Frailty Practitioner

South Downs Health and Care Ltd (SDHC); England; On-site; GBP 42,000 - 62,000; Full time

Benefits offered by this job

NHS Pension

Holiday entitlement

Employee assistance

Cycle scheme

Wellbeing centre discount

Job summary

South Downs Health and Care is seeking Two Frailty Practitioners to join a developing frailty service within the Integrated Neighbourhood Team model. You will assess, manage and coordinate care for older people with frailty, travelling between community localities, and prescribing independently within your competencies.

Applicants should have an RN (Adults) or Allied Health background, register with NMC/HCPC, and hold a Bachelor’s degree with CPD to master’s level. Enhanced DBS is required.

Qualifications

• RN (Adults) first level nurse or Allied Health Professional eligible to become an independent prescriber.
• Bachelor’s degree
• Teaching and assessing qualification
• Evidence of continuing professional development in specialist practice to masters equivalent

Responsibilities

• Assess physical and psychosocial needs, including Comprehensive Geriatric Assessments, and start evidence-based treatment.
• Agree personal management plans with patients, carers and other professionals
• Act as care co-ordinator for a caseload, taking responsibility for it and liaising across settings
• Carry out medication reviews and prescribe independently within competencies
• Make direct referrals and order investigations
• Manage complex needs proactively, prevent avoidable admissions, support safe discharge and reduce readmission risk
• Work with GPs, Community Geriatricians, community nursing and social care teams
• Support integrated frailty pathways, including the Frailty Virtual Ward and urgent community services
• Provide specialist clinical advice, health promotion and support for patients, carers and colleagues
• Contribute to clinical governance, audit, quality improvement and serious incident review
• Keep accurate records using the single assessment process
• Attend locality MDT meetings and support budget analysis and business cases

Skills

Autonomous practitioner

Independent prescribing

NMC/HCPC registration

Leadership

Clinical assessment

Education

Bachelor’s degree

Teaching & assessing qualification

CPD to masters equivalent

Tools

MS Teams

SystmOne

NerveCentre

Job description

Two Frailty Practitioners are being appointed to a developing frailty service within the new Integrated Neighbourhood Team model at South Downs Health and Care. The role assesses, manages and coordinates care for older people with frailty and complex long-term conditions, aiming to prevent admissions and support safe discharge. Post holders travel across community localities in their own car, prescribe independently within their competencies and work closely with GPs and geriatricians. Candidates need a registered nursing or allied health background and an enhanced DBS check.

What the job involves

• Assess physical and psychosocial needs, including Comprehensive Geriatric Assessments, and start evidence-based treatment
• Agree personal management plans with patients, carers and other professionals
• Act as care co-ordinator for a caseload, taking responsibility for it and liaising across settings
• Carry out medication reviews and prescribe independently within competencies
• Make direct referrals and order investigations
• Manage complex needs proactively, prevent avoidable admissions, support safe discharge and reduce readmission risk
• Work with GPs, Community Geriatricians, community nursing and social care teams
• Support integrated frailty pathways, including the Frailty Virtual Ward and urgent community services
• Provide specialist clinical advice, health promotion and support for patients, carers and colleagues
• Contribute to clinical governance, audit, quality improvement and serious incident review
• Keep accurate records using the single assessment process
• Attend locality MDT meetings and support budget analysis and business cases

What’s required

Qualifications

• RN (Adults) first level nurse or Allied Health Professional eligible to become an independent prescriber
• Bachelor's degree
• Teaching and assessing qualification
• Evidence of continuing professional development in specialist practice to masters equivalent

Registration & licences

• NMC and/or HCPC registration

Experience

• Working as an autonomous practitioner, including case management
• Extensive experience with older people living with frailty, complex conditions or long-term conditions such as COPD, heart failure and type 2 diabetes
• Multidisciplinary and multi-agency working in partnership with statutory and non-statutory agencies

Skills & knowledge

• Non-medical or supplementary prescribing, or willingness to train within 12 months
• Advanced clinical decision-making and physical assessment skills
• Leadership and organisational skills
• Good knowledge of anatomy and physiology and of local and national policy on frail older people
• Communicating complex presentations to GPs and communicating effectively across organisational boundaries

Checks & eligibility

• Enhanced DBS check

Other

• Able to travel regularly between base and patients' homes within a reasonable time and cost
• Reliable work record

Nice to have

• Experience in a community setting
• Experience working between health and social care organisations and settings
• Experience interpreting microbiology and pathology results
• Experience managing acute patients
• Use of IT systems including MS Teams, SystmOne and NerveCentre
• Relevant postgraduate or masters degree
• Experience contributing to new service development and working through cycles of change
• Ability to influence and manage change management programmes

What’s offered

• NHS Pension Scheme with generous employer contributions
• 25 days holiday plus bank holidays, rising to 30 days after 5 years' service (pro rata for part time)
• Employee Assistance Programme with counselling and legal and financial support
• Cycle scheme
• Christmas and summer events
• Discounted membership of Hillbrow Health and Wellbeing Centre