Adult Hospital At Home Nurse London

Job summary

The post holder is employed by Royal Free London NHS Foundation Trust and primarily based at North Middlesex University Hospital. As a member of the Adult Hospital @ Home (AH@H) service, you will be a skilled and adaptable nurse, contributing to both the Community Admission Avoidance and Accelerated Discharge pathways. Your ability to make timely, high-quality clinical decisions will directly support patient recovery and wellbeing.

The AH@H service aims to deliver early supported discharge, admission avoidance, and ongoing treatment within patients' own homes, ensuring safe, effective care in the community.

This includes reviews of adults experiencing worsening medical or functional conditions in their usual place of residence and works closely with wider community services to prevent clinical deterioration and avoid acute hospital admission.

Main duties of the job

As a Band 6 nurse, you will undertake complex, holistic assessments, deliver evidence-based interventions, and exercise sound clinical judgement within your professional scope. You will provide high-quality care, advice, and education to patients and carers, promoting independence and optimising quality of life.

You will be responsible for visiting patients requiring complex, time-critical assessment and intervention to prevent avoidable admissions and support early discharge.

Referrals to the AH@H service may come from Rapid Response, Same Day Emergency Care (SDEC), Accident & Emergency, NMUH wards, Barnet Hospital, the Royal Free Hospital, and community sources including GPs, care homes, community nursing teams, and London Ambulance Service (LAS).

You is expected to demonstrate competence in Advanced Physical Assessment skills, and if not already completed, have a commitment to completing training qualification.

The role requires the ability to work autonomously, while also drawing on the expertise of colleagues across both primary and secondary care. You will contribute to a collaborative, multidisciplinary approach to delivering safe, responsive, and person-centred care in the community.

About us

Royal Free World Class Values

• Welcome all of the time
• Confident because we are clearly Communicating
• Respected and cared for
• Reassured that they are always in safe hands

Details

Date posted: 10 September 2026
Pay scheme: Agenda for change
Band: Band 6
Salary: £45,953 to £54,254 a year
Per Annum Including HCAS
Contract: Permanent
Working pattern: Full-time
Reference number: 391-NMUH-8095991
Job locations: North Middlesex Hospital, North Middlesex Hospital, London, N18 1QX, United Kingdom

Job responsibilities

1 CLINICAL RESPONSIBILITIES

1.1 To undertake highly skilled and complex nursing care for patients suitable for AH@H in collaboration with the multidisciplinary team (MDT) through assessment, planning and evaluation of patient care.

1.2 To make skilled clinical decisions and communicate the rationale clearly.

1.3 To ensure that clinical practice is contemporary to meet the needs of patients and families.

1.4 To ensure that each patient has a comprehensive assessment of need, including risk assessment and that their care is culturally sensitive and addresses issues of equality, diversity and inclusion.

2 RESPONSIBILITY FOR PATIENTS

2.1 To deliver safe, effective, and timely nursing care to patients within their homes, which is individualised and ensures patients' and carers' dignity is maintained.

2.2 To address the distressing and emotional needs of patients and carers in an exemplary manner.

2.3 To manage complex patient care, ensuring that risks are adequately assessed, minimised, translated into appropriate care plans and reported across the organisation as appropriate.

2.4 To safeguard patients by adhering to clinical governance, infection control, and risk management standards

2.5 To advocate for patients needs, ensuring they receive appropriate interventions, referrals, and support across community and acute care pathways

3 RESPONSIBILITY FOR POLICY AND SERVICE DEVELOPMENT

3.1 To be professionally and legally accountable for all work undertaken to work within the standards and guidelines of the AH@H, the Trust, and the NMC/HCPC Code.

