Lancashire and South Cumbria Integrated Care Board (ICB) has been
selected to take part in one of four national Fit Note Reform Pilots
commissioned by the Department for Work and Pensions, helping to test a new
approach that aims to improve support for people whose health affects their
ability to work. The pilot is designed to address a recognised challenge within
the current system, where fit notes often focus on certifying sickness absence
rather than providing practical support to help people remain in work or return
to work safely.
MBPCC is delivering one of these pilots, taking fit note generation out
of practices within the Barrow and Mid Furness PCN areas. Patients will be
referred directly from general practice into a new service called Enable where
they will be offered a personalised Workability Plan setting out what they can
do, the adjustments that would help, and the support available to them to aid
them return to work.
The Occupational Health Nurse is one of the senior clinical assessment
resource within the Enable team. The post holder will undertake work and health
assessments for patients referred into the pilot, form an occupational health
judgement about functional capacity and fitness for work, and produce
Workability Plans that are clinically defensible, practical for employers and
genuinely useful to the patient.
This is a test-and-learn service. The post holder is expected not only
to deliver assessments, but to help shape the clinical model itself
Undertake structured work and health assessments with
patients referred into the pilot, face to face, by telephone or by video,
according to patient need and clinical appropriateness.
Assess the interaction between a persons health
condition, their functional ability and the demands of their role, taking
account of all appropriate physical, psychological, social and workplace
factors.
Formulate and co-produce personalised Workability
Plans focused on functional capability, phased return, adjustments and the
practical support required to sustain work.
Exercise autonomous professional judgement in
determining whether a period away from work is clinically appropriate, and
articulate that judgement clearly, proportionately and defensibly.
Provide specialist advice on reasonable adjustments,
graduated return to work, workplace modification and phased hours, informed by
an understanding of the Equality Act 2010 and relevant health and safety
legislation.
Review and update Workability Plans at agreed
intervals, adjusting recommendations as recovery,
circumstances or employer response change.
Recognise the limits of the pilot service and of
personal professional competence and escalate promptly and appropriately
Morecambe Bay Primary Care Collaborative is the largest employer
of Primary Care colleagues in South Cumbria, we are a not-for-profit Community
Interest Company, and work to support, guide and underpin primary medical care
across Lancashire and South Cumbria.
We deeply value education and learning, hosting the Lancashire
and South Cumbria Training Hub. We have a great team on our board that guide
our organisation, and you will be supported to excel in your role.
Job description
Job responsibilities
Post: Occupational Health Nurse
Service: MBPCC
Enable Service
Accountable to: Clinical Lead
Responsible to: Advanced
Nurse Practitioner
Hours: 37.5 per week
Salary:
£41,590 (30% enhanced hourly rate for Saturday
working)
Contract Type Fixed term 12 months.
Secondment applications welcome.
Base: Hybrid and
flexible with home working occasional Barrow and Mid Furness PCN sites
2.
SERVICE CONTEXT
The pilot operates across Barrow and Mid Furness
Primary Care Networks and is delivered by Morecambe Bay Primary Care
Collaborative on behalf of participating practices.
The service is multidisciplinary. The post holder
works alongside the Clinical Lead, Advanced Nurse Practitioner, allied health
professionals, administrative staff
Participation is voluntary for patients. The service
operates within an agreed clinical governance framework, defined escalation
routes back to general practice, and a Data Sharing Agreement covering all
information flows.
The pilot is time limited and subject to independent
national evaluation. Data capture, consistency of practice and adherence to
agreed protocols are therefore integral to the role rather than administrative
afterthoughts.
The post holder does not replace the patients GP and
does not assume responsibility for the management of underlying clinical
conditions. Where clinical need is identified, it is escalated to the
registered practice through agreed pathways.
3. KEY WORKING RELATIONSHIPS
Internal
Service Lead day to day management, absence and
sickness, appraisals
Clinical Lead, Advanced Nurse Practitioner, allied
health professionals, Enable administrator
External
Referring GPs, practice managers
and primary care teams across Barrow and Mid Furness.
Patients and, with consent, their employers, line
managers, HR
Local employers,
Jobcentre Plus, VCSE [Voluntary, Community, and Social Enterprise] partners,
therapy and mental health services, and other statutory agencies
4. MAIN DUTIES AND RESPONSIBILITIES
Clinical assessment and workability planning
Undertake structured work and health assessments with
patients referred into the pilot, face to face, by telephone or by video,
according to patient need and clinical appropriateness.
Assess the interaction between a persons health
condition, their functional ability and the demands of their role, taking
account of all appropriate physical, psychological, social and workplace
factors.
Formulate and co-produce personalised Workability
Plans focused on functional capability, phased return, adjustments and the
practical support required to sustain work.
