Job Title: Salaried GP Frailty & Neighbourhood Health
Contract: Fixed-term until March 2027, with potential to extend subject to continued funding
Hours: Up to 5 sessions per week (0.625 WTE)
Working Pattern: Flexible by agreement
Salary: Competitive enhanced sessional rate
Responsible to: GP Partners / Practice Manager
About the OrganisationWe are a forward-thinking, family-focused NHS GP practice with approximately
16,000 registered patients. We are a
training practice committed to developing our team and supporting the next generation of healthcare professionals.
We pride ourselves on providing high-quality, patient-centred care while maintaining the values of
traditional general practice, including continuity, strong patient relationships and a personal approach to care.
We are committed to innovation and developing new models of care, including working collaboratively with our wider neighbourhood and multidisciplinary teams. We have a supportive and friendly team ethos and aim to provide a positive working environment with a strong focus on staff wellbeing and work-life balance.
Job PurposeTo provide high-quality clinical care to patients with frailty and complex health needs, with a particular focus on delivering the frailty work commissioned through the
Single Neighbourhood Health contract.
The postholder will work proactively with patients, families, care homes and the wider multidisciplinary team to support personalised care, improve outcomes and reduce avoidable hospital admissions.
Main Duties and Responsibilities- Undertake Comprehensive Geriatric Assessments (CGA) for patients living with frailty and complex needs.
- Develop, review and update personalised care plans.
- Undertake Structured Medication Reviews (SMRs) where appropriate.
- Complete and review ReSPECT forms and advance care planning.
- Provide clinical input into the management of patients living in care homes.
- Undertake home visits for housebound and frail patients.
- Proactively identify and manage patients at risk of deterioration or hospital admission.
- Work closely with the wider Single Neighbourhood Health multidisciplinary team.
- Liaise with community services, care homes, social care and other healthcare professionals to coordinate patient care.
- Support admission avoidance and appropriate escalation of care.
- Maintain accurate and timely clinical records and complete relevant coding.
- Participate in clinical governance, significant event processes and quality improvement activity as appropriate.
- Undertake any other reasonable duties consistent with the role and level of responsibility.
Working EnvironmentThe role offers an opportunity to work within a
supportive and friendly practice, with a flexible approach to working patterns and a strong emphasis on achieving a sustainable
work-life balance.
The postholder will have the opportunity to contribute to the development of our frailty service and help shape how neighbourhood-based care is delivered locally, while remaining part of a practice that values the principles of traditional general practice.
Person SpecificationEssential
- GMC registration and inclusion on the NHS Performers List.
- Experience of working as a GP in primary care.
- Good understanding of the needs of older people and patients living with frailty.
- Ability to undertake holistic clinical assessments and develop appropriate care plans.
- Good communication and multidisciplinary working skills.
- Ability to work independently and manage a complex caseload.
- Commitment to high-quality, patient-centred care.
Desirable
- Previous experience of working with frailty or older people.
- Experience of care home medicine.
- Experience undertaking CGAs and advance care planning/ReSPECT.
- Experience of working within a multidisciplinary or neighbourhood team.
- Interest in developing new models of proactive and preventative care.
What We Offer- Up to 5 sessions per week (0.625 WTE).
- Flexible working pattern by agreement.
- Fixed-term contract until March 2027, with potential for renewal subject to continued funding.
- Competitive enhanced sessional rate.
- Strong focus on work-life balance and staff wellbeing.
- Supportive, family-focused practice environment.
- Opportunity to work within a training practice.
- Opportunity to contribute to and shape the development of frailty and neighbourhood health services.
- A role combining innovative models of care with the values and continuity of traditional general practice.
QualificationsEssential
- GMC registration and inclusion on the NHS Performers List
- Experience working as a GP in primary care
- Good understanding of the needs of older people and patients living with frailty
- Ability to undertake holistic clinical assessments and develop appropriate care plans
- Good communication and multidisciplinary working skills
- Ability to work independently and manage a complex caseload
- Commitment to providing high-quality, patient-centred care
- Good clinical decision-making and risk management skills
- Ability to maintain accurate and timely clinical records
- Commitment to safeguarding, clinical governance and professional standards
Desirable
- Previous experience working with frail and elderly patients
- Experience of care home medicine and management
- Experience undertaking Comprehensive Geriatric Assessments (CGA)
- Experience with Structured Medication Reviews (SMRs)
- Experience completing ReSPECT forms and advance care planning
- Experience working within a multidisciplinary or neighbourhood team
- Understanding of admission avoidance and proactive care planning
- Interest in developing and improving services for patients living with frailty
- Experience of working within or contributing to a training practice
This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.Applicants must have current UK professional registration. 
