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Job summary

Main area
Discharge Planning
Grade
Band 6
Contract
12 months (Fixed term end date March/April 2026)
Hours
Part time - 21 hours per week (Flexible days Monday-Friday)
Job ref
310-OPAC-7004513
Employer
Cambridgeshire and Peterborough NHS Foundation Trust
Employer type
NHS
Site
Fulbourn Hospital
Town
Cambridge
Salary
£37,338 - £44,962 per annum pro rata
Salary period
Yearly
Closing
21/05/2025 23:59

Employer heading

Cambridgeshire and Peterborough NHS Foundation Trust logo

Discharge Planning Facilitator/Social Worker

Band 6

Job overview

The post holder will demonstrate expert knowledge in discharge options, services available, whilst providing support to the patient, their family/carer and care workers in communicating the possible plan, estimated date of discharge and managing expectations and any concerns raised. The post holder will aim for a safe and sustainable discharge by highlighting and managing any potential risks thus reducing the risk of readmission.

The purpose of the role is to contribute at the multidisciplinary team meeting by ensuring that the patient’s wishes are heard, needs are assessed and are well managed to achieve a timely discharge. Also, to promote advanced care planning where appropriate to avoid unnecessary hospital admissions.

To identify social care needs of older people and to be aware of / able to access adult social care processes which facilitate the provision of care on discharge from hospital.

Main duties of the job

To act as a link between the wards and community teams/services for discharge planning.

The identification, assessment, planning, implementing and evaluating care as a practitioner with specialist Discharge Planning Skills. This involves the completion of specialist discharge planning liaising with the discharge planning nurse to complete specialist nursing assessments.

This role is to work closely with healthcare professionals, clinicians, social work teams, family members, personal care services and other multi-disciplinary team members to deliver a high quality, patient focused service

Working for our organisation

Cambridgeshire and Peterborough NHS Foundation Trust is a health and social care organisation dedicated to providing high-quality care with compassion to improve the health and wellbeing of the people we care for, as well as supporting and empowering them to lead a fulfilling life.

Our clinical teams deliver many NHS services, not only via inpatient and primary care settings, but also within the community. These services include children's, adult and older people's mental health, forensic and specialist mental health, learning disabilities, primary care and liaison psychiatry, substance misuse, social care, research and development.

To achieve our goal, we look to recruit high-calibre candidates who share our vision and values. As an equal opportunities employer, we encourage applications from all sectors of the community, particularly from under-represented groups including people with long term conditions and members of our ethnic minority and LGBTQ+ communities.

Please be advised we reserve the right to close adverts earlier than the closing date should we receive sufficient applications.

Regrettably, we cannot offer sponsorship for all our job roles. If you apply for a role that we cannot offer sponsorship for, unfortunately, your application form will be rejected from the process. 

Detailed job description and main responsibilities

Please refer to the attached job description and person specification for full details of responsibilities.

1. Observe and maintain strict confidentiality with regards to any patient/family/staff/records and information in line with the requirements of the Data Protection Act.

2. Any data that is taken/shared as part of a phone call or transported, or transferred electronically must be undertaken with regard to CPFT information Governance and information Security policies.

3. The post holder must adhere to CPFT risk assessment and risk management processes.

4. The post holder must adhere to infection control policies and procedures.

5. Undertake mandatory training and any other training relevant to the role as required by Cambridgeshire & Peterborough NHS Foundation Trust (CPFT).

6. The post holder must participate in clinical and other audits as required.

7. Provide patients and their families/carers with information on standards they should expect from the team.

8. Provide discharge planning training programmes and oversee issues across the Trusts to ensure all professional needs are met, thus ensuring the Trust’s discharge policies are adhered to.

9. Create discharge education packages appropriate to different grades/disciplines across different settings.

10. Identify, monitor, investigate and record reasons for delayed discharges and review ways of working with multi-disciplinary teams in order to reduce these delays.

Person specification

Education

Essential criteria
  • AHP/Social Work - with Relevant Degree/Diploma and registration
  • Evidence of continuing Professional development
Desirable criteria
  • Mentorship qualification
  • Continuing Health Care assessment training

Experience

Essential criteria
  • Significant amount of months post registration.
  • Working within older adults
  • Previous experience of undertaking assessments and evaluating needs
Desirable criteria
  • Experience of working in an acute setting.
  • Discharge planning work experience

Skills & Abilities

Essential criteria
  • Able to demonstrate commitment to high quality care and service provision
  • Ability to work flexibly as part of a team
  • Good communication skills
  • Good report writing
  • Able to assess plan and implement care
  • Good IT skills and ability to communicate through
  • Microsoft Teams or Skype to engage family members and other professionals when they are not able to visit the ward.
  • Time Management and prioritisation skills
Desirable criteria
  • Audit
  • Research

Knowledge & Understanding

Essential criteria
  • Accepts responsibility and accountability for own work and can define the responsibilities of others
  • Seeks and uses professional support appropriately
  • Understands the principle of confidentiality
Desirable criteria
  • SystmOne
  • Mosaic

Employer certification / accreditation badges

NHS Pastoral Care Quality AwardNHS Employers Diversity and Inclusion PartnersVeteran AwareApprenticeships logoNo smoking policyAge positiveDisability confident leaderInvestors in PeopleDefence Employer Recognition Scheme (ERS) - BronzeImproving working livesCare quality commission - GoodMindful employer.  Being positive about mental health.We offer Wagestream - A financial wellbeing benefit which lets you access your pay as you earn it.NHS Rainbow badgePrince's Trust - Proud to support the Prince's trust - Youth can do itStep into healthMenopause Workplace PledgeArmed Forces Covenant

Applicant requirements

You must have appropriate UK professional registration.

The postholder will have access to vulnerable people in the course of their normal duties and as such this post is subject to the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (Amendment) (England and Wales) Order 2020 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service to check for any previous criminal convictions.

Documents to download

Apply online now

Further details / informal visits contact

Name
Susan Mundora
Job title
Deputy Modern Matron
Email address
[email protected]
Telephone number
01733 776047
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