Frailty GP: Home-Care Lead & MDT Collaboration

NHS Jobs; Godstone; On-site; GBP 90,000 - 110,000; Full time

Job summary

South Tandridge Primary Care Network (PCN) seeks a Frailty General Practitioner to lead the frailty hub, delivering care at patients' homes and in care homes across the PCN. You will work with Community Matrons, District Nurses, Pharmacists and other teams to develop care plans and reduce unnecessary hospital admissions.

You will provide clinical leadership, undertake triage and supervise colleagues, with flexibility for up to five sessions per week and a focus on improving patient experience

Qualifications

• Experience delivering frailty care and home visits.
• Clinical leadership and supervision experience desirable.
• Ability to work across PCN partners and external teams.

Responsibilities

• Triage referred and proactively identified patients to provide timely medical care.
• Coordinate with Community Matron and wider PCN teams.
• Generic prescribing in line with local and national guidelines.
• Manage long-term conditions effectively.
• Handle admin tasks including referrals and prescriptions.
• Perform telephone triage and prioritize home visits.
• Maintain accurate clinical records and comply with policy.
• Lead discussions at PCN and Practice MDTs and contribute to governance.
• Support quality initiatives and professional development.
• Commit to ongoing learning and development.

Skills

Triage

Frailty care

Long-term conditions

Clinical governance

MDT collaboration

Self-learning

Education

Clinical supervision/education

Job description

South Tandridge Primary Care Network (PCN) seeks a Frailty General Practitioner to lead the frailty hub, delivering care at patients' homes and in care homes across the PCN. You will work with Community Matrons, District Nurses, Pharmacists and other teams to develop care plans and reduce unnecessary hospital admissions.

You will provide clinical leadership, undertake triage and supervise colleagues, with flexibility for up to five sessions per week and a focus on improving patient experience