Virtual Wards GP

**Reports to:** **Head of Clinical Services**
**Responsible to: Clinical Lead**

**Proposed salary: £13,111 per four hour session**

**Hours of work: Monday to Friday 09.00-13.00**

**Tenure: FTC**

**Base: Worthing UCR (Sussex Community NHS Foundation Trust, Unit 1 The Quadrant, 60 Marlborough Road, Lancing Business Park, Lancing, BN15 8UW) Mondays, Wednesdays and Fridays.**

**Remote working Tuesdays and Thursdays.**

**On Call Element: No**

**About Alliance for Better Care CIC**

Alliance for Better Care (ABC) is a GP Federation uniting 77 NHS GP member practices across 98 sites within 24 Primary Care Networks in Sussex and Surrey. We support our Primary Care colleagues – and their patients – to transform how healthcare is delivered in their communities.

We work closely with GP Practices, PCNs, Hospitals, Community Organisations, and the Third Sector. These vital partnerships enable us to deliver a truly integrated approach that offers the support and expertise needed to effectively serve our populations.

More about our organisation: www.allianceforbettercare.org

**Our Values**

· **We innovate**

If we can do something better, we should.

· **We are honest**

Even when it is difficult.

· **We care**

And put the patient first.

· **We are inclusive**

We listen and we act.

· **We deliver**

And we’re known to like a challenge!

**Services that ABC Provide**

· Additional Primary Care

· Anti-Viral COVID Medication (nMABs)

· Anticipatory Care

· COVID Response

· Enhanced Access

· Health Checks

· Inclusion Health

· MMR Service

· Outbreak Response Service

· Refugee and Asylum Seeker Support

· Remote Services

· Spirometry and Reversibility Service

· Sussex Smoking Cessation

· Urgent Care at Scale Service

· Urgent Primary Care Support

· Vaccination Programme

**Benefits**

· Generous annual leave allowance

· Access to NHS pension

· Bespoke training programme

· Cycle to Work Scheme

· Employee Assistance Programme

· Enhanced maternity pay

· NHS discounts

· Leadership Development Programme

· Salary sacrifice schemes – technology and electric vehicle

· Opportunities for secondments

**Study Leave/Training**

There are opportunities for a study leave allowance.

**Supervision**

Regular supervisions on a one-to-one basis including an annual formal appraisal will be held with a line manager. If you are in a patient-facing role, you will also receive regular Clinical Supervisions with a Clinical Supervisor.

**Induction Programme**

You will receive an in-depth induction programme and will be invited to a face-to-face induction day within your first week to give you relevant information about the organisation and your job role.

**Job summary**

This service is a collaboration between Sussex Community NHS Foundation Trust

(SCFT) and the Sussex Federations: Brighton & Hove Federation (B&HF), Alliance for Better Care (ABC) and South Downs Health & Care (SDHC). The Federations will be delivering the GP-led aspect of the Virtual Ward at a place-level to match SCFT’s Urgent Community Response service across Sussex. SCFT provides the service in West Sussex, Brighton and Hove and the High Weald, Lewes and Havens area of East Sussex.

B&HF are the lead contractor for the GP Service delivery and have sub-contracted to ABC for delivery within the federation’s geographical areas of Crawley/Horsham, Worthing and Chichester.

Since 2022, SCFT have delivered Virtual Wards (Hospital at Home) in line with the NHS England’s national definition that “a virtual ward is a safe and efficient alternative to NHS bedded care that support patients who would otherwise be in hospital to receive the acute care and treatment they need in their own home.

As of August 2024, SCFT re-modelled the Virtual Ward delivery and mobilised General Virtual Wards within Urgent Community Response (UCR), which supports Sussex patients within its catchment area with a higher level of acuity to be safely managed at home/chosen place of residence. This could be patients on either an admission avoidance pathway or early supported discharge pathway, where the alternative would be NHS bedded care.

The Virtual Ward activity is now prioritising admission avoidance whilst still delivering early supported discharge for patients from the Acute hospitals. It is delivered 365 days per year, 8am – 8pm. UCR teams within the SCFT footprint provide urgent support to help prevent unnecessary hospital admissions and ultimately keeping patients safely at the place they call home. There is a consistent service across Sussex and is made up of multi-disciplinary teams including General Practitioners, Nurses, Pharmacists, Therapists and Carers, ensuring they can meet a range of needs quickly offering the best level of support to patientsThe multi-disciplinary team that oversees and delivers care for the General Virtual Ward caseload is led by both medical (a General Practitioner) and clinical senior decision makers. Virtual and On Call GP cover is available seven days a week, 9am to 6pm 365 days a year, including bank holidays. This cover is linked to the respective team’s local UCR teams with a virtual board round each morning

On Mondays, Wednesdays and Fridays the UCR Hub Based GP will be required to work alongside the UCR MDT to support clinical decision making for a virtual ward of 30-50 “beds”.

The UCR Hub Based GP will work within their assigned place based SCFT UCR base. We are recruiting for a GP for the Worthing Virtual Ward (address above). The GP will present within the allocated UCR base working face to face with the SCFT MDT delivering GVW (including supervision of ACPs and team development). Patient visits may be required.

