Lead Complex Case Manager ( Learning Disability)

Job Description

Job Summary
The post holder will undertake comprehensive professional Continuing Healthcare and Funded Nurse
Care assessments for adults over 18 years of age with complex health needs including the
assessment, review and monitoring of care for those whose health needs are funded via NHS
Continuing Healthcare within the dedicated time scales. This will include retrospective and appeal
cases.
The post holder will act as a Case Manager for individual clients within Birmingham Solihull CCG who
are receiving continuing health care funding to assess the needs of the client and their family to
facilitate, plan and evaluate service provision to ensure the client achieves an optimum level of function
and receives appropriate levels of care in the most suitable environment.
DUTIES AND RESPONSIBILITIES
• The post holder will work jointly with health, social care and independent sector colleagues to
ensure care management processes are appropriate and at time may be asked to present
assessments to the BSOL continuing care panels for ratification.
• To follow the process laid out in the National Framework for NHS Continuing Healthcare; to
include organisation, co-ordination and participation in MDT eligibility recommendations to be
verified by CCG decision makers.
• The post holder will be responsible for complex clinical caseload comprising of; Assessments,
undertaking of review (3/12 CHC review unscheduled review and Fast Tracks and
implementation on Personal Health Budgets and ongoing Case Management of Patients funded
by Continuing Healthcare (CHC), Mental Health & Learning Disabilities.
• Ensure assessments conducted are robust, transparent and multi-agency (where required) for
NHS Continuing Healthcare/NHS-funded Nursing Care.
• Analysis of supporting documentation to establish critical history of the patient’s relevant needs
to produce a specialist nursing assessment.
• Complete new referrals for NHS Continuing Healthcare within 28 days as per the National
Framework for NHS Continuing Healthcare.
• To undertake NHS-funded Nursing Care (FNC) determinations for service users who require
ongoing nursing care in a care home with nursing, ensuring that patients are assessed within
current guidelines and then reviewed after three months/ annually in line with DoH framework
throughout the locality area
• Managing a defined caseload ( Assessment, Reviews (FNC/ CHC Fast Track, reviewing cases),
Transition, DOLS, LPS, and SEND, and Ongoing complex case management, Implementation of
PHB, Care Act Assessment). This list is not exhaustive
• Supporting delivery and implementation of those assessed for those requiring a personal health
budget (PHBs) for your defined case-load.
• Supporting delivery and implementation of DOLS/LPS for your defined case-load.
• Ensuring the clinical team are maintaining data systems in line with standard operating policy
and procedures
• Providing relevant and timely specialist advice and guidance on functional and information
matters relating to the service
• Coordinating and supporting the delivery of quality and assurance including core
documentation, information and reporting
• Coordinating and supporting the delivery of quality and assurance including core
documentation, information and reporting
• Ensuring the principles and duties of safeguarding are holistically, consistently and
contentiously applied
• Contributing to maintenance and monitoring of service standards around quality
• The post holder will be responsible for ensuring their mandatory training is up-to-date
• Manage the daily enquiries to the CHC Service and any case management issues that arise
unexpectedly
• Complying with NHS Codes of Conduct and Standard Business Conduct and/or NHS Trust
Standards of Business Conduct policies. Complying with the organisations conduct and
accountability code and any relevant codes of conduct dependent on your profession (e.g.
Nursing and Midwifery Council (NMC)
• It is envisaged that the post will be instrumental in securing and ensuring the highest
standards within Continuing Healthcare by maintaining standards within the CHC team and
by working in partnership with care providers to improve the patient experience.