Job summary
A Renal Supportive Care Clinical Nurse Specialist (CNS) plays a key role in providing palliative and end-of-life care to patients with advanced chronic kidney disease (CKD), particularly those in stage 5 CKD, across various care settings. This role is essential for patients who either choose not to undergo dialysis, are receiving dialysis, or have undergone a kidney transplant. The CNS ensures the holistic care of these patients, addressing their physical, emotional, psychological, and spiritual needs as they approach the end of life.

Due to increasing patient numbers, higher levels of complexity, and growing frailty, we have recently expanded our team to better meet the needs of this population, both in renal care and within the broader local community.

This is a full time post (1.0 FTE). This post is based within Guy's & St Thomas' NHS Foundation Trust and also includes our satellite sites.

Closing date: 31st August 2026
Interview date: 10th of September 2026

Main duties of the job
N urse lead clinics at the Guys site and satellite units, where you will assess patients and prescribe treatment with their care plans. Offer advance care planning discussions, help manage symptoms of CKD and dialysis, and provide end-of-life care to patients across a wide geographical area. Coordinate care ensuring close collaboration with community colleagues and palliative care teams to avoid unnecessary hospital admissions and facilitate out-of-hospital end-of-life care. Work with the MDT teams to deliver holistic care.

Provide palliative care to inpatients on renal wards. Assist in difficult discussions regarding treatment withdrawal and ensure that decisions align with the patient's preferences, avoiding overmedicalization of death. Support staff in delivering excellent end-of-life care to patients with renal disease, ensuring they are competent in managing sensitive end-of-life conversations and providing care that aligns with patient priorities.

Implement effective symptom management strategies. Ensure patients receive person-centred care that supports their physical comfort and emotional well-being during the final stages of their illness.Collaborate with nephrologists, palliative care teams, and other healthcare providers to ensure patients receive seamless, coordinated care tailored to their needs. Participate in discussions that consider all aspects of patient care, ensuring decisions made are in line with patient values and goals.

About us
The role sits within the Directorate of Transplant, Renal and Urology under the speciality of Renal. The successful candidate will be welcomed into the team, supported into transitioning into this role and will receive a structured induction to help them transition confidently into the role.

We offer a range of in-house training to enhance your clinical, research and managerial skills. The management team will support you to have a clear plan and support additional external training if required for your role, development and future career objectives.

In return, we are looking for an enthusiastic and motivated individual who will bring clinical expertise, strong leadership skills and a commitment to delivering high-quality, patient-centred care. You will be someone who contributes positively to the team, demonstrates initiative, and is keen to support service improvement and innovation. With a strong commitment to work collaboratively to achieve the best outcomes for our patients and the wider service.

Details
Date posted
07 August 2026

Pay scheme
Agenda for change

Band
Band 7

Salary
£58,133 to £65,261 a year

p.a. inclusive of HCA

Contract
Permanent

Working pattern
Full-time

Reference number
196-NM14054-M

Job locations
Renal - Guys Hospital
Great Maze Pond
London
SE19RT
United Kingdom

Job description
Job responsibilities
The JD and main responsibilities for this role are but not exclusively:

• Lead nurse-led clinics at the Guys site and satellite units, assessing patients, developing care plans, and prescribing treatments.
• Symptom Management and End-of-Life Care ensuring comfort in the final stages of life.
• Provide advanced care planning and guidance, especially for patients with those with CKD 5, those receiving dialysis, and those with failing kidney transplants.
• Supporting staff with patients with complex needs, liaising with community colleagues and palliative care teams. Ensure that patients are supported with holistic care.
• Inpatient Care: Provide palliative care to inpatients on the renal wards, particularly focusing on treatment withdrawal, uncertain recovery and ensuring that death is not overly medicalized.
• Support difficult communication around end-of-life decisions and facilitate care that aligns with patient wishes and values.
• Multidisciplinary Team Work: Collaborate with the wider MDT
• Patient and Family Support: Guide patients and families through the process of advance care planning, offering options for care based on their values and wishes.

