Job summary
- Main area
- Frailty
- Grade
- NHS AfC: Band 5
- Contract
- Permanent
- Hours
- Full time
- Part time
- Job ref
- 388-7541253-FC&I
- Employer
- Torbay and South Devon NHS Foundation Trust
- Employer type
- NHS
- Site
- Newton Abbot Community Hospital
- Town
- Newton Abbot
- Salary
- £31,049 - £37,796 pa pro annum
- Salary period
- Yearly
- Closing
- 16/11/2025 23:59
Employer heading
Frailty Coordinator
NHS AfC: Band 5
Job overview
As our Band 5 Frailty Coordinator, you 'll be the coordination heartbeat of our new Community Healthy Ageing Hub (CHAH) at Newton Abbot Hospital. You’ll steer patients through frailty pathways (Virtual Ward, SDEC, ambulatory care and—in some cases—bedded care), making timely, person-centred decisions that keep people closer to home. This is a 5-day service, and you’ll be central to delivering safe, rapid comprehensive geriatric assessment (CGA) care and discharge alongside an experienced multidisciplinary teams (MDT). If you love fast-paced, people-first care and tangible outcomes, you’ll thrive here.
Main duties of the job
We’re looking for calm, compassionate communicators who are organised and proactive, who are able to build relationships and agreements that are communicated seamlessly across multidisciplinary teams (MDT). Using IT confidently, and staying focused you will contribute to improving care and patient-centred outcomes.
What you'll do and what we value:
- Coordinate flow end-to-end: triage inputs, line up the right professional at the right time, and plan discharge from the start. Track each patient’s journey to minimise delays.
- Make every contact count: seek background info before arrival, record Rockwood CFS, and ensure CGA recommendations reach community teams and primary care. Be the go-to contact for patients and carers post-discharge.
- Communicate brilliantly: handle sensitive conversations, negotiate shared plans when views differ, and keep patients, families and colleagues informed—especially when anxious or under pressure.
- Orchestrate the MDT: connect wards, UCR, Virtual Ward, locality teams, discharge hub, care agencies and voluntary sector so assessments and actions happen on time.
- Use systems with confidence: EPR systems, Paris, CareFirst, PAS, CyberLab—confidently capture what matters, arrange transport, and keep EDDs accurate.
- Do the right thing, safely: apply the Care Act principles, aid screening for CHC, escalate safeguarding concerns, and follow Torbay and South Devon Trust policies.
Working for our organisation
You’ll join a friendly, supportive team spanning our Virtual Ward, Urgent Community Response, hospital clinicians and the Newton Abbot ward team including Trust GPs, ACPs/trainee ACPs, therapists, nurses, consultants and a consultant nurse.
We value kindness, respect and listening. We share learning, and celebrate successes and welcome ideas that improve the patient experience. You’ll be trusted to take ownership—and you’ll see the impact of your work every shift.
Detailed job description and main responsibilities
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Coordinate each patient’s journey: book the right assessments, prioritise what’s needed, and keep everyone informed.
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Keep records clear and timely: capture key details, track progress, and share simple next steps with patients and families.
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Support safe, timely discharge: arrange referrals, follow-up, transport and any community support needed.
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Bring people together: organise brief case discussions when needed so decisions are made quickly and safely.
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Protect people and standards: follow safeguarding guidance and Trust policies; escalate risks promptly.
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Help us improve: feed in ideas and data that make our service smoother and easier for patients and staff.
Person specification
Qualifications and training
Essential criteria
- • NVQ level 4 in Health and Social Care or evidence of working towards this
Desirable criteria
- • Working at degree level. Degree level education or equivalent ILM 5
Knowledge and experience
Essential criteria
- • Knowledge of legislation and policy that has shaped current health and social care provision e.g. Community Care Act; Disability discrimination Act; ‘Your Health Your Care Your Say’; The Care Act
- • Experience of health and/or social care IT systems.
- • Experience completing patient related documentation; legibly, accurately and to a high standard.
- • Excellent knowledge of community-based resources including those provided and commissioned by Torbay and South Devon NHS Foundation Trust and those provided by the voluntary sector.
- • Knowledge and understanding of competing priorities in acute and community settings.
- • Evidence of good problem-solving skills; ability to think laterally and creatively under pressure
Desirable criteria
- • Understanding of the national Agenda for Frailty (as laid out in the NHS 10 Year Plan)
- • Have an awareness/knowledge of local community & specialist services supporting older people/those living with Frailty
Specific skills
Essential criteria
- • Experience of carrying out assessments considering the wishes of the individual and/or their carer.
- • Experience of working with service users with a wide range of disabilities and clinical conditions e.g. physical, sensory and learning disabilities, cardiac and respiratory conditions, neurological conditions
- • Experience of resolving conflict effectively
- • Ability to demonstrate a clear understanding of differing needs of service users with different disabilities and clinical conditions.
Desirable criteria
- • Experience as a HSCC or CCW (or comparable health role)
- • Experience of previous hospital or community working
- • Experience of completing needs-led assessments with service users and/or carers resulting in provision of services
- • Experience of working with service users with life limiting conditions towards the end of their life.
Employer certification / accreditation badges
Applicant requirements
This post is subject to the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (Amendment) (England and Wales) Order 2020 and it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service.
Documents to download
Further details / informal visits contact
- Name
- Dr Katharine Bhatt
- Job title
- GP Clinical Lead TSDFT Frailty Virtual Ward
- Email address
- [email protected]
- Telephone number
- 01803 654120
- Additional information
My working days are Tuesday-Friday
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