Band 7 LTNC Neuro Case Manager

General Requirements To be proactive in identifying patients with complex needs within primary and secondary care and contribute towards and promote the coordination of relevant statutory and non-statutory health and social care services in order to optimise patient benefits and adhere to local and national guidelines and legislation To work as an autonomous practitioner and as a lone worker in the community. To exercise a high degree of professional autonomy and make critical judgements to satisfy the expectations and demands of the role and to practice within agreed protocols to support the client group to provide a single accessible service. To undertake any other duties, which may be allocated by the Operational Team Manager within the general scope of the post, and appropriate to the grade, after negotiation, adequate training and appropriate supervision (e.g. lead projects to review and improve service delivery, attendance at Directorate meetings) Principal Duties Clinical To independently manage and accept clinical responsibility for a designated specialist caseload of adult clients with highly complex presentations, prioritising need, taking on a co-ordinating role, working in conjunction with other members of the team and seeking support as required. To demonstrate a highly specialist level of clinical expertise in approach to the delivery and continual adjustment of care delivery, including assessment, treatment planning, clinical reasoning and care planning by self and other agencies to ensure effectiveness of statutory and non-statutory interventions and outcomes. To undertake the comprehensive assessment of patients, including those with a highly complex presentation, requiring prolonged concentration to investigate and analyse the assessment in order to formulate individualised care plans. To demonstrate a high level of clinical specialism and expertise in approach to assessment, treatment planning, clinical reasoning, decision making and care planning to formulate a specialised programme of holistic care and ensuring effectiveness of intervention and outcomes. To negotiate with others around case management model and care planning in complex cases, agreeing appropriate clinical and professional roles and ensuring a positive resolution to any areas of conflict, in order to ensure the efficient and effective delivery of multidisciplinary care. To apply a high level of understanding of the effects of disability and provide training, advice and formulate care and support plans on lifestyle changes and current use of health and social care resources, enabling the client in areas of self-management and empowerment over their situation. To receive and communicate highly complex, sensitive or contentious information to clients and carers, who may have barriers to understanding, e.g. dysphasia, complex cognitive, mental health problems, to maximise enablement and engagement potential and to ensure understanding of coordinated care plan. To adopt a flexible and innovative approach to work with clients, carers, relatives who may have distressing or challenging social/clinical circumstances or behaviour. To communicate effectively and work collaboratively to establish and maintain robust communication networks with clients, carers and statutory and non-statutory agencies and to ensure delivery of a co-ordinated multi-disciplinary service to clients within the complexities of a community environment To provide spontaneous and planned expert advice, education and guidance to relatives, carers and other professionals, to promote understanding of the aims of care coordination across health and social care networks and to ensure a consistent approach to client care and treatment e.g. health promotion, expectations of services etc. To deal with initial verbal complaints sensitively avoiding escalation where possible To assess capacity, gain valid informed consent and have the ability to work within a legal framework with patients who lack capacity to consent to treatment. To provide services in working conditions, which may frequently be hazardous, e.g. exposure to body fluids, aggressive persons, associated travel risks, high risk areas, and secure units. To undertake appropriate therapeutic handling and moving within clinical and non-clinical settings. This may involve bending, kneeling or frequent repetitive activities often in confined and restrictive spaces. To act as a patient advocate and present their needs and preferences for care when supporting the procurement of services. To actively promote risk and safeguarding policies and follow procedures to protect vulnerable people when necessary including prompt recording and reporting of incidents and accidents. To use judgement in dealing with unplanned crises/issues without direct supervision of senior management, which require investigating, analysing and decision making. Leadership To provide effective leadership, performance management, supervision, guidance and appraisal for Junior Staff To be responsible for the overall planning, co-ordination and allocation of work for your discipline and taking responsibility for this for the team as required. To ensure a high standard of clinical care for the clients under your management and support more junior staff to do likewise To delegate clinical duties to therapists and or assistants ensuring that they have appropriate knowledge, understanding and are competent to work autonomously within the community Service Development To contribute to the development and implementation of the SHSC Case Management Model and in line with all appropriate relevant national and local clinical guidelines and commissioning intentions. To lead and manage designated projects in relation to operational planning and implementation of policy and service development within LTNC services. To undertake research and audit projects relevant to LTNC services. To maintain accurate, comprehensive and up to date data and statistics for the use of the department To comply with the requirements of SHSC in relation to policy, governance and legislation Professional To ensure client confidentiality when dealing with complex cases, multiple agencies and the community setting. To promote awareness of your profession within the team, Trust, locally and nationally To train, supervise and assess students from higher education institutions to standards of clinical and professional tutoring. To comply with the requirements of Nursing Midwifery Council, Health Care Professionals Council or relevant professional body. To be professionally and legally responsible and accountable for all aspects of your own work To participate in and lead as appropriate staff recruitment, staff appraisal scheme, Personal Development Plan (PDP) induction and ongoing staff training programmes To comply with requirements for clinical supervision. To respect the individuality, values, cultural and religious diversity of clients and contribute to the provision of a service sensitive to these needs. To attend and contribute to the relevant professional forum at SHSC e.g. Nursing Forum, Allied Health Professional Leadership Group.

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