Royal Free London NHS Foundation Trust
Job summary
We are looking for a proactive nurse, who wishes to work part-time, to join our “Hospital at Home Case Finders team”.
The post holder will be responsible for assessing patient suitability for referral into community services such as Hospital at Home services and intermediate care services. Patients may be medically optimised or pre optimised at the point of referral but at a stage where ongoing needs can be met in the community and no longer require an acute admission.
The post holder will work closely between all wards and community providers to ensure smooth discharge for suitable patients.
They will identify assess and refer patients keeping a full log and managing all communications between teams – Working closely with the Integrated Discharge team to ensure all care and other services are in place upon discharge.
They will be be responsible for the delivery of a high-quality service to patients which is adapting to meet changing needs.
The post holder will be requested to join a roster system, to support service cover for 7days a week, implying working bank holidays and weekend.
Main duties of the job
1. CLINICAL RESPONSIBILITIES
1.1 To identify/casefind and pull potential intermediate care service and/or Hospital at home patients in partnership with acute colleagues-ensuring that as soon as patients are medically stable they are discharged with the most appropriate community service.
1.2 To independently undertake activities directly related to the clinical, physical, functional, social and psychological assessment of potential patients, specifically in the evaluation and planning of on going service requirements.
1.3 Make judgements involving highly complex facts requiring interpretation and analysis. Communicate highly complex, sensitive information to team members e.g vulnerable adults and older people
1.4 To prevent premature admission to long-term care by creative problem solving to find appropriate alternatives, using highly developed skills and knowledge of assessment and communication.
1.5 To proactively promote a seamless and multidisciplinary approach to health and social care provision.
1.6 To proactively develop close working relationships with primary, secondary, voluntary and social care colleagues which promotes and supports effectively, utilising resources, ensuring patients receive the right service at the right time and in the right environment.
Person Specification
Royal Free shared commitments
Essential
- Demonstrable ability to meet the Trust shared commitments
Education & professional Qualifications
Essential
- Registered Nurse
- Further professional studies
- Mentorship course or equivalent
- Able to evidence recent and continuing professional development
Experience
Essential
- Experience of negotiating and liaising within a multidisciplinary team
- Experience of working with patients with complex needs
- Experience of managing and coordinating own caseload
- Experience in presenting and service development
- Experience of working in collaboration with and across organizational boundaries
- Experience in Nursing assessments, care plans and referrals
- Relevant experience in discharge planning and knowledge of discharge pathways/processes
- Experience of board rounds and working with multiple professions
Desirable
- Experience of teaching others
Skills and aptitudes
Essential
- Expert specialist skills for the post
- Knowledge of current practices and pathways relevant to specialty
- Excellent communication skills and ability to negotiate and influence
- Skilled in use of Computer/Keyboard
- Knowledge of Excel and ability to manage own data
- Ability to problem solve, prioritise and work to a deadline
- Able to manage stressful situations and challenge decisions to ensure that patients needs are met.
Personal qualities and attributes
Essential
- Be a positive role model with the ability to demonstrate credible and professional approach
- Evidence of proven, ongoing professional development
- Ability to work under pressure
- Ability to work as a team and independently forming professional relationships with colleagues
- Diplomatic and calm approach
- To be flexible and approachable
Others
Essential
- Weekend and Bank holiday working required
- flexible start/finish times to meet service needs
Closing Date: 1 November 2026
To apply for this job please visit apps.trac.jobs.