NHS Jobs • King's Lynn PE30 5QX
About this role
Job Title
Acute
Frail Elderly Outreach Matron Band
8a
Reports to
Practice Manager Accountable to
Practice Manager and GP Partners Main Duties To work as an autonomous clinical practitioner to provide expert clinical care for frail, elderly & housebound patients with acute/intensive & complex medical needs. To diagnose, review and treat patients in their own home. Clinical Practice To provide expert clinical care for frail patients who may have multiple long term conditions and are at risk of deteriorating health that may result in declining clinical quality of life or avoidable hospital admission or unnecessary length of hospital stay. Supporting and working with carers and wider family members. Develop relationships with staff within the Practice, ICT, Rapid Response and Social Care relating to them on a day-to-day basis. Undertake comprehensive assessment of the physical and psycho-social care needs of frail patients who may also have complex chronic disease. Establish an individuals functional capabilities with regard to frailty as well as any long term conditions clinical management. Develop a person led evidence based holistic health and social care plan in conjunction with medical and other health and social care colleagues. Develop person led care plans in partnership with patients and their relatives. Use a high level of communication and interpersonal skills to communicate effectively with patients and carers, in particular the skills needed for cognitive assessment and mental health status. Refer individuals to mental health and/or other services where appropriate. Work with patients and carers to teach and educate them about the early warning signs in order to facilitate rapid management of complications or crises. Enable patients to be as independent as possible by facilitating a range of self-management strategies through undertaking desired occupations and non-occupational activities including the support that is available from the voluntary sector. End of life care and support. Prescribing medication for terminal patient care and liaising with specialist teams. Constantly strive to identify training needs for self and others. To fulfil the requirements for maintaining a professional registration. Communication Deliver sensitive communication to patients and colleagues alike including carers. Maintain effective communication within the practice nursing team, with the nurse manager, the GPs and the whole practice team Clinical Practice and Quality Work within own confidence and professional code of conduct as regulated by the NMC. Always produce accurate, contemporaneous and complete record keeping of patient consultations Support and participate in lifelong learning and shared learning across the practice. Understand and apply appropriate support to the identification of vulnerable adults and children and keep up to date with statutory child protection training, practice procedures and protocol. Work as an effective and responsible member of the practice nursing team, the emergency team and the overall practice team. Work effectively with others following the practice values, policies and protocols incorporating respect for all patients and colleagues. Manage and assess risk in a professional manner ensuring that appropriate measures are in place to protect staff and patients (where this is discovered not to be the case to draw this to the attention of the nurse manager/general manager as soon as practicable). Follow infection control guidelines within the practice. Follow the practice policies on equality and diversity to ensure the absence of discrimination. Other Any other appropriate duties that are requested by the Partners or Practice Manager Will be required to work across both The Southgates and The Woottons Surgeries At times may be required to work extended hours