Exercise autonomous professional judgement in
determining whether a period away from work is clinically appropriate, and
articulate that judgement clearly, proportionately and defensibly.
Provide specialist advice on reasonable adjustments,
graduated return to work, workplace modification and phased hours, informed by
an understanding of the Equality Act 2010 and relevant health and safety
legislation.
Review and update Workability Plans at agreed
intervals, adjusting recommendations as recovery,
circumstances or employer response change.
Recognise the limits of the pilot service and of
personal professional competence and escalate promptly and appropriately.
Triage, caseload and pathway management
Contribute to the triage of incoming referrals,
applying agreed criteria to determine the appropriate assessment route, practitioner and priority.
Manage a personal caseload, prioritising
effectively against service standards and pilot appointment targets.
Identify patients whose needs fall outside the pilot
model including those requiring urgent clinical assessment, safeguarding
intervention or mental health crisis support and escalate through agreed
routes without delay.
Refer and signpost to wider support, including WorkWell coaching, therapy services, musculoskeletal
pathways, social prescribing, debt and housing advice and employment support.
Support colleagues in the wider team with clinical
advice on complex or borderline cases, within scope of practice.
Employer and stakeholder liaison
With patient consent, participate in three way
conversations between the patient, their employer and the service to agree
practical adjustments and maintain workplace connection from day one of
absence.
Produce clear, objective written advice for employers
and managers that answers the question asked, respects medical confidentiality
and avoids unnecessary clinical detail.
Communicate sensitively with employers who may hold
differing views, using negotiation and persuasion to reach workable outcomes
for the patient.
Build constructive relationships with referring
practices, providing feedback that supports referral quality and confidence in
the pilot model.
Clinical governance, safety and record keeping
Practice at all times within the NMC Code,
professional standards, pilot protocols and standard operating procedures.
Maintain accurate, contemporaneous and legible records
in the approved clinical system, in line with the Data Sharing Agreement and
information governance requirements.
Obtain and record valid informed consent for
assessment, for information sharing and for any contact with employers or third
parties.
Discharge safeguarding responsibilities for children
and adults at risk, escalating concerns in accordance with agreed policy.
Report incidents, near misses, complaints and risks
through the pilot governance framework, and contribute to learning from them.
Participate in clinical supervision, case review and
multidisciplinary discussion, including reflective review of complex or
contested cases.
Maintain professional indemnity and NMC registration
and comply with revalidation requirements.
Service design, data and evaluation
Contribute to the development and refinement of
assessment templates, triage criteria, escalation thresholds, business rules
and standard operating procedures as the pilot matures.
Capture the agreed management information and
evaluation data set accurately and at the point of care, understanding that
incomplete data weakens the national evidence base.
Participate in audit, service evaluation, quality
improvement and test-and-learn cycles, and act on the findings.
Support the independent national evaluation, including
interviews, case note review and data collection, within the limits of patient
confidentiality.
Education, promotion and professional development
Promote the pilot to practices, patients, employers
and partners in a positive way
Provide informal supervision, coaching and clinical
advice to non-clinical members of the team.
Maintain and extend personal expertise in occupational
health, work and health policy and fitness for work assessment; undertake
training identified as necessary for the role, including any pilot specific
training.
Participate in appraisal, personal development
planning and mandatory training.
5. WORKING ARRANGEMENTS
This is a fixed term post for 12 months, funded
through the national pilot. Continuation beyond the pilot period cannot be
guaranteed and is subject to national decisions on the future of the model.
A flexible and agile approach to working is expected.
The service operates a blended model of face to
face clinics, remote consultation and home working, and the balance between
these will vary with service demand and patient need.
Home working is supported for remote assessment,
report writing and administrative activity, subject to a suitable, confidential
home working environment and compliance with information governance
requirements. Home working is an operational arrangement, not a contractual
entitlement, and does not remove the requirement to attend sites.
Regular travel across Barrow and Mid Furness is
required. Access to a vehicle and a full UK driving licence is necessary.
Some flexibility over working hours may be needed to
accommodate patients who are in work and employers who are only available
outside core hours such as Saturday working
The post holder will be expected to work in a rapidly
evolving service where processes, systems and documentation change during the
pilot period.
6. GENERAL RESPONSIBILITIES
Mandatory Training & Compliance
The post holder will be required to complete and remain compliant with
all mandatory training as defined by the organisation.
Evidence of current training may be requested prior to commencement, and
refresher training must be completed within specified timeframes.
MBPCC will consider the ability to passport training records if post
holder has evidence of completion from other relevant employment
Additional Information
This role includes being partly home-based, which requires a high level
of self-management.
Candidates must ensure a secure working environment in line with data
protection policies.