By managing these responsibilities, you will ensure that patients receive the best possible care throughout their journey with advanced kidney disease, especially during their final stages.

Please also see the attached detailed JD and expectations for a CNS at GSTT.

Job description
Job responsibilities
The JD and main responsibilities for this role are but not exclusively:

• Lead nurse-led clinics at the Guys site and satellite units, assessing patients, developing care plans, and prescribing treatments.
• Symptom Management and End-of-Life Care ensuring comfort in the final stages of life.
• Provide advanced care planning and guidance, especially for patients with those with CKD 5, those receiving dialysis, and those with failing kidney transplants.
• Supporting staff with patients with complex needs, liaising with community colleagues and palliative care teams. Ensure that patients are supported with holistic care.
• Inpatient Care: Provide palliative care to inpatients on the renal wards, particularly focusing on treatment withdrawal, uncertain recovery and ensuring that death is not overly medicalized.
• Support difficult communication around end-of-life decisions and facilitate care that aligns with patient wishes and values.
• Multidisciplinary Team Work: Collaborate with the wider MDT
• Patient and Family Support: Guide patients and families through the process of advance care planning, offering options for care based on their values and wishes.

By managing these responsibilities, you will ensure that patients receive the best possible care throughout their journey with advanced kidney disease, especially during their final stages.

Please also see the attached detailed JD and expectations for a CNS at GSTT.

Person Specification
Professional Registration
Essential

• Degree
• Leadership course
• Mentorship course
• Post qualification in Renal or Palliative Care

Desirable

• To have or working towards a Non Medical Prescribing Course
• To have or working towards a Masters
• To have or working towards and Advanced Assessment Course

Education
Essential

• Experience teaching in the formal and informal setting

Experience
Essential

• Extensive experience of working autonomously at an advanced level within the specialist area delivering effective patient focused care

Person Specification
Professional Registration
Essential

• Degree
• Leadership course
• Mentorship course
• Post qualification in Renal or Palliative Care

Desirable

• To have or working towards a Non Medical Prescribing Course
• To have or working towards a Masters
• To have or working towards and Advanced Assessment Course

Education
Essential

• Experience teaching in the formal and informal setting

Experience
Essential

• Extensive experience of working autonomously at an advanced level within the specialist area delivering effective patient focused care

Disclosure and Barring Service Check
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.

Certificate of Sponsorship
Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).

From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).

UK Registration
Applicants must have current UK professional registration. For further information please see
NHS Careers website (opens in a new window).

Additional information
Disclosure and Barring Service Check
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.

Certificate of Sponsorship
Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).

From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).

UK Registration
Applicants must have current UK professional registration. For further information please see
NHS Careers website (opens in a new window).

Employer details
Employer name
Guy's and St Thomas' NHS Foundation Trust

Address
Renal - Guys Hospital
Great Maze Pond
London
SE19RT
United Kingdom

Employer's website
https://www.guysandstthomas.nhs.uk/careers/careers.aspx (Opens in a new tab)

Employer details
Employer name
Guy's and St Thomas' NHS Foundation Trust

Address
Renal - Guys Hospital
Great Maze Pond
London
SE19RT
United Kingdom

Employer's website
https://www.guysandstthomas.nhs.uk/careers/careers.aspx (Opens in a new tab)

Employer contact details
For questions about the job, contact:
Advanced Nurse Practitioner
Sharon Frame
sharonframe@nhs.net
07591348457

Details
Date posted
07 August 2026

Pay scheme
Agenda for change

Band
Band 7

Salary
£58,133 to £65,261 a year

p.a. inclusive of HCA

Contract
Permanent

Working pattern
Full-time

Reference number
196-NM14054-M

Job locations
Renal - Guys Hospital
Great Maze Pond
London
SE19RT
United Kingdom

Guy's and St Thomas' NHS Foundation Trust's privacy notice (opens in a new tab)