Community Matron

Job summary

Hours Per Week

Weare looking for a motivated and dynamic Community Matron to work as part of ourNeighbourhood Teams within the Barnsley IntegratedServices Care Group.

AsCommunity Matron you will:

Supportthe patient throughout their journey including triaging & signpostingreferrals, admission avoidance, hospital discharge & managing long termconditions at home or in a patients long-term place of residence.

Supportthe prevention of inappropriate hospital admission/readmission followingdischarge from acute care.

Supportthe Enhanced Healthcare in Care Homes service office in Barnsley, beinginvolved & supporting MDTs & ward rounds alongside Primary Care.

Work on new & emerging pathwaydevelopments including Virtual Ward roll out alongside partner organisations.

Work as part of amulti-disciplinary team including nursing specialists, AHPs, Primary Care &Acute colleagues.

The successful applicant will beexpected to work across a seven-day week shift pattern including weekends &bank holidays, 8am-8pm.

For full job description, please see attached supporting documents.

At the time of advertising,this role does meet the minimum requirements set by UK Visas and Immigration tosponsor candidates to work in the UK. We look forward to receiving yourapplication.

Main duties of the job

Thesuccessful candidate will:

Bea Registered General Nurse with substantial post qualifying experience.

Haveor be willing to complete the Nurse Prescriber course.

Workautonomously as an Advanced Practitioner & as part of an MDT & be ableto suggest & contribute to improvements within the pathway/team.

Maximisepatients health, clinically assess, treat patients & reduce risks thatcontribute to ill health, reducing unnecessary admissions to acute services,reducing demand on Primary Care.

Providecare across our neighbourhood footprint, working in an integrated way withTherapy, Community Nursing, Acute, Primary Care & Adult Social carecolleagues as part of the wider system.

Deliveran efficient, effecting & safe pathway from triage to discharge,undertaking crisis & proactive interventions to people at home or residingin care homes across Barnsley.

All employees of the Trust are stronglyencouraged to be fully vaccinated against COVID-19 to protect patients.

About us

Weare a specialist NHS Foundation Trust that provides community, mental healthand learning disability services for the people of Barnsley, Calderdale,Kirklees and Wakefield. We also provide low and medium secure services and arethe lead for the west Yorkshire secure provider collaborative.

Our mission isto help people reach their potential and live well in their communities, we do thisby providing high-quality care in the right place at the right time. We employstaff in both clinical and non-clinical services who work hard to make adifference to the lives of service users, families and carers.

We encourageand welcome applications from all protected characteristic groups, we valuediversity and want our workforce to be reflective of our communities.

Beinga foundation Trust means were accountable to ourmembers, who can have a say in how were run. Around 14,300 local people(including staff) are members of our Trust.

Joinus and you will be one of over 4,500 staff committed to supporting and improvingthe mental, physical and social needs of the thousands of people we meet andhelp each year.

Weare committedto safeguarding and promoting the welfare of children, young people andvulnerable adults and expects all colleagues and volunteers to share thiscommitment.

We do reserve to right to close vacancy before the advertised closing date if necessary, so please apply as soon as possible.

Job description

Job responsibilities

The role of the CaseManager/ Community Matron is:

Toprovide systems leadership at a neighbourhood level for managers, specialistnurses and staff within a primary care setting.

Workeffectively in an integrated partnership way with primary care, secondary care,social care, the independent and voluntary sector.

Throughpatient involvement, brokering care across partnerships, whilst leading and promoting the principles of multidisciplinary teamworking, to support the achievement ofbetter health outcomes.

Toprovide a high quality, comprehensive and accessible community nursing serviceto housebound patients.

Undertakecomplex holistic assessments using advanced clinical examination and assessmentskills that encompass all aspects of an individuals needs.

Act askey worker, liaising and working collaboratively with otherprofessionals to co-ordinate care, preventing duplication, fragmentation andensuring the effective deployment of resources.

