Job overview
A Renal Supportive Care Clinical Nurse Specialist (CNS) plays a key role in providing palliative and end-of-life care to patients with advanced chronic kidney disease (CKD), particularly those in stage 5 CKD, across various care settings. This role is essential for patients who either choose not to undergo dialysis, are receiving dialysis, or have undergone a kidney transplant. The CNS ensures the holistic care of these patients, addressing their physical, emotional, psychological, and spiritual needs as they approach the end of life.
Due to increasing patient numbers, higher levels of complexity, and growing frailty, we have recently expanded our team to better meet the needs of this population, both in renal care and within the broader local community.
This is a full time post ( FTE). This post is based within Guy’s & St Thomas’ NHS Foundation Trust and also includes our satellite sites.
Closing date: 29th June 2026
Interview date: 23rd July 2026
Main duties of the job
Nurse lead clinics at the Guys site and satellite units, where you will assess patients and prescribe treatment with their care plans. Offer advance care planning discussions, help manage symptoms of CKD and dialysis, and provide end-of-life care to patients across a wide geographical area. Coordinate care ensuring close collaboration with community colleagues and palliative care teams to avoid unnecessary hospital admissions and facilitate out-of-hospital end-of-life care. Work with the MDT teams to deliver holistic care.
Provide palliative care to inpatients on renal wards. Assist in difficult discussions regarding treatment withdrawal and ensure that decisions align with the patient’s preferences, avoiding overmedicalization of death. Support staff in delivering excellent end-of-life care to patients with renal disease, ensuring they are competent in managing sensitive end-of-life conversations and providing care that aligns with patient priorities.
Implement effective symptom management strategies. Ensure patients receive person-centred care that supports their physical comfort and emotional well-being during the final stages of their illness. Collaborate with nephrologists, palliative care teams, and other healthcare providers to ensure patients receive seamless, coordinated care tailored to their needs. Participate in discussions that consider all aspects of patient care, ensuring decisions made are in line with patient values and goals.
Working for our organisation
The role sits within the Directorate of Transplant, Renal and Urology under the speciality of Renal. The successful candidate will be welcomed into the team and supported into transitioning into this role.
We offer a range of in-house training to enhance your clinical, research and managerial skills. The management team will support you to have a clear plan and support additional external training if required for your role, development and future career objectives.
Detailed job description and main responsibilities
The JD and main responsibilities for this role are but not exclusively:
Lead nurse-led clinics at the Guys site and satellite units, assessing patients, developing care plans, and prescribing treatments.
Provide advanced care planning and guidance, especially for patients with stage 5 CKD, those receiving dialysis, and those with failing kidney transplants.
Symptom Management and End-of-Life Care ensuring comfort in the final stages of life.
Supporting staff with patients with complex needs, liaising with community colleagues and palliative care teams. Ensure that patients are supported with holistic care.
Inpatient Care: Provide palliative care to inpatients on the renal wards, particularly focusing on treatment withdrawal, uncertain recovery and ensuring that death is not overly medicalized.
Support difficult communication around end-of-life decisions and facilitate care that aligns with patient wishes and values.
Multidisciplinary Team Work: Collaborate with the wider MDT
Patient and Family Support: Guide patients and families through the process of advance care planning, offering options for care based on their values and wishes.
By managing these responsibilities, you will ensure that patients receive the best possible care throughout their journey with advanced kidney disease, especially during their final stages.
Please also see the attached detailed JD and expectations for a CNS at GSTT.
Person specification
Professional Registration
Essential criteria
Desirable criteria
Education
Essential criteria
Experience
Essential criteria
Guy’s and St Thomas’ celebrates, respects and values the diversity of its staff and patients. We review our policies, procedures and practices to ensure that all employees, patients and carers are treated equitable according to their needs. We are actively committed to ensuring that no one who applies for a job, works or study’s at the Trust, or accesses our services is discriminated against on the grounds of race, ethnicity, nationality, disability, religion or belief, age, gender identity , gender reassignment, sexual orientation, pregnancy and maternity/paternity, or marital/civil partnership.