YICT Nurse

We are seeking a motivated individual with a solution focused attitude to work as a Nurse as part of York Integrated Community Team /Frailty Hub. This key role is vital in providing a comprehensive care coordination to facilitate the appropriate delivery of health care services whilst providing professional, competent and efficient care that meets patients health and social needs. Working directly with the Frailty Hub you will support this multidisciplinary team in the prevention of unnecessary hospital admission. You will also be case managing patients with frailty and long-term conditions to support patients to remain independent in their own homes, while continuing with healthcare assessments, rehabilitation, and recovery. In this busy challenging role you will be able to work on your own initiative, be comfortable in making decisions within the scope of the role whilst demonstrating an understanding of community services and using the guidance and support of the multidisciplinary team. Nimbuscare are committed to supporting the professional development of our employees and fostering growth opportunities to help build a long and rewarding career with us. Please note this role includes evenings and occasional weekends on a rota basis. You will also require use of your own car and a driving license., The role involves acting as a patient advocate and care coordinator, ensuring patients receive high-quality, patient-centered care tailored to their individual needs and preferences. Key responsibilities include:

• Coordinating care for a group of patients, ensuring communication of their needs to relevant healthcare providers.
• Delivering care and supporting staff in assessments and evidence-based care delivery.
• Providing advice and guidance to carers and healthcare assistants.
• Working across various healthcare settings, including surgeries, home visits, and community care.
• Offering on-call telephone support on a rota basis.
• Mentoring and training healthcare support staff.
• Facilitating patient education, self-management of disease, and behavior modification.
• Ensuring continuity of care, particularly during transitions like hospital admission and discharge.
• Managing complex patients in their homes or care facilities, collaborating with multidisciplinary teams.
• Focusing on high-risk patients and those with multiple conditions.
• Promoting clear communication within care teams and supporting medication management.
• Participating in team meetings, audits, and data collection for improving patient care.
• Ensuring compliance with CQC requirements and maintaining accurate documentation.
• Acting as a main contact for patients and their families.
• Managing caseloads autonomously, meeting targets, and contributing to business goals.
  
  Nimbuscare is one of the largest 'at scale' providers of primary care in the North of England, caring for more than 250,000 patients across our 11 Member GP Practices.
We work collaboratively across the York area delivering new, innovative, and sustainable health care services. As leaders in local care, our goal is to work together across the health and care system to improve the health, wellbeing, and experience of our patients. To learn more about Nimbuscare please visit our website at www.nimbuscare.co.uk In line with the General Data Protection Regulations (GDPR), Nimbuscare will use and hold your personal data for the intended purpose. We are committed to safeguarding the welfare of children/vulnerable adults and expect the same commitment from all staff and volunteers. Nimbuscare is committed to improving the diversity of its workforce to better reflect the communities we serve. We welcome applications from everyone and work to promote an inclusive supportive culture that values and celebrates our differences.