Overview
Part Time 33 hours per week
This post may be offered under Annex 21 AfC Terms & Conditions, subject to experience, competency and suitability.
The post holder will be required to provide clinical case management to a group of patients who meet the Trust identified criteria, who have long term conditions and other complex medical and social problems. They will develop the clinical case management role and function across health and social care organisations. The primary function of the role is to maximise the patient’s health, clinically assess and treat patients in a defined group and reduce risks that contribute to ill health, thereby reducing unnecessary admissions to acute services, reducing demand on GP time and facilitating the delivery of efficient, effective, co-ordinated and timely high quality care to patients.
An Enhanced DBS with barred lists for both Adults & Children is required for this post.
The JD & PS are currently under AfC review and may be subject to change.
From 1st July we have come together as a single organisation under the name Mersey & West Lancashire Teaching Hospitals NHS Trust.
The Trust delivers acute hospital care, intermediate care, community, and primary care services to a population of over 600,000 people with a combined workforce of around 9,000 dedicated and skilled staff from 17 locations. The Trust provides regional services for burns, plastic surgery and spinal injuries to more than 4 million people across Mersey and West Lancashire, Cheshire, the Isle of Man and North Wales.
Our Vision is to deliver 5 Star Patient Care: CARE, SAFETY, COMMUNICATION, SYSTEMS and PATHWAYS. Our achievements include Outstanding rating by CQC (August 2018), being among the Top 100 places to work in the NHS, and National Preceptorship Accreditation (2023).
Please see our Wellbeing & Benefits booklet for more information on staff benefits. Accessible version available upon request.
Advertising date 18th August 2025 • Closing date 5th September, 2025 • Shortlisting 8th September, 2025 • Interview date 22nd September, 2025
Key duties
* Maximise independence by supporting people with long term conditions and highly complex needs to remain in their own homes as appropriate, by utilising and commissioning available resources.
* Undertake clinical assessment and diagnosis and provide treatment for patients within the defined group.
* Link with existing services to facilitate early discharge from hospital and prevent re-admission.
* Develop Partnerships and joint working within the local health and social care economy.
* Work collaboratively across organisation boundaries to support the effective and co-ordinated provision of social care and health care services.
* Be aware of and adhere to the Professional bodies Standards for administration of Medicines Act 1992, and the Misuse of Drugs Act 1971.
* Challenge professional and organisational boundaries to ensure that the Case Management role is focused on meeting the needs of service users, thus promoting continuity of high quality patient centred health and social care.
* Acts as an advocate and champion for patients in a variety of forums and professional groups and challenges attitudes and behaviour.
* Act as a role model so that patients receive the most effective care possible through: encouraging optimum management of long term conditions to ensure that the patient is functioning at the most independent level possible; acting in patients’ interests at all times.
* Make, implement and communicate changes to clinical practice as necessary in relation to case management.
The Secretary of State has approved the partnership between St Helens & Knowsley and Southport & Ormskirk Hospitals. From 1st July we have come together as a single organisation under the name Mersey & West Lancashire Teaching Hospitals NHS Trust.
Clinical & Professional responsibilities
Conduct a comprehensive health and social care assessment, utilising any current information in order to develop an individualised plan of care for patients within a defined group. This will include: review of health assessment including medical history; physical examination; assessment and review of medication; prescribing in conjunction with management plans; making referrals for diagnostic tests; functional/cognitive assessment; assessment of social care need.
Develop, monitor and manage the plan of care in collaboration with the primary health and social care team and others through: application of clinical knowledge about long term conditions; analysis of symptoms and data; identification of risk factors; recognition and management of early signs of acute illness; involving patients and carers in the development of the care plan; documentation of progress and continuous reassessment; referral and investigation; maintaining competence in clinical and diagnostic skills; setting up and actively participating in case reviews; coordinating care to avoid fragmentation and delay; prioritisation and coordination of multiple health and social care needs; referrals to specialist services; ensure effective communication and sharing of information amongst professionals; integration across health and social care; identify and address deficiencies in service provision; understand entitlements to social care and financial assessments; lead the process of identifying caseload; participate in development of case management across the Trust; provide clinical leadership and mentoring; contribute to policy and service development; liaise with patients and carers, community and specialist nursing and other health professionals, GPs, acute colleagues, social care and voluntary sectors.
Teaching & Training responsibilities
* Promote formal and informal training to pre and post registration health and social care professionals in relation to integrated working and long term conditions; provide mentorship and teaching to others developing a case management function.
* Participate in the induction of new staff.
* Provide education, advice and support to health and social care staff, people with long term conditions and their carers in both community and acute settings.
* Maintain up to date knowledge and competence in line with professional requirements and demonstrate critical thinking and decision making for professional development.
Leadership and management responsibilities
* Manage the complex clinical and social care interventions of individuals within an identified patient group on an ongoing basis.
* Undertake risk assessment in relation to individuals within the client group; monitor and respond to changing clinical and social situations; ensure safe management of care and service delivery.
* Line manage a defined team of staff, including appraisal and development reviews; provide clinical support for complaints, investigations and staff development.
* Contribute to service developments; act as a role model with excellent communication; promote effective team working; participate in recruitment and selection.
* Promote and market the role of the community matron; provide leadership in clinical governance and shared governance; support training and development of nursing and HCA staff.
Research & Development, Quality and Service improvements
* Participate in research and audit relating to long term conditions management; develop and implement policies and strategies in line with evidence based practice; identify and implement relevant policy/guidelines for the MDT; assess effectiveness of care delivery through review and evaluation.
Personal attributes
Develop good working relationships with all staff and other MDT members; act in accordance with professional guidance and code of conduct.
Safeguarding responsibilities
* Comply with Trust Safeguarding Adult and Children’s Policy; liaise with relevant professionals; minutely document multi-professional meetings; provide administrative support for safeguarding leads; recognise signs of abuse and know actions to take; understand local policies; understand sharing information implications; report concerns and seek advice.
This advert closes on Friday 5 Sep 2025
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