South West London Integrated Care Board

Clinical lead of Appeals / Retros

Information:

This job is now closed

Job summary

o The post holder will manage the functions of Appeals, Retrospective Reviews, and Disputes for individuals who are currently or may be eligible for CHC and for supporting elements of the Transformation Plan.

o The post holder will be responsible for ensuring the associated functions are compliant with national policy, best practice and the National Framework for CHC.

o The post holder will have an excellent knowledge of the Natioanl Framework and will help support service development, analysis and improvement in AACC.

Main duties of the job

o This post will require good management and communication skills and requires the ability to work in a multi-disciplinary way with colleagues across professional and geographical boundaries.

o Deliver against objectives, achieving quality outcomes, prioritising own workload and working to tight deadlines

o The role will involve liaising with the SWL CHC service and local authorities, who will be required to provide support and input on individual cases that are being appealed, reviewed, disputed or where a complaint has been received.

o The post holder will be responsible for ensuring their professional registration and mandatory training is up-to-date

o The job description and person specification are an outline of the tasks, responsibilities and outcomes of the role. The post holder will carry out any other duties as may reasonably be required by their line manager.

o The job description and person specification may be reviewed on an ongoing basis in accordance with the changing needs of the AACC service and the ICB.

About us

NHS South West London Integrated Care Board (ICB), as part of South West London Integrated Care System (ICS), is a partnership of organisations that come together to plan and deliver joined up health and care services to improve the lives of people in our six boroughs: Croydon, Merton, Kingston, Richmond, Sutton and Wandsworth.

Each ICS consists of two statutory elements:

  • an Integrated Care Board, bringing the NHS together with its partners locally to improve health and care services
  • an Integrated Care Partnership (ICP): the broad alliance of organisations and representatives concerned with improving the care, health and wellbeing of the population, jointly convened by the ICB and local authorities in the area.

ICBs are statutory NHS bodies responsible for planning and allocating resources to meet the four core purposes of integrated care systems (ICSs):

  • to improve outcomes in population health and healthcare;
  • tackle inequalities in outcomes, experience and access;
  • enhance productivity and value for money and;
  • help the NHS support broader social and economic development.

NHS South West London Integrated Care Board decides how the South West London NHS budget is spent and develops plans to improve people's health, deliver higher quality care, and better value for money.

Details

Date posted

03 October 2024

Pay scheme

Agenda for change

Band

Band 8a

Salary

£59,490 to £66,239 a year Per Annum inclusive of Outer HCAS

Contract

Permanent

Working pattern

Full-time

Reference number

491-SWLCHC005-A

Job locations

SWL CHC (K&R) Team (930157) L4

120 The Broadway

London

SW19 1RH


Job description

Job responsibilities

Please refer to the Job Description for full details.

Manage the appeals and retrospective assessments for the whole of SWL CHC service (for adults)To ensure the above functions are managed in such a way that ensures a high quality service is delivered that meets local, regional and national standards

Represent the service at multi agency meetings/forums as required

Provide representation with external agencies in the NHS, Local Authorities or other disciplines as required

Ensure all data within these functions is collated and added to the data base to provide accurate, contemporaneous reports as required

Input to reports on the service and performance as required

Support monitoring and audit of key performance indicators for the department

Provide support and advice to the AACC Operations Senior Manager as required on issues relating to operational delivery.

Ensure effective communication within the CHC process, including delegation of decision letters, supporting documentation and general correspondence

Ensure communication and all local review/appeals processes meet the required quality standard and assurance requirements to prevent challenge

Understand professional and personal role in relation to safeguarding processes and procedures in BOB and Local Authority Partners

Job description

Job responsibilities

Please refer to the Job Description for full details.

Manage the appeals and retrospective assessments for the whole of SWL CHC service (for adults)To ensure the above functions are managed in such a way that ensures a high quality service is delivered that meets local, regional and national standards

Represent the service at multi agency meetings/forums as required

Provide representation with external agencies in the NHS, Local Authorities or other disciplines as required

Ensure all data within these functions is collated and added to the data base to provide accurate, contemporaneous reports as required

Input to reports on the service and performance as required

Support monitoring and audit of key performance indicators for the department

Provide support and advice to the AACC Operations Senior Manager as required on issues relating to operational delivery.

Ensure effective communication within the CHC process, including delegation of decision letters, supporting documentation and general correspondence

Ensure communication and all local review/appeals processes meet the required quality standard and assurance requirements to prevent challenge

Understand professional and personal role in relation to safeguarding processes and procedures in BOB and Local Authority Partners

Person Specification

Education /Qualifications

Essential

  • Educated to degree level in relevant subject or equivalent level qualification or significant experience of working at a similar level in specialist area
  • Current & relevant registration with professional body (NMC or HCPC)
  • Qualified healthcare professional (RN (adult), OT or PT)

Knowledge and Experience

Essential

  • Demonstrated experience of co- ordinating projects in complex and challenging environments.
  • Demonstrated experience in a Healthcare environment
  • Significant experience of successfully operating in a politically sensitive environment

Skills and Abilities

Essential

  • Ability to analyse very complex issues where material is conflicting and drawn from multiple sources.
  • Complex financial issues combined with deep analytical skills
  • Demonstrated capability to plan over short, medium and long-term timeframes and adjust plans and resource requirements accordingly.
Person Specification

Education /Qualifications

Essential

  • Educated to degree level in relevant subject or equivalent level qualification or significant experience of working at a similar level in specialist area
  • Current & relevant registration with professional body (NMC or HCPC)
  • Qualified healthcare professional (RN (adult), OT or PT)

Knowledge and Experience

Essential

  • Demonstrated experience of co- ordinating projects in complex and challenging environments.
  • Demonstrated experience in a Healthcare environment
  • Significant experience of successfully operating in a politically sensitive environment

Skills and Abilities

Essential

  • Ability to analyse very complex issues where material is conflicting and drawn from multiple sources.
  • Complex financial issues combined with deep analytical skills
  • Demonstrated capability to plan over short, medium and long-term timeframes and adjust plans and resource requirements accordingly.

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.

Employer details

Employer name

South West London Integrated Care Board

Address

SWL CHC (K&R) Team (930157) L4

120 The Broadway

London

SW19 1RH


Employer's website

https://www.southwestlondon.icb.nhs.uk (Opens in a new tab)

Employer details

Employer name

South West London Integrated Care Board

Address

SWL CHC (K&R) Team (930157) L4

120 The Broadway

London

SW19 1RH


Employer's website

https://www.southwestlondon.icb.nhs.uk (Opens in a new tab)

Employer contact details

For questions about the job, contact:

Deputy Director for CHC for Merton and Wandsworth

Parveen Brown

Parveen.brown@swlondon.nhs.uk

Details

Date posted

03 October 2024

Pay scheme

Agenda for change

Band

Band 8a

Salary

£59,490 to £66,239 a year Per Annum inclusive of Outer HCAS

Contract

Permanent

Working pattern

Full-time

Reference number

491-SWLCHC005-A

Job locations

SWL CHC (K&R) Team (930157) L4

120 The Broadway

London

SW19 1RH


Supporting documents

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