Highly Specialist Physiotherapist Rehabilitation Navigator in Milton Keynes

Home 1st is excited to advertise its first highly specialist Band 7 Physiotherapist Rehabilitation Navigator role. This fixed‑term contract, designed to meet winter pressures and trial future development, will shape the rehabilitation pathway in Milton Keynes. Successful candidates will work with the Milton Keynes Hospital Integrated Discharge Hub to reduce barriers to rehabilitation access.

Main duties of the job:

• Support the delivery of Home 1st Planned and Unplanned Care services in Milton Keynes, focusing on holistic management of long‑term conditions and frailty.
• Provide highly specialist holistic assessments and deliver person‑centred rehabilitation‑based discharge‑planning advice to patients requiring supported discharge from MKUH, including in‑reach support as required.
• Partner with integrated discharge and therapy teams at MKUH to support case management of discharge plans for transfer to community‑based inpatient Seacole beds for patients with complex frailty or social presentations.
• Liaise with other Home 1st Planned and Unplanned Care teams to expedite transfer of care.
• Collaborate with Milton Keynes Council Social Care teams to triage, allocate and respond to referrals requiring joint integrated care and therapy assessment to support discharge from hospital.
• Provide sign‑posting advice to individuals seeking support from community services.
• Undertake all aspects of clinical duties as an autonomous practitioner.
• Communicate effectively and work collaboratively with all members of the multidisciplinary team, both within CNWL and across partner organisations.
• Participate in the development of the Home 1st service.

Working for our organisation:

CNWL offers coaching, daily debriefs, remote working, 1:1 supervision, peer‑group CPD sessions and in‑service training. Home 1st provides a modern office, an ICT laptop, mobile phone, uniform and mileage expenses. Additional benefits include:

• Buying and selling annual leave
• Employee assistance programme – free, confidential help with personal life
• Staying well at work service
• Staff wellbeing zone – free, confidential online health and wellbeing programmes
• The Recovery College – health and wellbeing courses for staff
• A range of staff networks
• Discounts and savings at hundreds of retailers nationwide with Vivup
• Salary sacrifice schemes

Detailed job description and main responsibilities:

• Be professional and legally accountable for all aspects of work, including delivery of highly specialist therapy intervention and caseload management.
• Use specialist knowledge across procedures based on evidence‑based practice and treatment options, applying clinical assessment, reasoning skills and treatment expertise.
• Conduct comprehensive holistic assessments to determine suitable management of rehabilitation needs.
• Triaged and risk‑assess patients to prioritise therapeutic intervention response times.
• Obtain valid informed consent and manage legal frameworks for patients lacking capacity.
• Use verbal or non‑verbal communication tools with patients, relatives, carers and other health and social care professionals to progress rehabilitation, treatment programmes and discharge plans.
• Manage clinical risk within Home 1st waiting lists to prevent deterioration of patients needing therapeutic input.
• Prescribe, order and review equipment needs for supported discharge, ensuring high‑level equipment packages.
• Support in‑reach assessment and expedite discharge plans aligned with PW1 and PW2 requirements.
• Represent community services at MKUH integrated discharge hub multidisciplinary meetings for complex‑needs discharge planning.
• Make recommendations to multi‑professional teams about support levels required for individualised care packages or inpatient admission on discharge.
• Promote a risk‑enabling approach to staff, encouraging therapeutic intervention and functional activities to prevent deconditioning and reduce length of stay.
• Ensure safe and competent use of all appropriate equipment.
• Collaborate with multi‑professional teams, including GPs, clinicians, medical and therapy colleagues, social services and voluntary sector to deliver user‑led comprehensive treatment plans.
• Provide specialist communication and liaison between MKUH Integrated discharge hub, CNWL Single Point of Access (SPA), Acute Adult Frailty Team (AAFT), Seacole Inpatient Units and the Virtual Ward team to promote patient therapy requirements in treatment and discharge planning.
• Attend Virtual Ward, AAFT and inpatient multidisciplinary meetings as required.
• Maintain accurate electronic records in a timely and effective manner.
• Deliver seamless therapeutic treatment plans with Home 1st team during transition from hospital to Seacole or home.
• Take part in service audit to assess the effectiveness of Home 1st clinical pathways.
• Implement system flow response with CNWL, MKUH and BLMK ICB as part of escalation processes.
• Seek patient and carer feedback to inform decision‑making for service interventions.
• Analyse Datix incidents regarding patient discharge and implement actions to prevent recurrent risk.
• Supervise and support the development of Band 5 therapists on rotation.

Person specification:

Experience:

• Ability to manage own workload and make autonomous decisions.
• Experience working in community or acute settings.
• Experience managing triage of referrals or waiting lists.
• Experience completing risk assessments.
• Understanding of current guidelines for supported discharge pathways.
• Car owner / driver.
• Experience working in frailty, inpatient, neuro and NHS settings.

Qualifications:

• Current HCPC registration.
• Degree‑level (BSc/BA) education in Physiotherapy.
• Membership of a recognised professional body.
• Evidence of continuing professional development appropriate to role.
• Completion of a Rehabilitation / Frailty specific educational course or willingness to work toward (MSc or BSc equivalent).

The successful applicant may have contact with patients or service users. We strongly encourage and support vaccination as the best way to protect yourself, family, colleagues and patients.

Due to high response levels, vacancies may expire before the advertised closing date. Applications requiring sponsorship will be considered. All contracts have a 13‑week probationary period.

If offered a job, information will be transferred into the NHS Electronic Staff Records system.