Detailed job description and main responsibilities

•    To ensure patient discharge care needs are assessed, planned implemented and evaluated using research evidence as appropriate.
•    To ensure all nursing procedures are carried out in accordance with Wrightington, Wigan and Leigh Foundation Trust policies taking appropriate action in emergency situations.
•    In conjunction with the multi-disciplinary team, be responsible for setting, monitoring and maintaining excellent standards of care particularly for patients with multiple needs who require complex multi-disciplinary interventions.
•    Maintaining personal contact with patients, relatives and carers being sensitive to their needs for courtesy, dignity and privacy and ensuring a friendly environment at all times.
•    Ensuring that accurate and timely records of discharge planning assessments, planning, interventions and contacts are maintained.
•    To work in an unsupervised capacity throughout all areas of the speciality.
•    To prioritise own work load to facilitate a seamless and safe discharge of patients back in their own environment or new one that meets their present needs.
•    To contribute to the local resolution, investigation of any informal or formal complaints and carry out follow up action for those that specifically relate to discharge planning.
•    To support the Lead nurse and band 7 in the daily duties and activity within the Transfer of Care Hub (TOCH)
•    To support the Band 4 Discharge Co-ordinators in their daily duties and activities.
•    To assess medically optimised patients as suitable for community beds.
•    To support the multi-disciplinary team at the community beds with discharge planning.
•    Assist wards in the completion of continuing healthcare documentation and ensure that the documentation is sent to the ICB for decision.
•    Assist wards in the completion of fast track continuing healthcare documentation and ensure that the documentation is sent to the ICB for decision.
•    Attend the daily bed meetings when delegated by the Lead nurse.
•    Promotion of early discharge from ward areas.

Key results from the job holder
•    Undertake assessment of all patients’ discharge needs in appointed area of responsibility without supervision.
•    Co-ordinate and discuss with the appropriate therapy team if rehabilitation is required.
•    Develop and maintain communication links with Primary and Secondary Health Care Teams.
•    Attend and be an active member of the daily ward multi-disciplinary team whiteboard meetings. Keeping them informed of their patients rehabilitation and discharge planning progress.
•    Arrange and Chair multi-disciplinary team meetings for individual patients with very complex discharge needs.
•    Refer and liaise with Social Service Department and other member of the Integrated Discharge Team including third sector parties.
•    Carrying out government policy by completing the appropriate notification and discharge notification forms on the EPR system.
•    Co-ordinate the completion of assessments from other disciplines. Ensure that patients, relatives or carers are informed and supported through each phase of this discharge process.
•    Facilitate nurse led discharges ensuring medical staff has documented clear discharge criteria and discharge management summaries are in place.
•    Liaising with specialist hospital and community based teams in Palliative Care to ensure those patients and their families or carers requiring support in terminal care have rapid access to equipment and expertise.
•    Co-ordinating the multi-disciplinary team to prevent readmission and address problems that may have occurred in failed discharges.
•    Address any concerns or referrals that are received from any community based health teams.

Planning and Organisational Duties
•    Arranging in consultation with the ward team the transfer of patients to the Discharge Lounge.
•    Assessing patient transport needs and organising the appropriate vehicle and safe collection point.
•    Communication and co-operating with other wards and departments giving accurate information as required, particularly with regards to procedures which are delaying discharge and transfer needs. Care is evidenced and research based.

Communications and Key Working Relationships 
•    To act in accordance with the NMC Code of Professional Conduct for nurses, midwives and health visitors and to be accountable for own clinical practice and professional actions at all times.
•    Ensure continued and effective registration with the NMC.
•    To have responsibility for the health, safety and welfare of self and others and to comply at all times with the requirements of the Health and Safety policy.
•    To ensure confidentiality at all times, only releasing confidential information obtained during the course of employment of those acting in an official capacity.
•    To promote equal opportunities for staff and patients in accordance with Wrightington, Wigan and Leigh NHS Foundation Trust policies to ensure that no person receive less favourable treatment than another on grounds of sex, race,marital status, religion, colour, creed, nationality, ethnic or national origin or sexual orientation.
•    Be aware of and work within policies of Wrightington, Wigan and Leigh NHS Foundation Trust carrying out such duties as may be required and are consistent with responsibility of the grade.

Responsibility for Health & Safety
Compliance with the Health & Safety at Work Act 1974 – the post holder is required to fulfil a proactive role towards the management of risk in all of their actions. This entails the risk assessment of all situations, the taking of appropriate actions and reporting of all incidents, near misses and hazards, and a statutory duty of care for their own personal safety and that of others who may be affected by their acts or omissions.  

Work Circumstances 
Monday to Sunday between service hours of 0800-1800.