This six-month GP Clinical Lead post sits within the Berkshire West Proactive Care Service, a new model for around 1,000 high-risk frail patients run by the Primary Care Alliance. The postholder gives senior clinical leadership and governance, overseeing frailty GPs and prescribing clinicians and shaping caseload, escalation and step-down processes. It is not an operational management role, and frailty GPs keep decision making for their own patients. Full GMC registration and NHS Performers List inclusion are required.
What the job involves
- Act as principal clinical lead for PCS, providing senior clinical leadership
- Support safe mobilisation with the Chief Delivery Officer, Medical Director and operational team
- Lead clinical SOPs, inclusion and exclusion criteria, caseload processes, escalation pathways and step-down arrangements
- Oversee clinical oversight of the frailty GP and prescribing workforce, including escalation and complex case discussion
- Work with the Geriatrician Clinical Lead to make specialist geriatric input accessible
- Oversee the clinical approach to frailty, falls, deprescribing, ReSPECT, CGA and disease optimisation
- Support the caseload management model, including follow-up intensity, review after deterioration or discharge, and safe step-down
- Ensure PCS works around general practice without parallel ownership or avoidable actions back to practices
- Lead clinical induction, supervision and case-based learning for the clinical workforce
- Provide clinical leadership on governance, incidents, significant events and quality improvement
- Shape interfaces with UCR, SDEC, acute, community, primary care, Adult Social Care and VCSE partners
- Contribute to evaluation at 3, 6, 9 and 12 months and recommend what continues, changes, scales or stops
What’s required
Qualifications
- Qualified GP
- Evidence of relevant continuing professional development
Registration & licences
- Full GMC registration with licence to practise
- Current inclusion on the NHS Performers List
Experience
- Knowledge of frailty, multimorbidity, polypharmacy and deprescribing, falls and anticipatory care
- Understanding of UCR, SDEC, acute and community interfaces
Skills & knowledge
- Senior clinical decision making that balances safety, independence and proportionate risk
- Developing practical SOPs, escalation pathways and clinical governance arrangements
- Supporting clinicians without taking over case management
- Interpreting service and clinical data to drive improvement
- Building relationships across primary care, acute, community, social care and VCSE
Nice to have
- Additional qualification or training in frailty, older people, leadership or service development