On Tuesdays and Thursdays this can be a remote position with a daily touchpoint for urgent escalations. The GP will act as an on-call contact for advice/support/management of patients on an ad hoc basis as and when needed.These allocated sessions will allow for the completion of any outstanding administrative duties, including discharge summaries, where competing clinical demands on Mondays, Wednesdays, and Fridays have limited the opportunity to complete them.

GPs will need to meet regularly with other VW GPs across the SCFT footprint for shared training and supervision. Some of this can be done remotely, but this role will require some travel across Sussex.

**Primary duties and areas of responsibility**

The Virtual Ward GP role is to act as the senior clinical decision maker within the UCR Team and providing daily clinical leadership. The following duties are the core responsibilities of the Virtual Ward GP:

– adhering to the timetable of daily scheduled clinical activities
– holding the responsibility for medical decisions made during the contracted service hours
– appreciating the complexity of patients with multi-morbidity, frailty and polypharmacy where involving specialists is necessary
– providing care in line with recommended best practice as established through clinical guidelines
– providing medical advice and supporting decision-making to the members of the wider MDT through all stages of the patient journey:

o at triage of new referrals or admission to the virtual ward

o during daily handovers and Board rounds

o in an urgent / on-call capacity

o support pharmacists with medication reviews when needed

o upon discharge with a written discharge summary

– supporting and guiding the development of patient management plans, including:

o RESPECT forms

o DNAR forms

o Personalised Care and Support Plans

o Ceiling of care

– reviewing and prescribing medications, with clinical input from the VW Pharmacy Team proposing the use of digital monitoring where it may be appropriate, and: o setting thresholds for escalation

o acting upon signs of deterioration

– work with the MDT to support clinical decision-making based on readings from POC/remote monitoring equipment.
– requesting diagnostic investigations and managing test results
– providing virtual consultations or home visiting where clinically required
– keeping accurate and contemporaneous documentation, including:

o keeping accurate and up to date records on SystmOne

o supporting with writing of discharge summaries

– liaising with other health professionals / providers for advice, such as:

o the patients primary care team / GP

o acute medical teams where advice may need to be sought

o palliative care teams

o mental health teams

– identifying deteriorating patients and escalating care when needed and in line with patient wishes
– support the development of the multidisciplinary team by:

o identifying opportunities for development

o supporting or signposting to training

o providing supervision

o instilling a culture of self-directed learning and professional development

– working with the B&HF Clinical Lead and SCFT Leads on matters related to clinical governance and service improvement, for example:

o audit o quality improvement

o complaint handling

o promoting a culture of continuous improvement

– to promote a culture of collaborative team working

There may be a requirement to carry out other tasks dependent upon factors such as workload and staffing levels, and the job role may evolve over time.

**Person specification: Virtual Wards GP**

**Qualifications**

**Essential:**

– Qualified GP
– General Practitioner (Certificate of Completion of Training CCT)
– Full GMC Registration
– National Performers List registration
– Appropriate defence indemnity (MPS/MDU)
– Five years post-CCT in general practice

**Desirable:**

– MRCGP
– Diploma in Geriatric Medicine
– Diploma in Immediate Medical Care
– Diploma in Urgent Medical Care

**Experience**

**Essential:**

– Experience of working in a primary care environment
– Experience of continued professional development
– Experience and knowledge of Sussex ICB and referral systems

**Desirable:**

– Experience of working with Urgent Care, A&E and Out of Hours
– Previous post CCT experience of working in virtual wards or other acute care settings
– Experience of working effectively in collaboration with other organisations
– Experience of providing supervision/support to an MDT

**Skills and Abilities:**

**Essential:**

– Outstanding level of clinical knowledge and skills commensurate with that of an experienced GP
– Understands the importance of evidence-based practice and clinical effectiveness
– Excellent communication skills (written and verbal)
– Strong IT skills (competent in the use of Office and Outlook)
– Effective time management (Planning & Organising)
– Ability to work as a team member and autonomously
– Excellent interpersonal skills
– Problem solving & analytical skills
– Ability to follow clinical policy and procedure
– Ability to process information accurately and effectively, interpreting data as required
– Experience with clinical risk management
– Understanding of Clinical Governance and quality issues as well as health and social policy
– Adherence to the GMC Standards/Duties The duties of a doctor registered with the General Medical Council-ethical guidance-GMC (gmcuk.org)
– Motivated, forward thinker
– Ability to work under pressure
– Commitment to ongoing professional development

**Desirable:**

– Knowledge of the current issues facing primary care and the wider NHS
– EMIS and SystmOne user and Docman skills
– Experience with audit and able to lead audit programmes
– Ability and success in the implementation of change and/or service development within an organisation

**Behaviours & Values**

**Essential:**

– Flexibility in shift/working patterns to meet the needs of the service
– Strong Team Player
– Displays ABC Values
– Highly motivated, self-directed practitioner with excellent organisation skills
– Excellent communication skills both verbally and written

Pay: £63.03 per hour

Work Location: In person