Community Frailty Practitioner

We are looking for an experienced & motivated clinical practitioner to join our supportive & forward-thinking team, delivering high-quality care to housebound patients & residents within care homes.

This is a rewarding & varied role where you will work autonomously within your professional boundaries, undertaking history taking, clinical assessment, diagnosis, treatment, & evaluation of care for vulnerable patients.

You will play a key role in leading long-term condition management for elderly, frail, & housebound patients, helping to improve outcomes & quality of life within the community. A key part of the role will involve leading & participating in regular care home ward rounds, working proactively with care home staff & the wider multidisciplinary team to provide coordinated, person-centred care.

The successful candidate will demonstrate safe clinical decision-making, using advanced assessment & diagnostic skills within general practice. You will prioritise & triage patient needs effectively, arranging investigations, referrals, & onward care when required.

Working closely within a supportive multidisciplinary team, you will collaborate with GPs, nurses, care homes, & wider healthcare professionals to deliver holistic care.

This is an exciting opportunity to develop within a dynamic role, with strong clinical support, mentorship, & opportunities for professional growth. The workload will include home visits, care home visits, ward rounds, & telephone consultations.

Job responsibilities,

To work as part of a multi-disciplinary team across the PCN to

care for our housebound and care home patients, including proactive assessment,

diagnosis and treatment of individuals using a holistic approach.To undertake care home weekly ward rounds.

To assess, diagnose, investigate, treat, refer or signpost

patients/service users within the community with undifferentiated or

undiagnosed condition relating to minor illness, minor injury or urgent

problems.

The post holder will use advanced clinical skills to provide

education to service users, promoting self-care and empowering them to make

informed choices about their treatment.

The post holder must have access to a vehicle for home visits with

mileage expenses remunerated by submission of a monthly mileage form. (Please

note it is the postholders responsibility to ensure that their car insurance

is covered for business use).

patients who are frail/have co morbidity in their homes or in a care home. Undertake

care home ward rounds with the support of the PCNs Community Frailty

Practitioner, Community Frailty Paramedic and Care Coordinator

Prescribe/issue

medications as appropriate following policy, patient group directives and local

pathways. Independent Prescriber qualifications is essential.

May

be required to help with the Avoiding Unplanned Admission reviews

Consult

with patients, take medical histories, perform physical examinations, analyse,

diagnose and explain medical problems during consultations and home visits.

Recommend

and explain appropriate diagnostic tests and treatment.

Formulate

differential diagnoses and develop and deliver appropriate treatment and

management plans. Request and interpret results of laboratory investigations

when necessary.

Advanced

end of life care planning to include ReSPECT discussions and development of

Personalised Care and Support Plans.

Advise

patients on general health care and minor ailments, with referral to other

members of the primary and secondary health care team as necessary.

Undertake

assessment for patients within their place of residence using diagnostic skills, initiation of

investigations and feeding back to the patients GP where appropriate.

help manage/support patients with their long term condition.

Support quality improvement and assurance initiatives within the

PCN.

Promote public health and screening programs, including

immunisations and cervical screening.

Integrate population health management approaches to reduce health

inequalities.

Work collaboratively with the wider practice team to enhance

patient care.

Work

with local and national evidenced based policies and procedures.

To

communicate at all levels within the team ensuring an effective service is

delivered.

Ensure

evidenced-based care is delivered at the highest standards ensuring delivery of

high-quality patient care.

Severnvale PCN (Primary Care Network) comprises four GP practices

in South Gloucestershire delivering services to a population of circa 34,000 patients which includes 10 care homes. We are an enthusiastic, dynamic, and

friendly PCN who constantly strive to improve patient pathways and health care

outcomes.

The PCN team includes a Clinical Director, a PCN Manager, 2 Community

Clerks, dedicated Social

Prescribing Link Workers and First Contact Physiotherapists.

Experience

Other

Qualifications

Desirable: - Minimum 3 years post-registration experience.

Specialist knowledge/skills

Personal attributes & abilities

Desirable: - Confident in facilitating and challenging others; - Demonstrates a flexible approach to ensure patient care is delivered.