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Nhs - Continuing Healthcare - Appeals Clinical Team

8 months ago

Worcester, United Kingdom NHS Herefordshire & Worcestershire Integrated Care Board Full time

Continuing Healthcare (CHC) - Appeals Clinical Team Leader

Permanent 37.5 hours per week

Based in Acton House, Worcester or St Owen's Street, Hereford.

NHS Herefordshire and Worcestershire Integrated Care Board

An exciting new opportunity has arisen for an experienced CHC practitioner to lead the Continuing Healthcare (CHC) appeals and retrospective reviews service for Herefordshire and Worcestershire Integrated Care Board (ICB).

The post holder will work as a member of the Continuing Healthcare service within the Nursing and Quality division of the ICB and will be responsible for NHS CHC appeals and retrospective reviews.

The role will involve scrutinising and analysing the appropriate health and social care information, meeting with representatives to attempt to resolve the dispute locally, considering and examining representative comments and helping to prepare final reports. The post holder will have line manager responsibilities for the appeals team and take a leading role in relation to NHS England’s Independent Review Panel hearings.

NHS Herefordshire and Worcestershire ICB is the NHS organisation responsible for planning, buying and monitoring health services for our population of over 800,000 people who live within a mix of urban and rurally dispersed communities, spanning two of the largest counties in England.

We have a workforce of over 250 employees and hold a budget of £1.19 billion to commission hospital, community and mental health services. Our organisation is a dynamic, forward-looking and vibrant place to work, set within the backdrop of some of the country’s most beautiful countryside.

Main duties

Provide clinical expertise for CHC Appeals, and retrospective reviews.

Ensure the National Framework and local processes have been robustly applied within the dispute and retrospective review process, with evidence to support CHC eligibility recommendations and decision making.

Co-ordinate and Chair both local resolution and retrospective claim meetings and provide the expert clinical CHC advice at the meetings where patients/families have disputed decisions or requested back dated reviews of eligibility.

Line manage and support clinicians and administrators working in the appeal/retrospective team.

Work to timescales in line with National Framework guidance in respect of CHC disputes and previously unassessed periods of care assessments.

Support Line Manager to review CHC appeals and retrospective review processes to identify any opportunities to improve pathways as appropriate to enhance quality and effectiveness.

Meet with patients/representatives in potentially highly contentious situations and provide responses to complex CHC disputes.

Provide timely relevant correspondence to patients/families/representatives ensuring they are kept informed of developments.

Ensure the relevant documentation including Health and Social care records are provided in a timely manner to NHS England as part of the independent review panel appeal process.

Provide 1:1 support, supervision, development reviews and appraisals to band 6 clinicians and administration staff.

This role offers the opportunity for hybrid working.

Please refer to the JD for further information on roles and responsibilities.

As a new member of the Continuing Healthcare Team, you will complete a robust induction within the newly structured and dynamic team. Participation in Clinical Supervision is considered an essential support feature as well as encouragement for continued professional development. Regular clinical team meetings are utilised for peer supervision and support, as well as in-house education sessions.