Senior Integrated Care Nurse

Salus Medical Services Ltd; Farnham; On-site; GBP 55,000 - 75,000; Full time

Job summary

Salus Medical Services Ltd is seeking an experienced registered nurse to join as Interim Senior Integrated Care Nurse, supporting people with complex health and care needs across North East Hampshire and Farnham.

You will provide day‑to‑day clinical and operational leadership to the Integrated Care Team, strengthen teamwork, support supervision and turn audit feedback into practical improvements across the service.

Qualifications

• Registered Nurse with current NMC registration.
• Significant post‑registration clinical experience in community, primary or integrated care.
• Experience of audit, quality improvement or service development.
• Effective communication, influencing and relationship‑management skills.

Responsibilities

• Provide day‑to‑day clinical and operational leadership to the Integrated Care Team.
• Coordinate clinical priorities and workforce capacity for safe service delivery.
• Support nursing and Clinical Associate staff with operational management and supervision.
• Coordinate clinical supervision, reflective practice and team learning.
• Undertake clinical and documentation audits and turn learning into improvements.
• Promote consistent assessment, care planning, record keeping and safety netting.

Job description

Job summary
We are looking for an experienced registered nurse to join Salus Medical Services as our interim Senior Integrated Care Nurse, supporting people with complex health and care needs across North East Hampshire and Farnham.

You will provide day-to-day clinical and operational leadership to our Integrated Care Team, helping colleagues deliver safe, coordinated and person‑centred care. Your focus will be on strengthening team working, supporting clinical supervision, promoting consistent practice and turning learning from audits, incidents and feedback into practical improvements.

Working closely with the Head of Clinical Services, you will coordinate clinical priorities and workforce capacity, provide operational support to nursing and Clinical Associate staff, and offer advice on complex patient care. You will also maintain clinical practice through assessments, joint visits and reviews according to service need.

You will build effective relationships with GP practices, community services, acute teams, mental health and social care partners. Working within agreed delegated authority, you will recommend pathway improvements and implement approved changes.

This role would suit a confident, approachable nurse with experience in community, primary or integrated care who enjoys supporting colleagues and improving services.

Main duties of the job
You will provide day-to-day clinical and operational leadership to the Integrated Care Team, working within delegated authority and reporting to the Head of Clinical Services.

Your main duties will include:

• Providing clinical advice and support for complex patient care, triage, risk assessment and escalation.
• Coordinating workloads, staffing capacity and clinical priorities to support safe service delivery.
• Providing operational management and support to nursing and Clinical Associate staff.
• Coordinating clinical supervision, reflective practice and team learning.
• Undertaking clinical and documentation audits and supporting learning from incidents and feedback.
• Promoting consistent assessment, care planning, record keeping and safety‑netting across the team.
• Recommending improvements to clinical pathways and implementing approved changes.
• Working with GP practices, community services, hospital teams, mental health and social care partners to support coordinated care.
• Maintaining clinical practice through assessments, home visits, joint visits and complex patient reviews as required.
• Escalating significant clinical, workforce and operational concerns to the Head of Clinical Services.

About us
Salus Medical Services is a GP Federation supporting primary care and integrated working across North East Hampshire and Farnham.

We work collaboratively with GP practices, Primary Care Networks, community services, hospitals, mental health services and social care partners to support coordinated care for people with complex health and care needs.

Our Integrated Care Team brings together clinical and multidisciplinary expertise to support assessment, proactive care and joined‑up working across local services.

We value compassionate, person‑centred care, supportive teamwork and continuous learning. Joining Salus offers the opportunity to work closely with colleagues and partners to improve the quality and consistency of care for our local communities.

Job responsibilities
The Senior Integrated Care Nurse provides day‑to‑day clinical and operational leadership across the Integrated Care Team (ICT), supporting safe, consistent and effective care for people with complex health and care needs.

The post holder will provide an accessible senior clinical presence, strengthen team cohesion, support consistent clinical practice and coordinate supervision, clinical assurance and improvement activities. They will provide operational management for designated nursing and Clinical Associate staff and work collaboratively with multidisciplinary partners.

