Head of Service - Specialist Neurorehabilitation Case Management

at  NHS Greater Manchester Integrated Care

I ndicative band 8b – subject to job evaluation

To provide an operational and clinical leadership role to a team of specialist case management and support staff within the sustainable services team structure. The post holder will ensure mechanisms are in place so that patients requiring specialist “slow stream” neurorehabilitation services are placed in the most appropriate setting to meet their needs and that their progress and needs are reviewed regularly, ensuring rigorous oversight. The post holder will also build and maintain relationships with key individuals across NHS inpatient services, local authority, community services, independent sector (IS) providers and Continuing Healthcare (CHC) teams to ensure that a consistent strategic direction is developed and maintained.

• Ensure there is a robust specialist case management in-reach service in place for NHS Level 1 and 2b neurorehabilitation patients across GM.
• Work collaboratively with others across organisational boundaries to ensure that patients are cared for in the most appropriate setting to meet their needs. This includes, but is not limited to, GM Local Authorities, NHS neurorehabilitation inpatient services, CHC teams, community neurorehabilitation teams (CNRT) and IS providers.
• Ensure processes are in place that mean patients admitted to IS “slow stream” placements are reviewed at agreed and regular intervals with other agencies engaged at relevant points.
• Ensure processes are in place that mean patients can be moved out of IS placements in a seamless manner once their treatment goals have been reached or when the placement no longer meets their needs.
• Work with colleagues (both internal and external to the ICB) to unblock barriers encountered when trying to move patients into the most appropriate setting, including discharge to home.
• Manage an active caseload of the most complex cases, ensuring that all agreed procedures are adhered to in the management of those cases which may include patients with neuropsychiatry needs or out of area placements.
• Attend relevant multi-disciplinary team (MDT) meetings for patients on own caseload and ensure representation of the team at MDT meetings for all patients on the team’s caseload.

This is an exciting time to join and head up a newly established team. The team will form part of the wider sustainable services team which sits within the Commissioning function of NHS Greater Manchester.
Our NHS People Promise

Our NHS People Promise –the promise we must all make to each other, to work together to improve the experience of working in the NHS for everyone. Like many other employers, NHS GM currently has evidence of unwarranted inequalities in the workforce, most notably in relation to minoritised ethnic, female and\or disabled staff and their intersectionality. As a result, we will use positive action measures to bring benefits to our organisation, including a wider pool of talented, skilled, and experienced people from which to recruit and a better understanding of the needs of a more diverse range of customers.

• Review patient progress against current rehabilitation goals, ensuring that clear care plans are in place to help maximise recovery.
• Contribute to the identification of appropriate discharge pathways and support with the development and implementation of discharge plans.
• Ensure the team is embedded within local referral pathways and processes so that this leads to a streamlined pathway being developed.
• Provide both line management and clinical supervision to members of the GM specialist case management team, linking in with the ICB’s Quality team as required.
• Ensure a work plan is developed for the team with key performance indicators (KPIs) identified which are monitored and reported against in line with agreed processes.
• Develop improvement plans and provide regular updates of progress against these where performance against KPIs falls below the agreed standard.
• Monitor the quality and performance of Level 1 and 2b NHS commissioned services via UKROC data.
• Identify individual and trends of delayed transfers of care (DTOC), taking appropriate action to address these by facilitating discussions to resolve both local and external issues.
• Be responsible for monitoring ICB spend for IS placements with links to finance colleagues and provide reports of this as agreed.
• Contribute to the development of standardised GM tariffs for IS placements.

• Ensure there is a robust specialist case management in-reach service in place for NHS Level 1 and 2b neurorehabilitation patients across GM.
• Work collaboratively with others across organisational boundaries to ensure that patients are cared for in the most appropriate setting to meet their needs. This includes, but is not limited to, GM Local Authorities, NHS neurorehabilitation inpatient services, CHC teams, community neurorehabilitation teams (CNRT) and IS providers.
• Ensure processes are in place that mean patients admitted to IS “slow stream” placements are reviewed at agreed and regular intervals with other agencies engaged at relevant points.
• Ensure processes are in place that mean patients can be moved out of IS placements in a seamless manner once their treatment goals have been reached or when the placement no longer meets their needs.
• Work with colleagues (both internal and external to the ICB) to unblock barriers encountered when trying to move patients into the most appropriate setting, including discharge to home.
• Manage an active caseload of the most complex cases, ensuring that all agreed procedures are adhered to in the management of those cases which may include patients with neuropsychiatry needs or out of area placements.
• Attend relevant multi-disciplinary team (MDT) meetings for patients on own caseload and ensure representation of the team at MDT meetings for all patients on the team’s caseload