Clinical Community Pathway Co-ordinator

1 month ago


Swindon, United Kingdom Great Western Hospitals NHS Foundation Trust Full time

Integral to this role will be the requirement to work flexibly within the navigation hub as well as undertaking home visits as part of our wider multidisciplinary team, as is the requirement to work autonomously and independently providing safe and effective care and treatment. We provide our services between the hours of 8am and 22.00 hours across a 7 day service working alongside our community nursing team, specialist community services such as community IV team, end of life nurses, community COPD and community therapy teams.

You will need to have excellent communication skills and be confident in developing and maintaining positive relationships with consultants, GP’S, nurses, therapists and specialist services. We are looking for a clinician who has achieved their physical assessment and clinical reasoning course (PACR), teaching and assessing qualification and ideally has community experience in assessing and treating patients within their own home. We are committed to supporting staff with professional development to extend their skills and knowledge.

Our STAR values are at the heart of everything we do. You can expect to see them in the way we act and the way we treat each other. Our values make us who we are.

Service - We will put our patients first
Teamwork - We will work together
Ambition - We will aspire to provide the best service
Respect - We will act with integrity

1. To work as an autonomous practitioner managing and prioritising care needs through clinical assessment for patients with complex physical, mental and social care needs.
2. Work closely with the ward-based discharge coordinators, inpatient therapy teams and social care teams to facilitate an early discharge where possible.
3. Work with the clinical assessors and discharge coordinators to identify patients with complex health and social care needs who could be treated at home in the community.
4. To work closely with the multidisciplinary teams such as the ambulance service, emergency department, front door therapy team, ACP’s, specialist community services, and community nursing, promoting and supporting care and treatment in the patients own home.
5. Sharing information and acting as a link between the Hospital and Community services to help avoid unnecessary admissions
6. Excellent communication skills and knowledge of community services, mental health, social services and voluntary services within the Swindon area.
7. To use assessment and examination skills to plan, implement and evaluate evidenced based client centred interventions, maintaining the associated records in compliance with the standards from The Great Western Hospital NHS Foundation Trust, the Nursing and Midwifery Council (NMC), HCPC and the Care Quality Commission (CQC).
8. To use highly developed skills to screen, prioritise and delegate referrals into the service referring to other agencies where necessary.
9. To act as a clinician within Swindon Community Health Services with knowledge of longterm conditions, cognitive and functional impairments and end of life care which could have implications for the safe effective discharge of patients.
10. To understand how multiple health and social care needs will impact on the patient’s quality of life and what measures can be implemented to support and optimise this.

Refer to attached JD for further information


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