Clinical Review Nurse

Cheshire & Wirral Partnership NHS Foundation Trust; Birkenhead; On-site; GBP 50,000 - 65,000; Full time

Job summary

Cheshire & Wirral Partnership NHS Foundation Trust is seeking a qualified professional to oversee Continuing Healthcare referrals and decision verification. You will ensure timely, accurate assessments within the single point of access and manage complaints and disputes to a high standard.

The role requires senior experience, a current NMC registration, and strong communication and negotiation skills. The Trust emphasises values and equality, offering supportive induction and development

Qualifications

• Educated to 1st degree level or equivalent level of experience in a senior role.
• Current NMC Registration.
• Evidence of continued professional development and modern practice would be advantageous.

Responsibilities

• Ensure appropriate referrals to NHS Continuing Healthcare Services using established frameworks.
• Provide patient-focused service with prompt, accurate decisions within the single point of access for Continuing Healthcare.
• Verify Continuing Healthcare decisions in line with procedures and policy.
• Oversee resolution of complaints, appeals and disputes with high-quality outcomes.
• Lead disputes involving Responsible Commissioners and liaise with senior leadership as needed.

Skills

Strong communication skills

Team leadership

Negotiation / influencing

Relationship building

Attention to detail

Education

First degree or equivalent experience

NMC Registration

Tools

Microsoft Office

Job description

Responsibilities

• To use expert knowledge of National Continuing Healthcare and Funded Nursing Care Framework and Mental Health Act (117 aftercare) to ensure appropriate referrals to the Service;


• To provide patient focused service by ensuring prompt and accurate and effective decisions within the single point of access of NHS Continuing Healthcare Services;


• To use Who pays - Determining Responsible Commissioner guidance to determine appropriate patient referrals;


• Responsible for the verification of Continuing Healthcare decisions on behalf of the ICB, in line with operational procedure and organisational policy;


• Overseeing the management resolution of complaints, appeals and disputes, ensuring operational staff complete to a high standard.


• Lead the resolution of Responsible Commissioner disputes with out of area ICB's or other organisations; liaising with legal and Senior ICB leadership when appropriate., All new starters will commence in post on one fixed start date each month, in line with our Prepare to Care (P2C) induction programme date. P2C offers up to 3 weeks training to support you to meet the induction / initial training requirements of the role.

Whether you are just starting out in your career or looking to use your existing skills and experience in a new role, you'll find something to suit you at CWP.

Detailed job description and main responsibilities

At CWP, our recruitment selection processes are based on both competence (see person specification for details) and values. CWP recruits people that can demonstrate the Trust's Values in their everyday life and we use a values-based approach in our interviews, which explores not only what you do but how and why you do it. Before applying, we encourage you to review the Trust's Values and think about how these align with your own personal values. The supporting information section in your application should reflect your understanding of the Trust's Values and associated behaviours and you should provide examples from your work experience and/or personal life which demonstrate these values through your behaviours.

If you have a disability that meets the definition set out in the Equality Act 2006, and you can show that you meet the 'essential' criteria described in the person specification for an available position, please answer 'YES' to the question: 'Do you wish to be considered under the Guaranteed Interview Scheme?' Please inform the team if you have any special support needs to be considered as part of the interview and selection processes.

The trust offers a Guaranteed Interview Scheme to any armed forces community applicants who meet the essential criteria for the post and encourages applications from armed forces reservists or cadet force adult volunteers. Please note applicants will be required to pay for their DBS check. Costs are deducted from salary following appointment. You are encouraged to enrol for the DBS Update Service. A small annual fee of £16 per year applies.

Essential criteria

• Educated to 1st degree level or equivalent level of experience of working at a senior level in specialist area.


• Current NMC Registration.

Desirable criteria

• Certificate in management or substantial equivalent internal training.


• Evidence of continued professional development.


• Understanding of the patient experience agenda & its contribution to quality.


• Conversant with national and local guidance on NHS Continuing Health care/NHS Funded Care for adults.


• Conversant with Mental Health Act 1983.


• Working knowledgeable of Who Pays Guidance 2020.


• Strong understanding of the operational management and clinical role of the NHS.


• Full understanding of Social Services and other Local Authority functions.


• Knowledge & understanding of the current NHS agenda and of primary care.


• Highly developed communication skills both verbal & written.


• Ability to communicate with clinical and all levels of staff effectively.


• Capability to work across boundaries and foster close collaboration; using influencing and negotiation skills.


• Ability to build effective working relationships across a range of health care and other organisations.


• Will consider the most effective way to promote equality of opportunity and good working relationships.


• IT skills ability to use Microsoft Office programmes (Word, Outlook).


• Accurate data entry and text processing skills.


• High level critical thinking skills and ability to develop logical and comprehensive opinions with attention to detail.


• Understanding of the commissioning agenda including its scope, structure, methods of operation, processes and inter-relationships.


• Working knowledge Children's and Young People Continuing Care Framework.


• Understanding of dispute resolution process both for individuals and organisations.


• Clear evidence of successfully working with a wide range of external organisations.


• Manages self and own workload, delivering outcomes in a timely and efficient manner.


• Track record in clinical quality & performance activities.


• Effective delegator when required.


• Ability to motivate / support team members.


• Experience of partnership working with other agencies.


• Managerial experience.


• Experience of managing change.

Trust Values

• Demonstrate alignment with Trust Values (6 C's: Commitment, Communication, Care, Courage, Compassion, Competency), You must have appropriate UK professional registration.

Cheshire and Wirral Partnership (CWP) provides health and care services for a population of over one million people, including mental health, learning disability, community physical health and all-age disability care, as well as the provision of three GP surgeries in Cheshire.

We employ around 4,500 staff across 73 sites and have services across Wirral and Cheshire, as well as Trafford, Warrington, Bolton, Halton, Liverpool and Stockport. Our aim is to help improve the lives of everyone in our communities, adopting a compassionate, person-centred approach to everything we do. We are rated as Outstanding for Caring by the Care Quality Commission, with a Good rating overall. As a Disability Confident Employer, Rainbow Badge Scheme member, Veteran Aware organisation and proud holder of the Armed Forces Covenant Employer Recognition Scheme Gold Award, CWP is committed to making our recruitment practices as inclusive as possible and developing a culture that values differences, and welcome applications from people who have direct experience of accessing our services.