3.2 To maintain and update a Continuing Professional Development Portfolio (CPD) and undertake revalidation.

3.3 To comply with Trust policies and procedures, and the Health and Safety at Work Act.

3.4 To evaluate your practice through audit and outcome measures with the support of senior colleagues when required. To participate in the AH@H Quality Improvement work

3.5 To ensure effective implementation of infection control policies

3.6 To participate in resource projects and health promotion programmes within the AH@H as requested

4 RESPONSIBILITY FOR FINANCIAL AND PHYSICAL RESOURCES

4.1 To provide informal day-to-day support to AH@H colleagues and students.

4.2 To work closely with the Community, Acute Trust, Doctors, GPs, nursing and therapy colleagues to prevent inappropriate hospital admissions.

4.3 To manage the effective coordination and continuity of patient care, working within the AH@H service closely with external agencies and community colleagues, ensuring safe and effective delivery

4.4 To ensure efficient use of clinical resources and equipment within the AH@H service.

5 RESPONSIBILITY FOR LEADING AND MANAGING

5.1 Attend regular MDT meetings with consultants, Doctors, therapists and nurses.

5.2 To participate in the annual appraisal review.

5.3 To comply with all mandatory training: fire, violence awareness, CPR, manual handling, child protection and safeguarding of vulnerable adults.

5.4 To provide supervision, annual appraisal and monitoring of the work of junior colleagues and students with support from senior staff.

5.5 To participate in gathering real-time feedback, contribute to audits, and evaluate service effectiveness to enhance patient outcomes.

6 RESPONSIBILITY FOR INFORMATION RESOURCES

6.1 To ensure that accurate and evaluative records of patient care and statistics are maintained in accordance with the AH@H policy

6.2 To be responsible for the safe use of all equipment

6.3 To ensure that all equipment damaged, malfunctioning, accidents and complaints are reported to the team leader promptly.

7 RESPONSIBILITY FOR RESEARCH AND DEVELOPMENT

7.1 To participate in the in-service training, lectures and education programmes to other nurses, other disciplines and to visitors to the department.

7.2 To utilise opportunities to develop skills and knowledge, apply critical appraisal and keep up to date with current practice in the field and attend accredited courses and participate in education programmes for client groups

7.3 To actively participate in health promotion and health education initiatives within the Trust and in the community directorate.

GENERAL RESPONSIBILITIES

Infection Control

Infection control is everyones responsibility. All staff, both clinical and non-clinical, are required to adhere to the Trusts Infection Prevention and Control policies and procedures and the Health Act (2006) Code of Practice for the prevention and control of healthcare-associated infections and make every effort to maintain high standards of infection control at all times, thereby reducing the risk of Healthcare-Associated infections.

It is the duty of every member of staff to take personal responsibility for the prevention and control of infection, as laid down in the Trusts polices and procedures, which reflect the statutory requirements of the Hygiene Code.

To work in close collaboration with the Infection Control Team.

To ensure that monitoring of clinical practice is undertaken at the agreed frequency.

To ensure that the work environments are cleaned and maintained to the highest standards, ensuring that shortfalls are rectified or escalated as necessary.

To ensure that all relevant monitoring data and issues are provided to the Directorates Governance structures.

To ensure that all staff are released to attend infection control-related educational sessions and staff with specialist roles, e.g. link practitioners, are released to undertake their duties.

Health and Safety at Work

• Take reasonable care for the health and safety of himself/herself and other persons who may be affected by their actions or omissions at work.
• Co-operate with the employer in ensuring that all statutory and other requirements are complied with.

Confidentiality & Data Protection

The post holder has a responsibility to comply with the Data Protection Act and General Data Protection Regulation 2018 and maintain confidentiality of staff, patients and Trust business.

If you are required to process information, you should do so in a fair and lawful way, ensuring accuracy is maintained. You should hold information only for the specific registered purpose and not use or disclose it in any way incompatible with such a purpose.

You should disclose information only to authorised persons or organisations as instructed. Breaches of confidentiality in relation to information will result in disciplinary action, which may include dismissal. Employees are expected to comply with all Trust policies and procedures and to work in accordance with the Data Protection Act and General Data Protection Regulation 2018. For those posts where there is management or supervision of other staff it is the responsibility of that employee to ensure that their staff receive appropriate training (e.g. HISS induction, organising refresher sessions for staff when necessary.)

