This permanent, part-time post (18.75 hours a week) sits in the new Home First service at Gloucestershire Health and Care NHS Foundation Trust, which supports patients to return home safely from hospital. The nurse completes holistic assessments and personalised care plans for people discharged through Home First and similar pathways, and coordinates handover to community nursing teams. Work takes place in patients' homes and communities, alongside therapists, reablement staff and GPs. Candidates need independent practice experience; visa sponsorship is not available.
What the job involves
- Complete holistic nursing assessments and personalised care plans for patients discharged through Home First and discharge-to-assess pathways
- Support safe and timely hospital discharges and help prevent avoidable admissions
- Deliver evidence-based nursing care, treatment and interventions for patients with complex, acute, sub-acute and long-term conditions
- Identify ongoing nursing needs and coordinate handover to community nursing teams where required
- Work collaboratively with therapists, reablement staff, GPs, social care teams and other system partners across One Gloucestershire
- Promote independence through health coaching, education, goal-setting and personalised care
- Support medicines management and clinical decision-making to optimise patient outcomes
- Advise and support patients, carers and families on health, wellbeing and self-management
- Contribute to service improvement, quality assurance, audit and patient safety initiatives
- Support the development of colleagues and students through supervision, coaching and leadership
- Manage and prioritise a dynamic caseload using clinical judgement and organisational skills
What’s required
Qualifications
- Registered Nurse (adult / RGN)
- Individual modules at degree or masters level, e.g. PACR
- Recognised teaching or mentoring qualification
Registration & licences
Experience
- Working without direct supervision
- Consolidated community nursing practice
- Managing long-term conditions and case management of complex patients
- Delivering extended role clinical interventions
- Evidence of post-registration education and training
Skills & knowledge
- Working on own initiative, assessing patients competently and linking with the wider MDT to tailor plans of care
- Managing workload, prioritising and delegating to manage capacity and demand
- Effective written and oral communication
- Knowledge of safeguarding procedures
Nice to have
- Understanding of national policy in relation to community nursing
- Up-to-date clinical knowledge including risk assessment
- Knowledge of health coaching techniques to engage patient participation and outcomes