Are you passionate about supporting people to return to their own homes following acute illness or injury?
About the Role
UHBW has launched two new Transfer of Care Hubs to support patient discharge planning from admission through leaving hospital and into the community, located at the Bristol Royal Infirmary and Weston General Hospital. These hubs will bring together the acute trust, community partners (Sirona), Local Authorities, and Voluntary Sector colleagues across BNSSG to form a multidisciplinary team.
The aim is to work collaboratively to support patients in achieving Home First by colocating professionals from different organizations to streamline complex discharges.
Candidate Requirements
* Experience working in a community setting
* Understanding of clinical acuity levels supported in people's homes
* Knowledge of rehabilitation pathways, discharge planning, and mental capacity issues
* Excellent interpersonal and negotiation skills
What We Offer
We provide regular training and supervision, and opportunities to participate in future service developments.
Key Responsibilities
1. Be a key member of the multidisciplinary team, providing person-centered, holistic assessments to facilitate discharge from hospitals to appropriate pathways.
2. Triaging referrals received by CToCH, liaising with patients, families, carers, and ward staff to identify suitable discharge options.
3. Discuss complex cases with partners in the Transfer of Care Hub to agree on joint actions and discharge plans.
4. Utilize multidisciplinary assessment skills and clinical reasoning to facilitate timely hospital discharges.
5. Prioritize a large caseload effectively, adjusting work plans as system pressures dictate, and optimize community capacity daily.
6. Gather information from diverse sources, using professional experience and clinical knowledge to inform decisions, including mental capacity assessments and best interest decisions where appropriate.
Join Our Team
Ever dreamed of a career that excites you and fosters professional growth? Join Sirona care & health, England's largest provider of Adult and Children's Community Services, in Bristol, North Somerset, or South Gloucestershire.
We offer an Agenda for Change salary, NHS benefits, 27+ days' annual leave, and participation in the NHS Pension Scheme. We are committed to creating development opportunities for all colleagues and apprentices.
Interested? View our benefits leaflet attached to this vacancy.
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