Are you ready for a new, exciting and rewarding challenge? The High Intensity User (HIU) Service in the Integrated Local Services directorate at Guy's and St Thomas' NHS Foundation Trust is looking for a highly motivated, engaging HIU Project Lead to directly support clients who attend A& E regularly. It provides an assertive engagement through phone coaching and home visits aimed primarily around the patient's social issues, health access, engagement, and various situations. The post holder will be based in the community and will work closely with a small well established team but will need to be able to work independently too. This role is about building a connection with patients and using that to foster connections with in the community.

We are among the UK's busiest, most successful foundation trusts. In the Integrated Local Services Directorate, our services work closely with A& E all inpatient teams at Guy's and St. Thomas' NHS Foundation Trust and King's College Hospital, and collaborate closely with social services, mental health services and the voluntary sector. We are an excellent award-winning service (two-time Winner of Lammy Award, Regional Winner of Health and Social Care Award for Improving Health and Reducing Inequalities)

We are looking for a committed person fixed term contract (secondments would be considered) with excellent people and communication skills and a passion for customer service.

Main duties of the job

• To provide relevant interventions for long term clients and design and implement suitable support and engagement programme for patients ensuring access and continuation of support.
• To provide psychosocial interventions support and advice by phone and in person to identified patients with the aim of maximising the individual's potential for independence, and achievement of personal goals.
• To be able to work and make decisions independently regarding appropriate client interventions, care plans and levels of risk.
• To understand and decide independently when to escalate concerns or decision making to High Intensity User Leads.
• To signpost and refer to relevant support services, following up and attending initial appointments as necessary with other service providers and professionals.
• To develop manageable goals with patients and deliver motivational interventions.
• To collect and analyse the Frequent Attenders data, identify high priority clients and provide feedback on service development needs identified from the data. Ensuring information is timely available and accurate.
• To manage relationships and referral pathways with statutory and voluntary sector organisations, including developing service level agreements where necessary.
• Develop and write policies and procedures within own work area
• To carry out audits for the internal services
• To support continuous improvement and development of the service through casework, team discussion and reflective practice.

About us

Guy's and St Thomas' NHS Trust

Guy's and St Thomas' NHS Foundation Trust comprises five of the UK's best known hospitals - Guy's, St Thomas', Evelina London Children's Hospital, Royal Brompton and Harefield - as well as community services in Lambeth and Southwark, all with a long history of high quality care, clinical excellence, research and innovation.

We have a long tradition of clinical and scientific achievement and - as part of King's Health Partners - we are one of England's eight academic health sciences centres, bringing together world-class clinical services, teaching and research. We have one of the National Institute for Health Research's biomedical research centres, established with King's College London in 2007, as well as dedicated clinical research facilities.

Integrated and Specialist Medicine consists of 9 Directorates and provides care and treatment to patients who require emergency and inpatient care, community services including district nursing and specialist care, dental services, specialist inpatient / outpatient areas, imaging and pharmacy. Integrated and Specialist Medicine also have responsibility for cross site operations. The integrated approach of the clinical group facilitates and promotes the shared learning of best practice, innovative and creative ways of working to enhance the patient experience and ensure the delivery of outstanding care