The role combines clinical leadership and operational coordination with direct clinical practice according to service need. The post holder will exercise professional judgement within agreed policies, clinical competence and delegated authority. The Head of Clinical Services retains overall service accountability and responsibility for decisions outside that delegation.

Key responsibilities
1. Clinical leadership and professional practice

• Provide visible and accessible clinical leadership, advice and support to nursing and Clinical Associate staff.
• Act as a clinical escalation point for complex patient care, triage, decision‑making and risk within professional competence.
• Support assessment, safety‑netting, onward referral and escalation, seeking further clinical advice where required.
• Undertake joint visits and clinical reviews when additional senior nursing input is needed.
• Promote safe delegation and clear accountability between registered and non‑registered staff.
• Identify variations in clinical practice and work with colleagues to improve consistency.
• Encourage professional challenge, reflection and learning within a supportive team environment.
• Role‑model compassionate, respectful and accountable practice.

2. Clinical quality, governance and assurance

• Coordinate clinical quality and assurance activities agreed with the Head of Clinical Services.
• Undertake and coordinate clinical and documentation audits, identify themes and implement agreed improvement actions.
• Review incidents and Significant Events allocated to the role, contributing to investigation, learning and action within delegated responsibility.
• Identify emerging clinical risks, take proportionate action within authority and escalator concerns promptly.
• Support clinical governance reporting and evidence gathering, including preparation for CQC requirements.
• Promote infection prevention and control, accurate record keeping, sound clinical decision‑making and professional accountability.
• Support monitoring of professional registration requirements and provide appropriate support for revalidation.
• Share learning from incidents, complaints, audits, supervision and feedback, checking that agreed changes are incorporated into practice.

3. Consistent clinical practice and pathway improvement

• Review clinical processes, documentation, templates and working practices to identify unwarranted variation.
• Recommend improvements to assessment, caseload management, clinical review, follow‑up, escalation and safety‑netting.
• Contribute clinical and operational expertise to pathway development and service redesign.
• Submit proposed pathway and service changes to the Head of Clinical Services for consideration and approval.
• Coordinate implementation of approved changes within delegated authority.
• Ensure agreed pathways and standard operating procedures are understood and applied consistently.
• Work with colleagues to identify practical barriers to implementation and agree solutions.
• Evaluate approved changes using audit, feedback and relevant service information.
• Escalate proposals requiring wider organisational, contractual, financial or strategic decisions.

4. Day‑to‑day operational coordination

• Coordinate the daily clinical operation of ICT within agreed service arrangements.
• Prioritise clinical resources according to patient need, demand, staff competence and available capacity.
• Monitor workloads, referrals, caseloads and outstanding clinical activity across localities.
• Support rota coordination, including extended‑hours clinical cover where applicable.
• Respond to staffing pressures, absence and service disruption through proportionate adjustments within delegated authority.
• Identify capacity pressures that may compromise safe delivery and escalat ewhere these cannot be resolved.
• Troubleshoot operational problems and coordinate action with relevant colleagues.
• Support business continuity, lone‑working and personal safety arrangements.
• Communicate operational priorities, changes and escalation arrangements clearly across the team.

5. Operational staff management and support

• Provide day‑to‑day operational management and support to designated nursing and Clinical Associate staff.
• Hold regular check‑ins covering workload, wellbeing, objectives, support needs and agreed actions.
• Coordinate induction and help new staff understand clinical processes, responsibilities and escalation routes.
• Provide constructive feedback, coaching and mentorship.
• Identify development needs and contribute evidence to appraisal and development discussions.
• Support attendance monitoring and return‑to‑work arrangements within agreed delegation.
• Recognise performance, conduct, attendance or wellbeing concerns and refer matters requiring formal action to the Head of Clinical Services and HR as appropriate.
• Support constructive resolution of day‑to‑day disagreements and promote positive working relationships.
• Ensure staff understand their professional boundaries and delegated responsibilities.

Overall workforce accountability and formal management decisions outside the post holders operational delegation remain with the Head of Clinical Services and the appropriate organisational lead.

