Job Description

Help Lead a New Model of Primary Care for Long-Term Conditions

Are you an experienced General Practice Nurse with a strong interest in long-term condition management? We're offering an exciting opportunity to be part of a pioneering NHS initiative with

Spirit Primary Care

, aimed at transforming care for patients with conditions such as diabetes, hypertension, COPD, and heart disease.

You'll join a proactive, digitally enabled pilot programme working across 7 GP surgeries:

Rushey Mead Health Centre, LE4 7ZX Beaumont Leys Health Centre, LE4 0UZ Asquith Surgery, LE2 6FQ Satis House, B46 1TH Camp Hill Gp Led Health Centre, CV10 9EB Chaucer Surgery, CV11 4UZ Brownsover Medical Centre, CV21 1JF
They are designed to reduce unplanned admissions and improve quality of life through early intervention and personalised support.

About the Role

As a

Band 7 Nurse

, you will play a pivotal leadership role in the delivery of proactive, preventative care for patients living with complex, long-term conditions. This is a mobile/remote role requiring close collaboration with GPs, nurses, care coordinators, and digital health teams.

You'll provide clinical oversight, support evidence-based care plans, and work autonomously across multiple practices to improve outcomes, reduce hospital burden, and support self-management in primary care.

Responsibilities

Lead structured reviews for patients with long-term conditions Carry out advanced assessments (e.g. BP, spirometry, ECGs, phlebotomy, BMI) Interpret clinical findings and escalate or refer appropriately Develop and oversee personalised care plans and prevention strategies Promote patient education and empowerment in self-care Use digital tools and remote monitoring platforms to support patient engagement Maintain high standards of clinical documentation and safety Work collaboratively across multidisciplinary teams to deliver joined-up care Travel between 7 practices (mileage reimbursed)

Person Specification - You Will Be:

A registered nurse (NMC) with Band 7-level experience, ideally in general practice or community settings Clinically confident in managing patients with multiple long-term conditions Experienced in developing and delivering care plans and patient reviews Skilled in leadership, decision-making, and autonomous clinical practice Passionate about prevention, early intervention, and integrated care Adaptable to new technologies, ways of working, and remote delivery models Proficient in using clinical systems such as SystmOne or EMIS Web A strong communicator, able to collaborate across clinical and non-clinical teams V300 prescriber (not essential)

What We Offer

A chance to lead and influence a nationally significant care model Exposure to cutting-edge digital health tools and proactive care pathways Ongoing CPD and tailored training for your career progression A supportive, forward-thinking team and working culture NHS pension eligibility Flexible working arrangements and reimbursement for travel across sites

Ready to Lead the Change?

If you're an experienced nurse with a passion for improving long-term condition care and shaping the future of general practice, we want to hear from you.

Job Types: Part-time, Fixed term contract
Contract length: 12 months

Benefits:

Company events Company pension Cycle to work scheme Life insurance Sick pay
Work Location: In person