Focus: Clinical triage, pathway coordination, leadership, decision-making
Responsible to
DDS Clinical Lead
Role Purpose
The Digital Care Navigator provides senior clinical‑operational coordination and assurance for the Digital Discharge Service (DDS). The role is responsible for end‑to‑end oversight of referrals, clinical and functional triage, pathway allocation, escalation management and partner coordination to enable safe, timely discharge or admission avoidance.
The postholder acts as the central decision‑making and escalation point, ensuring all actions across the DDS pathway are completed, risks are managed and appropriate support is in place for every patient.
Key Responsibilities
* Lead end‑to‑end coordination of DDS referrals, including prioritisation and allocation in line with service criteria.
* Undertake clinical and functional triage to assess suitability for technology‑enabled discharge or admission avoidance.
* Determine and authorise appropriate DDS pathways and technology solutions based on patient need, risk and context.
Multi‑agency Coordination
* Work collaboratively with acute teams, discharge services, therapy teams, social care, reablement and community providers to identify and coordinate suitable DDS referrals.
* Liaise with third‑party technology, monitoring and service partners to ensure timely delivery and completion of pathway actions.
* Hold oversight of responsibilities, timescales and dependencies across the pathway.
* Act as the single escalation point for clinical, operational, technological or safeguarding concerns.
* Ensure risks are identified, mitigated and escalated in line with governance and safeguarding procedures.
* Provide senior oversight to ensure no patient is discharged or managed without appropriate support in place.
End‑of‑pathway Decision‑making
* Lead decisions relating to pathway completion, step‑down to ongoing services, continuation of monitoring or transition to self‑managed/self‑funded models.
* Support admission avoidance decision‑making where DDS can safely replace traditional models of care.
Workforce Support & Practice Development
* Provide leadership, guidance and coaching to TED Support Officers and wider MDT colleagues.
* Support embedding of technology‑first approaches within discharge, assessment and care planning processes.
* Contribute to training, pathway refinement and best‑practice dissemination.
Governance, Data & Assurance
* Provide assurance reporting to WM5G / commissioners on referral activity, outcomes, risks and benefits realisation.
* Use data and insight to identify trends, capacity pressures and pathway improvements.Contribute to service improvement, clinical safety reviews and pathway development.
* The role does not routinely deliver equipment or undertake day‑to‑day setup, unless required for escalation or complex cases.
* Focus is on leadership, coordination, assurance and decision‑making across the DDS pathway.
Core Skills & Attributes
* Demonstrated experience working in health, social care, or discharge settings, ideally in roles related to hospital discharge, community support, or reablement.
* Strong understanding of discharge pathways including Virtual Wards, Pathways 0/1, Discharge to Assess, and social care interventions.
* Experience supporting or delivering care in a community‑based model using assistive technologies, TEC or remote monitoring.
* Comfortable working across multidisciplinary teams including hospital, local authority, and third‑sector stakeholders.
* Proven track record supporting patients and professionals through digital transformation or service redesign.
* Minimum 3 years’ experience working within discharge services in either acute or community services
* Strong organisational and coordination skills
* Minimum 3 years’ experience in patient‑facing roles
* Confident communicator with patients, carers and multidisciplinary teams.
* Comfortable working in fast‑paced, ward‑based environments.
* Attention to detail and commitment to accurate documentation.
* Ability to identify issues early and elevate appropriately.
* Experience working within a clinically regulated service
* Adept at data capture and management reporting
Skills
* Highly proficient within Health and Social Care settings.
* Have an interest and knowledge of technology that can be used to improve health and social care.
* Skilled in navigating discharge workflows and cross‑sector care transitions.
* Able to engage both clinical and social care professionals with confidence and credibility.
* Strong coordination, communication, and tech adoption skills — capable of unblocking operational issues quickly.
* Ability to balance user‑centred empathy with pathway efficiency and service goals.
* Strong influence and persuasion skills, re‑enforced by persistence and resilience.
* Excellent verbal, written and presentation skills, preparing and delivering effective communications.
* Exhibit a high degree of pro‑activity and creative thinking when faced with challenges requiring resolution.
* Effective self‑starter able to work on own initiative to tight deadlines where there are often conflicting requirements and requests for support from other parts of the team.
Qualifications
* NVQ Level 4 in Health and Social Care or equivalent qualification
* Relevant professional qualification or significant relevant professional experience.
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