Senior Adult Hospital At Home Nurse (AH@H)

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Senior Adult Hospital At Home Nurse (AH@H)

NHS AfC: Band 7

Main area Adult Hospital At Home Grade NHS AfC: Band 7 Contract Permanent Hours Full time - 37.5 hours per week Job ref 391-NMUH-8327802

Site North Middlesex Hospital Town London Salary £55,524 - £62,652 Per Annum Salary period Yearly Closing 17/11/2026 23:59

Our trust has over 17,000 staff serving 2 million patients every year. It comprises Barnet Hospital, Chase Farm Hospital, the Royal Free Hospital, North Middlesex University Hospital and more than 30 services in the community. This larger scale organisation provides an unprecedented opportunity for us to continue our pioneering work, particularly in finding ways to deliver even better care to our patients.

Our mission is to deliver world class care and expertise in our clinical services, underpinned by world class teaching and research and we will continue to measure our progress against our five governing objectives: excellent outcomes, excellent patient and staff experience, excellent value for taxpayers’ money, being safe and meeting our external duties, and building a strong organisation.

Everyone is welcome at Royal Free London NHS Foundation Trust. We're proud of our diversity and we continue to undertake new initiatives to advance equality for LGBT+, BME, gender equality, staff carers and people with disabilities and lived experiences to promote good relations and understanding between our staff.

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The post holder will be employed by Royal Free Hospital with primary responsibility at North Middlesex University Hospital (NMUH) Adult Hospital at Home Service. The Registered Nurse is accountable to the Service Lead and will have continuing responsibility for the nursing care given to patients with sub-acute conditions in identified community settings, without direct supervision. S/he is personally accountable for the nursing standards of such delegated duties. S/he is also responsible for demonstrating procedures for qualified and/or unqualified staff. S/he will provide evidence-based care, advice and information to patients and carers enabling them to enjoy maximum independence and optimum quality of life The post holder will proactively manage a caseload of patients requiring complex case management to prevent hospital admissions and facilitate early discharge to improve patient health outcomes. Patients requiring case management in the Rapid Response and Virtual Ward service will be identified by case-finding in the Same Day Emergency Care (SDEC) unit, Accident and Emergency department, NMUH wards and via Community referrals e.g., GP, Care Homes, Community Nurses, and LAS. Key partners are NMUH and Whittington Hospital- Emergency Departments, assessment units, acute wards, community nurses, LAS, and GPs within the Borough of Enfield. Patients will be identified as not requiring hospital admission but needs Community support to go home safely.

Main duties of the job

Working autonomously, the post holder will have continuing responsibility for proactively monitoring and managing, patients on the caseload. The post holder will be expected to develop skills in physical assessment, diagnostic reasoning and nurse independent prescribing and use these both in the community and ambulatory care centre setting. Using these skills will assist in the recognition of early symptoms of disease exacerbation, acute illness, and injuries. The post holder will be expected to co-ordinate care and navigate the patient through pathways across the primary, secondary care interface, including the prevention of unnecessary admissions, facilitating appropriate ones through in-reach case finding in both the hospital setting also via GP referral. Care, compassion, competence, communication, courage, and commitment will underpin all care delivered as well as Standards for Better Health Care, National Service Frameworks, the long-term conditions agenda, hospital avoidance and care closer to home. The post holder will be a senior nurse within the NMUH AH@H Service and therefore act as a clinical leader and role model to staff, offering clinical advice on the care of patients with complex needs as required. They will work with colleagues and managers to support the integration of care pathways and patient care across community and acute settings. This post will also involve in reach to hospital settings.

Working for our organisation

Working for our organisation means joining a supportive and dedicated team committed to delivering high-quality services to our patients and communities. We value our people and promote a culture of respect, inclusion, teamwork and continuous improvement. You will have opportunities to develop your skills and experience, work collaboratively with colleagues across the organisation, and make a meaningful contribution to the services we provide. We are committed to creating an inclusive working environment where everyone is valued, supported and encouraged to reach their potential.