Undertakenline management responsibilities of the District Nurse and Assistant CommunityMatron roles.

Proactively manage a caseload of patients with long term conditions who have complex needs, increasing and decreasing input into a patient care as required and discharging from the caseload as appropriate in line with the Community Nursing Service Operating Framework.

Undertake the keyworker role, liaising and working collaboratively with other professionals to co-ordinate care, preventing duplication, fragmentation and ensuring the effective deployment of resources.

Actively case find using data bases and risk stratification tools to actively seek out patients who will benefit from clinical case management techniques to avoid unplanned hospital admissions and reduce the length of hospital stays by facilitating a timely discharge.

Undertaken complex holistic assessments using advanced clinical examination and assessment skills that encompass all aspects of an individuals needs in conjunction with the individual and their family.

Use self-management and joint care planning principles to care delivery that promote the resilience, enhance well-being and maintain independence.

To provide evidence based care plans based on sound clinical decision making using the knowledge of the unique presentation of long term conditions, negotiated with the person.

To initiate and lead medicines management reviews, independently prescribing medicines and appliances where appropriate and within scope of practice.

Use expert knowledge to promote healthy lifestyles and self-management of long term conditions.

Prevent unplanned hospital admissions through intensive clinical management and health and social care support at home. Reducing the length of stay of unplanned hospital admissions through communication and coordination of care with secondary and primary care.

We are aware that an increasing numberof applicants are using AI technology to generate responses on NHS Jobapplication forms. Over reliance on AI-generatedcontent in application forms is strongly discouraged and we will conduct a thorough screening process before selectingcandidates to progress to the next stage. If you are using AI to enhance yourapplication, please disclose this in your NHS Jobs application form.

Person Specification

Special Knowledge and Skills

Essential

Ability to undertake advanced clinical practice and examination skills independently that encompasses all aspects of the patients needs. Skilled in care pathway planning, promotion of health and self-care, disease prevention and the management of acute or long-term conditions. Ability to lead and participating in multi-professional/agency meetings and strategies. Awareness of and ability to contribute to national, local, strategic and operational policy developments. Evidence of developing, delivering and evaluating training packages for individuals and groups in a variety of settings. Ability to undertake quality assurance measures, including research and audit. Excellent communication and interpersonal skills. Ability to motivate staff and work across organisations and professional boundaries. Demonstrate an understanding of clinical governance Demonstrate good IT skills.

Experience

Essential

Substantial post registration experience and able to demonstrate relevant effective learning from this experience. Demonstrable leadership experience. Experience of working as an autonomous practitioner. Experience in management of Long term Conditions including palliative care. Evidence of working effectively in an integrated and partnership way with a range of professionals and agencies. Evidence of innovative practice.

Desirable

Experience of undertaking investigations/significant event audits.

Qualifications

Essential

Registered Nurse Level 1. First Degree. Mentorship Qualification. Independent prescriber or willingness to undertake. Post Graduate Certificate in Advanced Clinical Practice. Masters Degree or equivalent experience.

Desirable

Qualification as Community Specialist Practitioner (District Nursing). Palliative Care qualification.

Training

Essential

Motivational Interviewing/ Behaviour Change. Leadership and Management. Venepuncture or be prepared to complete the training required.

Desirable

Specialist courses appropriate to Long Term Conditions. CHD, Diabetes, Respiratory conditions.

Personal Attributes

Essential

Ability to work on own initiative. Able to negotiate and influence. Reliable and flexible. Enthusiastic and highly motivated.

Physical Attributes

Essential

Ability to undertake the duties and demands of the post. A satisfactory sickness record over the previous 2 years (subject to the need to act with fairness and equality of opportunity, particularly where the sickness is related to a disability and/or pregnancy). A Current driving licence and access to a car during the working day is essential (reasonable adjustments will be considered for any applicants who are unable to drive due to a disability).

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