Frailty Assessment Clinician

Westrop Medical Practice; Swindon; On-site; GBP 45,000 - 60,000; Full time

Job summary

Westrop Medical Practice in Swindon is introducing a Frailty Review Clinician role to support delivery of the Enhanced Frailty Service Local Commissioned Service (LCS). The post holder will undertake autonomous clinical decision-making, frailty assessments and personalised care planning to support independence and reduce hospital admissions.

The role suits an Advanced Clinical Practitioner, Advanced Nurse Practitioner, Paramedic Practitioner or other experienced clinician with UK registration

Qualifications

• Must be Registered ACP and UK compliant.
• Experience working autonomously in primary care or community services.
• Experience assessing patients with complex needs.
• Understanding of frailty and long-term conditions.
• Experience completing structured medication reviews.
• Experience of care planning.
• Experience completing RESPECT forms.
• Experience of home visiting.

Responsibilities

• Deliver the Enhanced Frailty Service LCS.
• Identify and review patients with moderate/severe frailty.
• Improve outcomes and reduce avoidable admissions.
• Support care planning and coordination.

Skills

Registered ACP

Autonomous practice

Complex needs assessment

Frailty & long-term care

Structured medication reviews

CARE planning

RESPECT forms

Home visiting

Job description

Job summary

Westrop Medical Practice is introducing a new Frailty Review Clinician role to support delivery of the Enhanced Frailty Service Local Commissioned Service (LCS). The role has been created in response to the increasing requirements of the service and will focus on identifying, assessing and supporting patients living with frailty to ensure they receive appropriate care, reviews and care planning. We anticipate this role would be particularly suited to an Advanced Clinical Practitioner, Advanced Nurse Practitioner, Paramedic Practitioner or other experienced registered clinician with the skills and experience to undertake autonomous patient assessment, clinical decision-making and care planning. Applications from suitably qualified and experienced clinicians from other professional backgrounds will also be considered.

Main duties of the job

The postholder will support delivery of the Enhanced Frailty Service Local Commissioned Service, helping identify, assess and manage patients living with moderate to severe frailty. The role will involve undertaking frailty assessments, evaluating patients' physical, psychological and social needs, and developing personalised care plans to support independence, wellbeing and quality of life. The successful candidate will exercise autonomous clinical decision-making, identifying appropriate interventions, initiating referrals and escalating concerns where required. The postholder will work proactively with patients identified through electronic frailty scoring and clinical review, ensuring assessments, reviews and care planning are completed in line with local and national guidance. This will include supporting advance care planning and RESPECT discussions, identifying patients who may benefit from additional community support, and helping reduce avoidable hospital admissions through early intervention and coordinated care. Working as part of a multidisciplinary team, the successful candidate will liaise with GPs, Nurses, Paramedics, Social Prescribers, Care Coordinators and community services. The role may include face‑to‑face consultations, telephone reviews, home visits and multidisciplinary meetings. The postholder will also contribute to service development, maintain accurate clinical records and support the practice in meeting the requirements of the Enhanced Frailty Service.

About us

We are a well‑established, forward thinking and innovative GP practice based in Swindon, Wiltshire. Our goal is to offer the highest standard of patient‑centred healthcare. Our Practice is made up of six separate Surgeries with 50,000 patients, located in Highworth, North Swindon, Old Town, Tadpole Garden Village and Blunsdon. We aim to offer convenient appointments in pleasant surroundings with polite and friendly staff. We want all patients to benefit from appointment times and services that suit their lifestyle. Teamwork is at the heart of our culture. We work hard but effectively with a passion for improving health outcomes for all our patients. Our welcoming, friendly and supportive team are committed to delivering high quality patient care. We are very open to hearing new ideas and trying different ways of working. We offer NHS pension scheme as well as providing a supportive environment and in return the post holder will be vital to our practice success. Westrop Medical Practice are members of the Brunel Health Group. As a group we are the largest primary care research group across the Southwest of England.

Job responsibilities

Purpose of the Role

• Deliver the Enhanced Frailty Service LCS.
• Identify and review patients with moderate/severe frailty.
• Improve outcomes and reduce avoidable admissions.
• Support care planning and coordination.

Key ResponsibilitiesClinical Assessment

• Review patients identified through eFI scoring.
• Assess physical, psychological and social needs.
• Identify deterioration and safeguarding concerns.

Care Planning

• Develop personalised care plans.
• Undertake advance care planning discussions.
• Support completion of RESPECT forms where appropriately trained.
• Work with patients, carers and families.

Clinical Management

• Make autonomous clinical decisions within competence.
• Refer to appropriate services.
• Escalate concerns to GPs/ACP colleagues where required.
• Support medication and treatment reviews where appropriate.

MDT Working

• Liaise with GPs.
• Work with district nurses.
• Work with social prescribers.
• Work with care coordinators.
• Attend MDT meetings.
• Work with community and secondary care services.

Service Delivery

• Support achievement of LCS requirements.
• Maintain accurate records.
• Ensure coding and documentation standards are met.
• Contribute to audit and service development.

Qualifications

Essential

• Registered ACP.
• Experience working autonomously in primary care, community services, urgent care or similar.
• Experience assessing patients with complex needs.
• Understanding of frailty and long‑term conditions.
• Must have experience completing structured medication reviews
• Must have PACA training or equivalent
• Experience of care planning.
• Experience completing RESPECT forms.
• Experience of home visiting.

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).

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.

Applicants must have current UK professional registration.