Detailed job description and main responsibilities

Job summary

The post holder will be employed by Royal Free Hospital with primary responsibility at North Middlesex University Hospital (NMUH) Adult Hospital at Home Service. The Registered Nurse is accountable to the Service Lead and will have continuing responsibility for the nursing care given to patients with sub-acute conditions in identified community settings, without direct supervision. S/he is personally accountable for the nursing standards of such delegated duties. S/he is also responsible for demonstrating procedures for qualified and/or unqualified staff. S/he will provide evidence-based care, advice and information to patients and carers enabling them to enjoy maximum independence and optimum quality of life. The post holder will proactively manage a caseload of patients requiring complex case management to prevent hospital admissions and facilitate early discharge to improve patient health outcomes. Patients requiring case management in the Rapid Response and Virtual Ward service will be identified by case-finding in the Same Day Emergency Care (SDEC) unit, Accident and Emergency department, NMUH wards and via Community referrals e.g., GP, Care Homes, Community Nurses, and LAS. Key partners are NMUH and Whittington Hospital- Emergency Departments, assessment units, acute wards, community nurses, LAS, and GPs within the Borough of Enfield. Patients will be identified as not requiring hospital admission but needs Community support to go home safely.

Working autonomously, the post holder will have continuing responsibility for proactively monitoring and managing, patients on the caseload. The post holder will be expected to develop skills in physical assessment, diagnostic reasoning and nurse independent prescribing and use these both in the community and ambulatory care centre setting. Using these skills will assist in the recognition of early symptoms of disease exacerbation, acute illness, and injuries. The post holder will be expected to co-ordinate care and navigate the patient through pathways across the primary, secondary care interface, including the prevention of unnecessary admissions, facilitating appropriate ones through in-reach case finding in both the hospital setting also via GP referral. Care, compassion, competence, communication, courage, and commitment will underpin all care delivered as well as Standards for Better Health Care, National Service Frameworks, the long-term conditions agenda, hospital avoidance and care closer to home. The post holder will be a senior nurse within the NMUH AH@H Service and therefore act as a clinical leader and role model to staff, offering clinical advice on the care of patients with complex needs as required. They will work with colleagues and managers to support the integration of care pathways and patient care across community and acute settings. This post will also involve in reach to hospital settings.

Person specification

Education and professional qualifications

• Registered Nurse with current NMC registration.
• Bachelor’s Degree Evidence of continued professional development.
• Advanced Clinical Assessment Course

Experience

• Experience of working within the Community Nursing. Extensive post registration experience in Acute care Experience in ITU, A&E, Acute assessment units would be advantageous
• Experience of managing a team. Experience of managing staff recruitment and retention. Able to work as part of a multiprofessional team.
• IT skill, data input, collection, analysis, audit, and evaluation. Use of databases. Standard keyboard skills and knowledge of a number of IT packages such as word, e - rostering. Presentation software – power point. Able to work safely under pressure across completing priorities.
• Work with targets and deadlines. Ability to utilise research and develop a research awareness culture.
• Ability to undertake clinical skill and competency to maintain credibility. Can act on own initiative. Able to follow detailed written instructions and assessments outcomes Sound clinical judgements and decision making regarding acutely unwell patients. Ability to prioritise work/response/triage referrals and messages effectively.
• Understanding of the role of Primary care in admission prevention and supporting a timely discharge.

Skills and aptitudes

• Phlebotomy, IV Cannulation and IV therapy skills and knowledge (Including PICC and Central line). Physical assessment skills training & V300 Prescriber. 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. Broad range of knowledge relating to multiple specialties. Understanding of evidenced based practice. Excellent oral communication skills and ability to communicate clearly and concisely with the MDT. Maintaining accurate, timely, concise, and legible clinical records both electronic and handwritten which adhere to the BEH policies. Able to talk to people about sensitive issues in a supportive manner but also challenge others assertively where necessary.
• IT Skills: Able to maintain electronic patient records. Use Microsoft Word for letter and report writing. IT skill, data input, collection, analysis, audit, and evaluation. Use of databases. Standard keyboard skills and knowledge of a number of IT packages such as word, rostering.
• Clinical Leadership: Lead and work with others. Work well with other members of the team including communicating effectively, being kind, considerate, reliable, and enthusiastic. Aid management in bringing changes to the service by being supportive and bringing solutions to problems. Undertake deputy duties for the service lead when required. Manage/support students, HCA’s, All junior staff and contribute to the management of the team. Contribute to the culture of the team and play a role in making. It inclusive, kind, and hard working. Coordinate work allocation and shifts as part of Clinician of Day duties. Help others in the team achieve their objectives and deliver safe, effective care Mentor, teach and support others in the team. Undertake Annual Reviews for junior staff.

Personal qualities and attributes

• To be a team player. To strive for excellence. To be innovative and forward-thinking.
• To be able to critically evaluate situations. Adaptable and responsive to changing needs of the service.
• Ability to accept a wide range of responsibility and use own initiative.
• Ability to identify and prevent stress in self and others, also taking effective action to manage the situation when it does impact on capability.
• Able to cope with and confidently work in adverse situations, being able to rapidly assess the situation and act accordingly.

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