6. Clinical supervision, education and development

• Coordinate an agreed programme of clinical supervision and reflective practice for registered and non‑registered clinical staff.
• Identify learning needs arising from complex cases, incidents, audits, feedback and service developments.
• Facilitate clinical meetings, education sessions and multidisciplinary reflection.
• Work with internal and external specialists to arrange learning relevant to the team.
• Support maintenance of clinical competence and continuing professional development.
• Contribute to induction and support student, trainee and other professional placements where appropriate.
• Deliver or coordinate education with partner organisations where this supports integrated working.

7. Integrated pathways and partnership working

• Support the safe and consistent delivery of integrated care pathways, which may include reactive care, proactive and frailty care, clinical triage, multidisciplinary working, in‑reach, discharge support and delirium pathway activity.
• Identify gaps, duplication and operational difficulties across interconnected pathways.
• Work with colleagues and partners to resolve issues within delegated authority.
• Maintain effective relationships with GP practices, Primary Care Networks, community nursing and therapy services, Community Matrons, Adult Health & Care, mental health services, acute providers, Frailty Leads and Consultant Geriatricians.
• Represent ICT at relevant operational and multidisciplinary meetings.
• Support appropriate case selection, participation, decision‑making and follow‑through within MDT arrangements.
• Promote understanding of ICT referral pathways and its clinical offer.
• Communicate approved changes affecting partners and support coordinated implementation.
• Escalate system barriers and issues requiring commissioner, contractual or strategic decisions through the Head of Clinical Services.

8. Clinical performance and reporting

• Review clinical activity, demand, caseloads and service pressures to identify areas needing attention.
• Explore variation in triage, assessments, clinical contacts, follow‑up and pathway activity.
• Provide clinical context to performance information and contribute to agreed quality measures.
• Maintain clear records of actions, risks and matters requiring escalation.
• Contribute to reports and assurance information for the Head of Clinical Services.
• Monitor actions allocated to the role and escalat e delays or dependencies affecting delivery.

9. Direct clinical practice

• Maintain clinical practice within professional competence and according to service need.
• Undertake clinical triage, holistic assessment, home visits, complex patient reviews, joint visits and proactive or frailty assessments as required.
• Participate in MDT discussions and contribute to coordinated care planning.
• Recognise deterioration or changes in need and arrange appropriate escalation or onward referral.
• Maintain clear and timely clinical records.

Direct clinical activity will be balanced with the roles leadership, supervision, governance and operational responsibilities. Deployment to clinical capacity gaps should be agreed so that these responsibilities remain achievable.

Delegated authority and accountability
The post holder may make proportionate decisions about day‑to‑day clinical priorities, staff deployment and routine operational matters within agreed policies and delegation.

The post holder remains professionally accountable for their own clinical practice and decisions. They must recognise the limits of their competence and authority and seek advice when required.

The Head of Clinical Services retains overall accountability for the service and approval of pathway or service developments. Significant strategic, contractual, financial, organisational and formal workforce matters must be referred to the appropriate senior lead.

Person Specification
Experience
Essential

• Registered Nurse with current NMC registration.
• Significant post‑registration clinical experience.
• Experience in community, primary, integrated or complex care.
• Experience of clinical leadership, supervision or senior clinical support.
• Understanding of clinical governance, risk, delegation and professional accountability.
• Experience of multidisciplinary and multi‑agency working.
• Ability to assess complex situations and provide appropriate clinical advice and escalation.
• Experience of audit, quality improvement or service development.
• Effective communication, influencing and relationship‑management skills.
• Ability to manage competing clinical and operational priorities.
• Ability to provide constructive feedback and manage difficult conversations.
• Evidence of continuing professional development.
• Previous operational management or team‑leadership experience.
• Clinical supervision training or experience.
• Experience of frailty, admission avoidance or integrated neighbourhood working.
• Experience of incident review and quality improvement methodology.
• Experience of pathway redesign.
• Knowledge of CQC requirements in primary or community care.
• Experience of working with commissioners or wider system partners.

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.