therapy assessment for patients with acute illness, frailty, cognitive impairment, complex multi-morbidity, and diverse psychosocial needs, using validated tools (Rockwood Clinical Frailty Scale, Barthel Index, 6CIT, MUST, FRAT, environmental and manual handling risk assessment, seating and postural assessment) and applying higher-level clinical reasoning to formulate accurate occupational profiles and intervention plans.
• Deputise for the UCR / H@H Clinical Lead as needed in the day-to-day clinical leadership of the H@H pathway, including triage and prioritisation of referrals, chairing the morning MDT in the Clinical Lead’s absence, and supporting the H@H COD in complex case management and caseload prioritisation by acuity.

Working for our organisation

There are over 300 Occupational Therapists (OTs) in CNWL. We work in many different teams in both physical and mental health, as well as a number of specialist areas. There are plenty of opportunities to develop your career with us and maintain your dual skills.

OT in CNWL is very fortunate in having an established professional structure including an AHP director, Trust wide Professional Head of OT, borough and specialist Head OTs. This has the huge benefit of ensuring representation of our profession at all levels - both strategically and operationally.

Personal and professional development is a high priority for the profession and is underpinned by research groups and OT clinical networks. We invest in the development of our staff by providing excellent internal training as well as commissioning specialised external training and providing quality supervision.

We actively support the next generation of OTs through Apprenticeships, student placements and the promotion of the profession as a career in schools. We are proud of the diversity in our workforce and have invested time in supporting and developing this further through our Equality Diversity and Belonging OT group.

Occupational Therapy Careers at CNWL

Occupational Therapy :: Central and North West London NHS Foundation Trust

https://vimeo.com/954749344?fl=pl&fe=cm

Detailed Job Description And Main Responsibilities

• Be professionally and legally accountable for the full management of the patient’s UCR / H@H clinical episode of care, from step-up admission through to discharge.
• Undertake specialist occupational therapy assessment of patients’ functional, cognitive, environmental, and psychosocial needs within the H@H caseload, understanding diverse and complex presentations including frailty syndromes, acute medical exacerbations, delirium, end-of-life care, and post-discharge reablement needs.
• Apply advanced clinical reasoning to analyse complex clinical and social information from multiple sources (SystmOne record, EMIS, MDT discussion, patient and carer interview, environmental assessment) to identify significant health changes warranting clinical intervention and to recommend the best course of occupational therapy management.
• Formulate and deliver individualised OT treatment and goal-directed management programmes, using a wide range of evidence-based approaches including Comprehensive Geriatric Assessment (CGA) components, cognitive rehabilitation, graded functional activity, occupational adaptation, and carer training.
• Assess the patient’s understanding of treatment proposals; gain valid informed consent; and work within a legal and ethical framework for patients who lack capacity to consent, in line with the Mental Capacity Act 2005, DoLS, and relevant CNWL policies.
• Evaluate patient progress against the H@H care plan and daily C2R criteria; reassess and modify plans in response to clinical change; and determine discharge readiness in conjunction with the SCDM at the daily morning MDT.

Person specification

Essential

• Diploma or Degree in Occupational Therapy
• Current, unrestricted HCPC registration
• Membership of the Royal College of Occupational Therapists (RCOT)
• Evidence of substantial postgraduate CPD maintained in a portfolio, relevant to community OT, frailty, virtual ward, or urgent community response
• Extensive postgraduate OT experience across a range of clinical areas demonstrating increasing seniority, including Band 6 experience in at least one of: neurology, orthopaedics, medicine of the elderly, frailty, or MSK
• Significant experience of working with adults and older people with frailty, chronic conditions, complex co-morbidities, and cognitive impairment in a clinical setting
• Experience of supervising and mentoring other OTs, therapy assistants, or students
• Experience of clinical audit, service evaluation, quality improvement, and/or change management
• Knowledge of a wide range of OT assessment approaches and specialist equipment prescription, demonstrated by advanced clinical reasoning including Comprehensive Geriatric Assessment (CGA), 6CIT, Rockwood Clinical Frailty Scale, Barthel Index, MUST, FRAT, seating and postural assessment, and environmental risk assessment
• Knowledge and application of the Mental Capacity Act 2005, DoLS, Care Act 2014, safeguarding adults and children frameworks, and their implications for H@H practice
• Ability to carry out moderate to intense physical effort throughout the working day, including manual handling, home assessments, equipment manoeuvres, and patient transfers in domestic environments
• Licensed driver and car owner with business-use insurance; able to travel across the London Borough of Hillingdon

Desirable criteria

• Non-medical prescribing qualification (or working towards)
• Previous NHS experience in intermediate care, Hospital at Home, UCR, early supported discharge, or virtual ward settings
• Knowledge of current national policies relevant to Hospital at Home, virtual wards, UCR, and frailty (NHS England Virtual Wards Operational Framework; NICE NG159; NICE NG56; OPEL Framework 2024–2026)