Job Description

Key Responsibilities Clinical Care Provide nursing care to housebound patients and those in care homes, in line with the Enhanced Health in Care Homes (EHCH) requirements of the PCN DES. Deliver compassionate, personalised care tailored to individual patient needs. Assess, plan, implement, and evaluate care across the full patient pathway, working in partnership with patients, carers, and multidisciplinary teams (MDTs). Carry out physical, psychological, and emotional assessments to ensure holistic care.



Provide physical, psychological, and therapeutic interventions as appropriate. Deliver care visits as scheduled by the HVS Team Lead or care navigators, based on clinical need. Support national vaccination campaigns for patients in care homes. Complete and share advanced care plans, ensuring patient-centred decision making.



Conduct long-term condition reviews in line with the Quality Outcomes Framework (QOF). Proactively identify and address patient needs to promote health and prevent deterioration. Coordination & Collaboration Work collaboratively with community care staff and partner organisations to provide joined-up, high-quality healthcare. Act as a liaison between local organisations (e.g., voluntary sector, social care) to enhance the support available for patients at home.



Refer to and attend MDT meetings, contributing to integrated care planning and delivery. Support for Patients & Carers Assist patients in maintaining mobility and physical activity where possible. Provide carers with appropriate support, including tools to identify deterioration in a patients mental or physical wellbeing. Promote mental health and wellbeing for both patients and carers.



Professional Practice Maintain accurate, up-to-date documentation of all care interventions. Ensure compliance with all care policies, guidelines, and legal requirements. Communicate effectively, verbally and in writing, including handling highly sensitive or contentious information with empathy and professionalism. Use de-escalation, mediation, and resolution techniques where necessary, upholding the professional Duty of Candour.



Work within NHS frameworks and adhere to the Nursing and Midwifery Council (NMC) Code of Conduct to maintain the highest standards of practice. Confidentiality While seeking treatment, patients entrust us with, or allow us to gather, sensitive information in relation to their health and other matters. They do so in confidence and have the right to expect that staff will respect their privacy and act appropriately. In the performance of the duties outlined in this job description, the post-holder may have access to confidential information relating to patients and their carers, practice staff and other healthcare workers.



They may also have access to information relating to the PCN as a business organisation. All such information from any source is to be regarded as strictly confidential. Information relating to patients, carers, colleagues, other healthcare workers or the business of the practice may only be divulged to authorised persons in accordance with the practice policies and procedures relating to confidentiality and the protection of personal and sensitive data. Health and Safety The post-holder will ensure all members of staff: Comply with the member practices health and safety policies.



Ensure any health and safety concerns are reported to the Practice and PCN Transformation Manager. Maintain up to date knowledge of health and safety and infection control statutory and best practice guidelines and ensure implementation across the business. Make effective use of training to update knowledge and skills and initiate and manage the training of others. Actively identifying, reporting, and correction of health and safety hazards and infection hazards immediately when recognised.



Equality and Diversity The post-holder will support the equality, diversity and rights of patients, carers and colleagues, to include: acting in a way that recognises the importance of people's rights, interpreting them in a way that is consistent with practice procedures and policies, and current legislation; respecting the privacy, dignity, needs and beliefs of patients, carers and colleagues; and behaving in a manner which is welcoming to and of the individual, is non-judgmental and respects their circumstances, feelings priorities and rights. Personal/Professional Development The post-holder will participate in any mandatory training implemented by the PCN as part of this employment and take responsibility for maintaining a record of their own personal and/or professional development. Governance Ensure that the PCN complies with NHS contractual obligations in relation to patient care and business objectives. Ensure all complaints are recorded, reported and managed in accordance with the requirements of the NHS Complaints Regulations.



Quality and Improvement Work collaboratively as a key member of the PCN team, help develop and promote a positive working culture, encouraging staff participation and involvement in developing and improving their own contribution towards the success of the organisation. Manage and maintain credibility with all key contacts within the network, to foster a culture of collaboration, and promote inter-service learning to drive continuous improvement There may be, on occasion, a requirement to carry out other tasks; this will be dependent upon factors such as workload and staffing levels.