Overview
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Job Overview
This is an exciting opportunity to join the Integrated Discharge Service (IDS) based at North Bristol NHS Trust and play a pivotal role in supporting the development of the Transfer of Care Hub.
The post holder will be either a Registered Nurse, Therapist, Paramedic or Social Worker and will focus on enhancing the patient, carer, and family experience around discharge from hospital. You will help ensure beds are available for patients in need and maintain bed flow. You will work with a wide range of professionals from the health and social care system, so strong communication and knowledge of complex discharge processes are important. You will have experience supervising and supporting team members (or the ability to do so) and have involvement in or leadership of change within a pressurised environment.
Main Duties
The role requires managing complex discharge processes and developing the IDS service.
* Lead in championing the Home First ethos – “There’s no place like Home”
* Facilitate timely and appropriate discharges, enhancing patient and staff experience
* Hold early discharge conversations and drive quality board rounds
* Drive flow by delivering timely discharges to keep beds available for those who need them
* Provide discharge expertise to conversations with patients, families and staff, including supporting Managing Expectations procedures
Applicants should demonstrate effective communication, lateral thinking, and problem solving to meet individual needs. You will be a role model for the IDS and Transfer of Care Hub within the organisation and wider system.
Working for Our Organisation
NBT Cares is a simple statement that reflects the commitment to providing the best possible care. NBT Cares stands for caring, ambitious, respectful and supportive, underpinned by a positive behaviours framework. Our values guide how colleagues work together.
Detailed Job Description And Main Responsibilities
* Drive and deliver high-quality Board Rounds on every ward, with coaching and mentoring to the ward MDT, assist with actions and accountability
* Support early discharge conversations for every patient to enable earlier discharge, engaging families with the patient
* Promote the effective completion of the Transfer of Care document for people with complex needs
* Adopt and champion a “Home First” approach to discharge
* Facilitate and deliver safe, timely discharges for people with complex needs
* Provide expert resource on discharge processes and community service provision to the MDT
* Develop High Impact User plans for patients at high risk of repeat admissions
* Collaborate with partners to support a caseload of highly complex individuals whose discharge may not be facilitated through the Community Transfer of Care hub
o Examples: Homeless people with no health or care needs, Self-funded patients, CHC/Fast Track, Complex mental health needs, Local areas not covered by the hub, Coordination of off-site bed bases such as NBT NWB
* Work with Ward leads to implement Managing Expectations protocol and escalate if unresolved
* Coordinate multi-professional care planning for highly complex patients with multiagency involvement
* Undertake training and development of new staff and students on effective assessment of patient needs
* Escalate concerns to IDS Operational Leads as appropriate while maintaining professional autonomy
* Be able to advise on criteria and processes including: DOLs, CHC and CHC Fast Track, Mental Capacity Assessment, Mental Health Act, Safeguarding, Consent, and referrals including Out of Area Services
* Support wards in restarting a Package of Care and advise if a new referral is required
* Implement BNSSG operational standards and record codes reflecting actual delays; report trends to heads of service
* Facilitate actions for admission avoidance and proactively manage readmissions per BNSSG procedures
* Challenge and prevent discharge cancellations, highlighting risks of remaining in hospital longer than needed
* Liaise with providers including care providers, 3rd sector services, housing, out-of-area services, Drugs and Alcohol services to support the Transfer of Care Hub
* Provide a 7-day service, liaising with ward leads during escalation
* Use specialist knowledge to support implementation of NBT policies to facilitate discharges
* Support and maintain accurate IDS documentation (discharge forecasting, stranded patient reviews, outlier progress)
* Support clusters by providing supervision to IDS team members to maintain a self-supporting service
* Assist in investigation and resolution of discharge-related complaints and apply learning to improve service
Communication And Information
* Use excellent communication to collaborate within IDS and with Transfer of Care Hub partners to secure timely and safe discharges
* Maintain professional communication with partners and patients, especially when sharing difficult or emotive information
Person Specification
Essential criteria
* Qualified Health or Social Care
* Current Professional Registration with relevant body (e.g., HCPC, NMC)
* Substantial post-graduate experience
* Experience supporting complex discharges
* Evidence of recent Continuing Professional Development in this area
Desirable criteria
* Experience of managing complex discharges in an acute setting
* Experience in an Integrated Discharge Team
* Expert knowledge of managing complex discharges
Please note: If you apply and have not received communication within three weeks of the closing date, assume your application was unsuccessful. North Bristol NHS Trust does not reimburse travel expenses for interview attendance. If you need support under the Disability Act / Two Ticks, contact 0117 414 1151.
North Bristol NHS Trust is committed to safeguarding and promoting the welfare of children and young people and expects all staff and volunteers to share this commitment. The successful applicant(s) will normally commence at the minimum of the scale unless they have NHS service at the same band, with progression by annual increments. We encourage applications from candidates underrepresented in NBT’s workforce at Band 8a and above, including Black, Asian and minority ethnic backgrounds, disabled people and LGBTQIA+ people.
Please note that stringent pre-employment checks are undertaken on all successful applicants prior to commencement in post.
Seniority level
* Mid-Senior level
Employment type
* Full-time
Job function
* Other
Industries
* Hospitals and Health Care
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