Conflict of Interest

The Trust is responsible for ensuring that the services for patients in its care meet the highest standards. Equally, it is responsible for ensuring that staff do not abuse their official position, to gain or benefit themselves, their family or friends.

Equality and Diversity

The Trust values equality and diversity in employment and in the services we provide. It is committed to promoting equality and diversity in employment and will keep under review our policies and procedures to ensure that the job related needs of all staff working in the Trust are recognised. The Trust aims to ensure that all job applicants, employees or clients are treated fairly and valued equally regardless of sex, marital status, domestic circumstances, age, race, colour, disablement, ethnic or national origin, social background or employment status, sexual orientation, religion, beliefs, HIV status, gender reassignment, political affiliation or trade union membership.Selection for training and development and promotion will be on the basis of the individuals ability to meet the requirements for the job.

You are responsible for ensuring that the Trusts policies, procedures and obligation in respect of promoting equality and diversity are adhered to in relation to both staff and services.

Vulnerable Groups

To carry out responsibilities in such a away as to minimise risk of harm to children, young people and vulnerable adults and to promote their welfare in accordance with the Children Act 2004, Working Together to Safeguard Children (2006) and No Secrets guidance (DH 2000).

To demonstrate an understanding of and adhere to the trusts child protection policies.

Smoke Free

The Trust implements a Smoke Free policy that applies to all staff. Staff are not allowed to smoke while wearing a recognisable Trust uniform or visible trust identification badge, and not allowed to smoke anywhere on hospital grounds. Staff are not allowed to take additional breaks in order to smoke. They may smoke during designated breaks but only out of uniform and off site. Staff contravening this policy may be subject to disciplinary procedures.

Standards of dress

All staff are expected to abide by the Trusts guidance on standards of dress.

Person Specification

Royal Free World Class Values

Essential

• oDemonstrable ability to meet the Trust Values (Positively welcome / Actively Respect / Clearly Communicate / Visibly Reassuring

Education & professional Qualifications

Essential

• Registered Nurse with current NMC registration / Bachelor's Degree
• Evidence of continued professional development
• Advanced Clinical Assessment Course or working towards.

Experience

Essential

• Experience of working within the Community
• Extensive post registration experience in Acute care / Ability to prioritise work-load and response to queries effectively.
• Able to work as part of a multi-professional team / work safely under pressure across completing priorities / Work with targets and deadlines.
• IT skill, data input, collection, contribute to audits and evaluation. Standard keyboard skills and knowledge of a number of IT packages such as word, Healthroster, Presentation software - power point.
• Can act on own initiative / Able to follow detailed written instructions and assessments outcomes
• Understanding of the role of AH@H in admission prevention and supporting a timely discharge.

Desirable

• oExperience in ITU, A&E, SDEC, Acute Assessment Units would be advantageous.
• Previous experience working in and Adult Hospital At Home Service

Skills and Aptitudes

Essential

• Ability to assess and implement appropriate care plan and adapt plan depending on patient's response to treatment.
• Ability to assess and identify the deteriorating patient.
• Excellent clinical reasoning skills & decision- making skills. / Able to work confidently in an independent and autonomous role whilst being aware of own limitations.
• Excellent drug/medication knowledge and able to link pharmacology to patient's treatment and presentation.
• Excellent verbal / written communication skills and ability to communicate clearly and concisely within the MDT.
• Able to communicate with patient on sensitive issues in a supportive manner whilst able to also challenge others assertively where necessary.
• Leadership skills - Manage and support students, HCA's, Band 5 Nurses and contribute to the management of the team. Undertake appraisals
• Phlebotomy, IV Cannulation and IV therapy skills and knowledge (Including PICC and Central line.

Desirable

• Advanced Physical Assessment skills / Heart Failure Nursing experience

Others

Essential

• Full UK Drivers License with no more than 3 points endorsed.
• Must have own vehicle with Business Insurance.

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

Certificate of Sponsorship

Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).

From 6 April 201