Proactive Care Matron - Surrey Downs H&C

at  Epsom and St Helier University Hospitals NHS Trust

Provide a clinical triage/assessment with inbound referrals and assign the appropriate urgency (i.e. 2 hr Rapid Response) and determine the best clinician to undertake the visit from their multi-disciplinary team. Support annual Learning Disability or Serious Mental Illness Health checks. Care coordination both clinical and administrative, managing patient caseloads and offering proactive support (i.e.
frequent attenders; support for cancer patients; CVD remote monitoring and support; blood pressure monitoring etc). i.e. Accept referrals from practices to proactively manage and support patients diagnosed with cancer, patients at risk of CVD and will act as a step down from the Social prescriber/mental health team as appropriate to manage frequent attenders who have been discharged from their care with management plans in place. Anticipatory care liaising with both primary, secondary and community teams to support the reduction of admission for patients with ambulatory care sensitive conditions and closing the hypertension diagnosis gap Enhanced Health in Care Homes proactive and targeted visits for specific cohorts of patients To support the co-ordination with the delivery of all housebound annual vaccinations.
Support and manage a small team of non-clinical care co-ordinators to support delivery of duties. Demonstrate clinical expertise and act as a professional role model to all co owners, both internal and external on behalf of SDHC, working as part of an integrated team taking the lead and developing services in line with the needs of the patient Treat all patients as individuals, respecting their privacy and dignity at all times Investigate and diagnose an unwell individual as part of the long term conditions clinical management Involving, supporting, informing and educating family/carers Promote the health of patients and the provision of support and advice Be responsible for planning cover, appropriate staffing and skill mix ensuring adequate cover when supporting community nursing teams or community matrons Provide specialist knowledge and advice to influence the SDHC strategic agenda Maintain clear and comprehensive, signed and contemporaneous records according to procedures Identify workforce planning issues and actively participate in the recruitment, selection and retention of clinical staff Provide support and an appropriate learning environment for both pre and post registration students as required Be responsible for ensuring that policies and procedures and standards of care, are adhered to at all times To work with other community matrons to ensure consistency of approach and share practice development Participate in research and development opportunities as appropriate Provide assistance with the resolution of complaints within the clinical specialty, or sphere of responsibility Have the ability to negotiate and work effectively across all agencies for the maximum effectiveness of care Undertake physical and social assessments and examinations and initiate appropriate diagnostics To work autonomously Help individuals with LTC to change their behaviour to reduce the risk of complications and improve their quality of life To work collaboratively with other specialist nurses and multidisciplinary teams such as GPs, Community Nurses, Social Care and Voluntary Services Contribute to the development of Integrated care in the community Be aware of and act upon when necessary, procedures that are in place to protect vulnerable individuals Lead and implement the SDHC Clinical Governance Strategy within your practice area, facilitating and instigating clinical audit and monitoring of care Lead and implement the SDHC Risk Management Strategy within your practice area, ensuring that all processes are adhered to Maintain own professional and clinical integrity in line with NMC guidelines Undertake any other such duties as may be required from time to time as are consistent with the responsibilities of the post Be responsible for individual timely data entry and responsible for the corporate teams data entry Co-owners are employed to work within SDHC localities and may be reasonably requested to move base temporarily or on a more permanent basis, as requested by service needs To undertake clinical supervision and appropriate training for the role

Please refer the Job description for details