Job description

Job responsibilities

• To take an active role in supporting your own caseload of patients, managing your patients social needs.
• To provide motivational, solution-focused, coaching interventions that will support patients to manage their long term physical, mental health conditions with the aim to improve their health and avoid or minimise attendances at A& E and unplanned admissions to hospital.
• To provide psychosocial interventions support and advice by phone and in person to identified patients with the aim of maximising the individuals potential for independence, and achievement of personal goals.
• To complete formal and ongoing assessment, including assessment of risk, of patients over the phone and in person.
• To be able to work and make decisions independently regarding appropriate client interventions, care plans and levels of risk.
• To understand and decide independently when to escalate concerns or decision making to High Intensity User Leads.
• To advise and direct vulnerable patients to relevant support and services, for example if they have dementia you will find and refer to local dementia support groups, for those who need a healthier lifestyle find them healthy eating classes and exercise groups etc
• To complete home visits as necessary and appropriate with appropriate use of risk assessment and PPE.
• To provide relevant interventions and actively facilitate patients access and engagement to local services and local initiatives, this involves understanding patient needs and facilitating their recovery and self-management.
• To provide relevant interventions for long term clients and design and implement suitable support and engagement programme for patients ensuring access and continuation of support.
• To attend relevant networking, MDT or case management meetings as necessary.
• To work alongside other health and social care services to support the patients.
• To Introduce and encourage self-care and self-management to patients.
• To signpost and refer to relevant support services, following up and attending initial appointments as necessary with other service providers and professionals.
• To develop manageable goals with patients and deliver motivational interventions.
• To identify and report safeguarding and other risks to and make referrals or seek support as appropriate. Act as patient advocate when appropriate.
• To identify, develop and maintain new relationships with relevant voluntary sector and statutory organisations, including developing partnership agreements for joint work where necessary.
• To work across the organisation to support and promote the High Intensity User Service, including support to other teams on the journey to self-management.
• To support continuous improvement and development of the service through casework, team discussion and reflective practice.
• Responsible for the design and carry out audits in collaboration with the HIU Leads.
• Undertake specific service improvement actions under supervision of the HIU Leads.
• To identify good practice example and support service development based on evidence based.
• To engage with a supportive group supervision process with other staff to assist your own professional practice.
• Collaborating with service providers, patients and carers to develop and review integrated patient pathway.
• To comply with Trust infection control procedures.
• To attend relevant internal team meetings and line-management meetings.
• Maintaining contemporaneous computerised records and ensure all relevant information is documented on relevant systems.
• Deal with data queries in a timely and efficient manner.
• Organise and prepare documentation for audit and monitoring visits.
• Respecting patient confidentiality and privacy with respect for diverse cultural backgrounds and requirements.
• Maintain accurate records of the service and ensuring that confidentiality of information is adhered to.
• To comply with all relevant Trust procedures.

Management and Leadership

• Support HIU leads in managing various sections of service. This will require working autonomously to understand and driver operating targets and achieve patients outcomes.
• To co-ordinate data collection from Guys & St Thomas Frequent Attenders list, Kings College Frequent Attenders list and the London Ambulance Service Frequent Attenders list.
• To collect and analyse the Frequent Attenders data, identify high priority clients and provide feedback on service development needs identified from the data. Ensuring information is timely available and accurate
• To collect, collate and manage the patient feedback processes.
• To patient feedback data and provide reports based on the data.
• To manage relationships and referral pathways with statutory and voluntary sector organisations, including developing service level agreements where necessary.
• Develop and write policies and procedures within own work area
• To carry out audits for the internal services
• To line management of staff members
• Set objectives and review performance of service staff, identifying individual training and development needs and promote continued personal and professional development.
• Recruit and induct staff and volunteers in line with Trust policies and procedures.
• Coordinating and supervise of staff volunteers and work experience placements as necessary
• Support conflict resolution from patients, staff, suppliers, other internal and external service providers and partner organisations in the service.

To lead and develop key HIU areas by identifying service gaps and in coordination with HIU Leads

Person Specification

Qualifications

Essential

• Educated to degree level or equivalent experience/ qualifications

Desirable

• Professional registration

Skills

Essential

• Advanced managerial and leadership skills in specialty/ dealing with patients with complex needs
• Excellent verbal, written and interpersonal communication as well as negotiation skills to influence others
• Up to date knowledge of current health, legal and social issues affecting the client group

Desirable

• Ability to interpret and analyse complex data and findings

Experience

Essential

• Advance experience of case management, patient engagement, managing a case load and demonstrate outcomes for patients
• Extensive experience of working autonomously
• Experience of working with vulnerable people and delivering effective patient focused interventions to meet complex & multiple needs
• Experience of developing partnership/ joint work with local agencies
• Experience of delivering change

Trust value based behaviours

Essential

• Candidate understands and shows the Trust value based behaviours in application

Employer details

Employer name

Guy's and St Thomas' NHS Foundation Trust

Address

Gracefield Gardens Health centre

2-8 Gracefield Gardens, , London,

Streatham

SW16 2ST

Any attachments will be accessible after you click to apply.

196-LIS7872