Detailed job description and main responsibilities

The candidate would be responsible for the strategic development of the services as well as the day-to-day operational management.  The role supports the Six Goals for Urgent and Emergency Care.

This patient cohort of High impact service users are extremely complex and the lead nurse would be responsible for providing the expert advice and guidance to both the service and to other divisions and partner agencies. It would enable further multi professional working across divisions and partner organisations, work closer with the leads for the Urgent and Emergency Care goals  and internal and external stakeholders to support demand reduction from a wider perspective.

The High Impact Service started in ABUHB in 2019. In the initial scope of the service focused on frequent presenters at the emergency department and managed them through appropriate links with health services, local authorities and the 3rd sector, however through critical review of the service and service users needs identified that case management alone is not sufficient to meet the needs of urgent and emergency care services and the service has widened to supporting patients patient flow agenda along with preventative healthcare and health equality of socially vulnerable and complex patients.

There are various reasons behind why HIS patients represent at the ED and urgent care settings. Social crisis often drives re-attendance as it is often linked with mental health/wellbeing, substance misuse, housing, social isolation/loneliness and domestic abuse. Additional causes of representations include acute/chronic illness or conditions, poor health management, frailty and falls of the elderly cohort and medically unexplained symptoms. Furthermore, difficulty in accessing services and navigating health and social care systems plays another contributing role as ED is always accessible and patients often present themselves to the urgent and emergency care services. Evidence suggests that this patient group also access other health and social care settings frequently and have a higher admission rate (Killian et al 2017 & RCEM 2017). This is evidenced through ABUHB High Impact Service, therefore the scope of the service has widened to not only supporting patients that frequently present to the ED but also support complex patients within the hospital setting and complex discharge management, along with working with the multi agency to prevent attendances of patients with complex health and social needs and enable them to be seen by the right service at the right time.

The aim of the service is:

· ED avoidance

· Reduced length of stay

· Prudent healthcare – reducing unnecessary investigations/ admissions – (Appendix 1)

· Reduction in contacts with other health, social and emergency care services

· Improved patient experience

· Improved communication/ co-ordination with other services

· Safeguarding

· Protection of staff

· Education

· Partnership working to address inequity in health

The service offers an interface not only between divisions but between clinical/ medical care and social care to supporting the holistic needs of individuals. Through the multi-disciplinary/ agency working and attending a number of patient focused forums such as primary care virtual wards and complex housing needs panels, patients are discussed and appropriate care and support offered along with care and support plans devised and shared to advise health care staff on managing patients when they present to health care services, which has proven to reduce the length of time in the department/ admissions.

You will be able to find a full Job description and Person Specification attached within the supporting documents or please click “Apply now” to view in Trac.

The ability to speak Welsh is desirable for this post; Welsh and/or English speakers are equally welcome to apply.