Buckinghamshire Healthcare NHS Trust
Community High Intensity Nurse Case Manager - Countywide
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An Exciting Opportunity for a Qualified District Nurse
An exciting opportunity has arisen for a motivated and experienced Qualified District Nurse to join our Community High Intensity User Service as a Nurse Case Manager.
This innovative role focuses on supporting individuals who frequently access urgent and emergency healthcare services and often have complex physical health, frailty, mental health or social care needs. Through proactive case management, comprehensive assessment and coordinated multidisciplinary working, you will help patients achieve better health outcomes while reducing avoidable Emergency Department attendances and hospital admissions.
Role Overview
Working across community, primary care, acute, mental health, social care, and voluntary sector services, you will develop personalised care plans that address the underlying causes of repeated healthcare use. You will build strong therapeutic relationships with patients, families, and carers, supporting individuals to access the right care, at the right time, in the right place.
Responsibilities
- Manage a designated caseload of high intensity users, undertaking comprehensive holistic assessments and developing personalised care plans to address complex health and social care needs.
- Act as the lead coordinator for patients requiring multi-agency input, ensuring effective communication and collaboration between primary care, community services, acute trusts, mental health services, ambulance services, social care, and voluntary sector organisations.
- Proactively monitor patients at risk of deterioration, provide timely interventions following emergency department attendances, hospital admissions, or discharge, and lead multidisciplinary reviews to support coordinated care delivery.
- Work closely with patients and carers to promote self-management, facilitate advance care planning, and develop crisis and escalation plans that reduce avoidable admissions and emergency service use.
- Contribute to service development, quality improvement, and outcome measurement, providing specialist advice, education, and support to colleagues across the wider healthcare system.
- Help deliver improved patient experience, enhanced health outcomes, and more effective use of healthcare resources through strong clinical leadership and partnership working.
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Why Join Us?
- Contribute to an innovative service that improves patient experience, promotes independence, and supports more effective use of healthcare resources across the Buckinghamshire healthcare system.
- Benefit from learning and development opportunities to support your career progression.
- Enjoy flexible and agile working opportunities, alongside your NHS benefits of generous annual leave entitlement, pension, and access to NHS discount schemes.
- Be part of a team committed to promoting inclusion and making sure all colleagues feel they belong.
- Work in a supportive environment where differences are valued, and colleagues treat one another with dignity and respect.
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Our Values
- Vision: To provide outstanding care, support healthy communities, and be a great place to work.
- Mission: To provide personal and compassionate care every time.
- Care values: Collaborate, aspire, respect, and enable.
Contact Information
For further details or informal visits, contact:
- Name: Claire Jones
- Job Title: Lead Nurse for Community Nursing & Transformation
- Email Address: claire.jones18@nhs.net
- Telephone Number: 07929370499
Listen to why colleagues think we are a great place to work! - BHT - A great place to work (buckshealthcare.nhs.uk)
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