Herts Health LTD
GP Clinical Lead (Frailty)

Job summary
Hertsmere Proactive Anticipatory Care (PAC) Service
4.5 Sessions per Week (18.75 hours)
£12,000 per session
Help Shape One of Hertsmere's Flagship Neighbourhood Programmes
Herts Health Federation is seeking an enthusiastic and forward-thinking GP to join the new Hertsmere Proactive Anticipatory Care (PAC) Service.

The PAC service is one of Hertsmere's flagship neighbourhood transformation programmes, developed through a partnership between:

• Herts Health Federation
• Central London Community Healthcare NHS Trust (CLCH)
• West Hertfordshire Teaching Hospitals NHS Trust

with funding support from Macmillan Cancer Support.

The service has been designed to identify people earlier, intervene proactively and coordinate support around patients living with frailty, multiple long-term conditions and increasing risk of hospital admission.

Using population health management tools, multidisciplinary working and proactive case management, the service aims to improve patient outcomes whilst reducing avoidable deterioration and crisis-led care.

This is a new team and with recruitment underway for all roles we have an anticipated start date of 1st February 2027.

The hours are expected to be delivered during weekdays.

Main duties of the job
This is not a traditional GP surgery role and it is not a routine clinic.

The successful candidate will act as the Primary Care Interface GP within the PAC multidisciplinary team. Working alongside a Clinical Operational Lead, Nurse, Physiotherapist, Paramedic, Pharmacist and Care Coordinators, you will provide senior primary care clinical leadership and help ensure patients receive timely, coordinated and holistic care.

The role focuses on helping the multidisciplinary team manage complexity within the service wherever possible and preventing unnecessary work being referred back into routine practice workflows.

The postholder will support the team with clinical decision-making, investigations, medications, risk management, advance care planning and pathway navigation for some of Hertsmere's most vulnerable patients.

About us
This role will be working as part of an integrated neighbourhood team comprising staff from primary care and community services with links to secondary care.

Herts Health GP Federation is a membership organisation supporting 8 local GP practices in Hertsmere.

We are a warm and welcoming team with great links to our local practices and community.

Details
Date posted: 13 November 2026
Pay scheme: Other
Salary: Depending on experience
Contract: Fixed term
Duration: 18 months
Working pattern: Part-time
Reference number: B0195-26-0001

Job locations
The Walk, Potters Bar, Hertfordshire, EN6 1QH, United Kingdom
Other Sites: Potters Bar Community Hospital; Elstree Way Clinic; Bushey Practice Locations, Locations within Hertsmere, WD6 1UZ, United Kingdom

Job description
Job responsibilities
Key Responsibilities
Clinical Triage and MDT Support

• Participate in structured clinical triage of patients entering the service.
• Support allocation of patients to the most appropriate clinician.
• Participate in MDT reviews and complex case discussions.
• Provide senior clinical advice and support across the team.

Complex Clinical Decision Making

• Support management of complex frailty and multimorbidity.
• Assist with diagnostic uncertainty and clinical risk.
• Support admission avoidance planning.
• Review patients requiring additional medical input following CGA assessment.

Advance Care Planning

• Support ACP and ReSPECT discussions.
• Assist with anticipatory care planning.
• Support clinicians with complex decision making around long-term care preferences.

Investigations and Monitoring

• Support the team with requests and interpretation of investigations.
• Advise on follow-up arrangements.
• Assist with management of abnormal results.

Medicines Optimisation

• Work alongside the service pharmacist.
• Support medication optimisation decisions.
• Assist with complex prescribing decisions and polypharmacy management.

Service Development

• Help shape and refine the PAC operating model.
• Support development of neighbourhood pathways.
• Contribute to service evaluation and improvement.

Why This Role Is Different
This role has been specifically designed around proactive care rather than reactive demand. You will not be expected to run a standard surgery list. Instead, you will be working with a dedicated multidisciplinary team to:

• Identify unmet need.
• Support Comprehensive Geriatric Assessment.
• Coordinate care across organisations.
• Remove barriers to accessing services.
• Support proactive management of frailty and complexity.
• Enable the team to work at the top of their professional licence.
• Reduce unnecessary workload being passed back into general practice.

The emphasis is on clinical leadership, collaboration and problem solving rather than volume consulting.

Person Specification
Essential

• Hold full GMC registration and licence to practise.
• Are included on the GP Register.
• Have experience managing patients with frailty, multimorbidity and complex needs.
• Enjoy MDT working and system collaboration.
• Have strong communication and relationship-building skills.
• Are interested in neighbourhood working, proactive care and service development.

Desirable
Experience in frailty, elderly care, admission avoidance, community services, anticipatory care planning or integrated care would be advantageous.

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.
UK Registration: Applicants must have current UK professional registration. For further information please see NHS Careers website.

Employer details
Employer name: Herts Health LTD
Address: The Walk, Potters Bar, Hertfordshire, EN6 1QH, United Kingdom
Employer's website: Apply via the company portal

Employer contact details
For questions about the job, contact: Head of Operations, Ash Diver, ashleen.diver1@nhs.net