Advanced Occupational TherapistNHS

Job summary

The Hospital at Home (H@H) service is an adjunct pathway to Urgent Community Response (UCR), delivering hospital-level monitoring and clinical intervention to acutely unwell adults in their own homes across the London Borough of Hillingdon. Operating 08:00-20:00, seven days per week, H@H provides an integrated step-up (admission avoidance) and step-down (early supported discharge) model in accordance with the NHS England Virtual Wards Operational Framework and the Hillingdon Health and Care Partnership Borough-wide Reactive Care Service.

The Band 7 Advanced Occupational Therapist is a senior clinical role at the heart of the UCR and H@H MDT. As the most senior therapy clinician on the H@H establishment, the post holder is the primary OT lead for the service, providing expert occupational therapy assessment, intervention, clinical reasoning, and discharge planning for complex, frail, and acutely unwell patients in their own homes. The role encompasses autonomous clinical practice, H@H Initial Visits, clerking of step-up patients, caseload prioritisation, and senior clinical oversight of therapy delivery within the team.

The post holder must be able to work flexibly over a 7-day week including weekday and weekend shifts and will frequently work as a lone practitioner in community settings.

Main duties of the job

o Be professionally and legally accountable for all aspects of own clinical work, managing an autonomous and complex caseload of UCR and H@H patients in accordance with HCPC standards and the RCOT Code of Ethics and Professional Conduct. Ensure a high standard of care and support more junior staff to do likewise.

o Perform the UCR / H@H Initial Visit for patients stepped up to H@H following the 48-hour C2R review, within 4 hours of the MDT decision - including OT-specific components of the clinical clerking, functional status, environmental risk, equipment, and advancing goal setting.

o Conduct advanced occupational therapy assessment for patients with acute illness, frailty, cognitive impairment, complex multi-morbidity, and diverse psychosocial needs, using validated tools (Rockwood Clinical Frailty Scale, Barthel Index, 6CIT, MUST, FRAT, environmental and manual handling risk assessment, seating and postural assessment) and applying higher-level clinical reasoning to formulate accurate occupational profiles and intervention plans.

o Deputise for the UCR / H@H Clinical Lead as needed in the day-to-day clinical leadership of the H@H pathway, including triage and prioritisation of referrals, chairing the morning MDT in the Clinical Lead's absence, and supporting the H@H COD in complex case management and caseload prioritisation by acuity.

Job description

Be professionally and legally accountable for the full management of the patients UCR / H@H clinical episode of care, from step-up admission through to discharge.

Undertake specialist occupational therapy assessment of patients functional, cognitive, environmental, and psychosocial needs within the H@H caseload, understanding diverse and complex presentations including frailty syndromes, acute medical exacerbations, delirium, end-of-life care, and post-discharge reablement needs.

Apply advanced clinical reasoning to analyse complex clinical and social information from multiple sources (SystmOne record, EMIS, MDT discussion, patient and carer interview, environmental assessment) to identify significant health changes warranting clinical intervention and to recommend the best course of occupational therapy management.

Formulate and deliver individualised OT treatment and goal-directed management programmes, using a wide range of evidence-based approaches including Comprehensive Geriatric Assessment (CGA) components, cognitive rehabilitation, graded functional activity, occupational adaptation, and carer training.

Assess the patients understanding of treatment proposals; gain valid informed consent; and work within a legal and ethical framework for patients who lack capacity to consent, in line with the Mental Capacity Act 2005, DoLS, and relevant CNWL policies.

Evaluate patient progress against the H@H care plan and daily C2R criteria; reassess and modify plans in response to clinical change; and determine discharge readiness in conjunction with the SCDM at the daily morning MDT.

About us

There are over 300 Occupational Therapists (OTs) in CNWL. We work in many different teams in both physical and mental health, as well as a number of specialist areas. There are plenty of opportunities to develop your career with us and maintain your dual skills.

OT in CNWL is very fortunate in having an established professional structure including an AHP director, Trust wide Professional Head of OT, borough and specialist Head OTs. This has the huge benefit of ensuring representation of our profession at all levels - both strategically and operationally.

Personal and professional development is a high priority for the profession and is underpinned by research groups and OT clinical networks. We invest in the development of our staff by providing excellent internal training as well as commissioning specialised external training and providing quality supervision.

We actively support the next generation of OTs through Apprenticeships, student placements and the promotion of the profession as a career in schools. We are proud of the diversity in our workforce and have invested time in supporting and developing this further through our Equality Diversity and Belonging OT group.

Occupational Therapy Careers at CNWL

Occupational Therapy :: Central and North West London NHS Foundation Trust

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