Job summary
This role is offered on a fixed term/secondment basis for 6 months. The hours are 37.5 hours per week.
Internal applicants who wish to be considered for a secondment opportunity should discuss with their line manager the suitability of a possible secondment.
The Complex Care at Home Matron/Clinical Case Manager assumes the role of an autonomous Clinical Practitioner, responsible for overseeing the care of their assigned patients. This entails triaging, planning, managing, and coordinating intricate care and treatment requirements within the confines of patients\' homes.
As a member of the Complex Care at Home Multidisciplinary Team, they proactively manage patients with long-term conditions and at risk of deterioration, including those with frailty. The Community Matron/Clinical Case Manager provides comprehensive and specialised support to patients, carers, and families, enabling them to lead fulfilling lives alongside their conditions. They employ motivational interviewing and health coaching to establish therapeutic relationships, thereby mitigating unplanned hospital admissions. This proactive strategy fosters improved health outcomes.
The Community Matron/Clinical Case Manager works closely with primary and secondary care services, including Physical and Mental Health, as well as statutory and non-statutory agencies. This collaborative approach enables the development of personalised care plans, consistently advocating for the \"What matters to you?\" principle.
Main duties
* Triage: Ensure patients meet the criteria for the service.
* Holistic Assessment: Within a patient\'s home environment, conduct a comprehensive assessment.
* Risk Assessment: Evaluate patients\' safety needs to determine the most appropriate care setting. This involves providing specialist advice and, if necessary, signposting or referring to other healthcare providers.
* Medication Assessment and Review: Assess and review medication for therapeutic effectiveness, prescribing, and/or de-prescribing in accordance with evidence-based practice, national and local protocols, and within the scope of practice and legislative framework.
* Collaborate with other prescribers (GPs, pharmacists, consultants, and specialists) to ensure continuity and safe prescribing practices.
* Case Management: Identify, prioritise, and implement case management plans to achieve health gains and maximise patient independence.
* Maintain effective and timely communication with patients, carers, and all relevant services and agencies (statutory and non-statutory).
* MDT Meetings: Attend, participate, and lead where appropriate weekly internal MDT meetings and external meetings as required.
* Provide clinical supervision to Health 7 Wellbeing Coordinator and, as a line manager, have the responsibility of signing off expenses and annual leave according to Trust policy.
Qualifications and experience
The qualification, training & experience requirements for the role are underlined in the Job Description/Person Specification.
Details
Date posted: 30 September 2025
Pay scheme: Agenda for Change
Band: Band 7
Salary: £47,810 to £54,710 a year per annum
Contract: Fixed term
Duration: 6 months
Working pattern: Full-time
Reference number: 327-25-812
Job locations: Independent Living Centre, Kimbrose Way, Cheltenham, GL51 0BY
This post is not eligible for sponsorship as per the Governments UK VISA and Immigration Rules and Regulations. For more information please ensure you review the official guidance.
Employer details
Employer name: Gloucestershire Health and Care NHS Foundation Trust
Address: Independent Living Centre, Kimbrose Way, Cheltenham, GL51 0BY
Employer's website: Gloucestershire Health and Care NHS Foundation Trust
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