Job Description:

Critical Care Outreach Lead Nurse

Cromwell Hospital, London SW5 0TU

Permanent role

Salary: Competitive + Bupa Benefits

Full Time – 37.5 hours a week

Shifts of 8am to 8.30pm & 8pm to 8.30am

Monday to Sunday

Any administrative duties associated with the role would be completed on a weekday

As the Critical Care Outreach Lead Nurse, you will provide advanced clinical, professional and operational leadership for the hospital-wide Critical Care Outreach Service. You will lead the early recognition, assessment, stabilisation and escalation of adults who are deteriorating, at risk of critical illness or recovering after critical care, while strengthening ward capability through education, coaching, governance and quality improvement.

The role combines autonomous expert practice with service leadership. You’ll be expected to practise within demonstrated competence, professional regulation, approved pathways and local clinical governance arrangements.

What you'll do:

• Undertake prompt, structured and holistic assessment of acutely unwell adults, integrating physiological observations, NEWS2, history, examination, investigations, frailty, comorbidity, medicines, mental capacity, patient preferences and clinical trajectory.
• Use advanced clinical reasoning to identify actual or potential organ dysfunction, determine urgency, initiate immediate supportive care within competence and escalate for senior medical review without delay.
• Recommend and, where authorised and competent, initiate investigations and interventions under approved pathways, including blood gas sampling, venous access, 12-lead ECG, oxygen therapy, fluid management, enhanced monitoring and basic airway support.
• Recognise when emergency pathways take precedence and activate the appropriate resuscitation, medical emergency or emergency response process.
• Assess hospital-wide outreach workload and risk, prioritise activity and allocate team resources safely across simultaneous referrals and operational pressures.
• Analyse team capability, competence and skill mix when making deployment decisions, and escalate any inability to provide a safe service.
• Set clear shift and service priorities, maintain situational awareness and proactively manage emerging clinical, workforce and resource challenges.
• Lead the hospital safety huddles at 09:15 and 21:15, ensuring patients of concern, team allocation, escalation status, operational risks, actions and responsible leads are recorded and communicated.
• Lead day-to-day delivery of the Outreach Service, including rota coordination, leave planning, staffing review and response to changes in demand and acuity.
• Ensure each shift has an appropriate level of critical care and outreach competence and that contingency arrangements are risk assessed, documented and escalated.
• Lead recruitment, induction, probation, appraisal, objective setting, clinical supervision, wellbeing support, attendance management and professional development for direct reports
• Provide professional leadership for clinical governance, patient safety and quality assurance across the Outreach Service.
• Lead the development and review of outreach, deteriorating-patient, escalation and post-critical-care pathways, policies and standard operating procedures.
• Ensure incidents, near misses, complaints, concerns and emerging risks are reported, reviewed and escalated through the appropriate hospital systems
• Communicate clearly and compassionately with patients and families, recognising individual communication, cultural, spiritual and accessibility needs.
• Listen to and act on patient and family concerns about deterioration and ensure they understand escalation routes and agreed care plans.

Skills/ Experience/ Qualifications required:

• Registered Adult Nurse with current NMC registration.
• Recognised post-registration adult critical care qualification or documented equivalent competence.
• Completed CC3N Step 1, Step 2 and Step 3 competencies, or formally assessed equivalent competence.
• Completed CC3N Step 4 competencies, or a documented plan to complete within an agreed period following appointment where organisationally approved.
• Current Resuscitation Council UK Advanced Life Support provider status.
• Evidence of preparation for practice supervision, assessment and teaching
• Substantial recent adult critical care experience and recent experience in Critical Care Outreach or an equivalent deteriorating-patient service.
• Senior nurse, Sister or Charge Nurse experience with responsibility for clinical coordination and operational leadership.
• Evidence of advanced assessment and management of acutely unwell adults across specialty boundaries.
• Evidence of competence at the CCOP Enhanced Practice Level, or completion within an agreed supervised development plan before independent outreach practice.
• Experience of leading teams, managing staff, appraisals, supervision, recruitment and capability development.
• Experience of incident review, audit, risk management, policy development and quality improvement.
• Advanced knowledge of adult acute deterioration, organ dysfunction, resuscitation, escalation, critical care admission and discharge, rehabilitation and end-of-life principles.
• Knowledge of CC3N Step 4 leadership expectations and the CCOP Framework.
• Knowledge of GPICS V3, NOrF standards, NICE CG50, NEWS2 and current patient-safety escalation arrangements.
• Knowledge of the NMC Code, accountability, delegation, consent, capacity, safeguarding and duty of candour.
• Understanding of clinical governance, human factors, systems-based incident learning, audit and quality-improvement methods.
• Understanding of workforce planning, competency governance, data quality, digital safety and business continuity.

Benefits

Our benefits are designed to make health happen for our people. Viva is our global wellbeing programme and includes all aspects of our health – from mental and physical, to financial, social, and environmental wellbeing. We support flexible working and have a range of family friendly benefits.

Joining Bupa in this role you will receive the following benefits and more:

Equivalent to 25 days holiday per year, increasing through length of service, with option to buy or sell.

Bupa health insurance as a benefit in kind

An enhanced pension plan and life insurance

Support with travel costs via a season ticket loan or cycle2work

Discounted access to online gym sessions through Gympass

Various family friendly benefits

Free onsite massages as a recognition for your hard work

Opportunity to participate in our annual awards ceremony

Why Bupa? 

We’re a health insurer and provider. With no shareholders, our customers are our focus. Our people are all driven by the same purpose – helping people live longer, healthier, happier lives and making a better world. We make health happen by being brave, caring, and responsible in everything we do.

We encourage all our people to “Be you at Bupa”, we champion diversity, and we understand the importance of our people representing the communities and customers we serve. That’s why we especially encourage applications from people with diverse backgrounds and experiences.

Bupa is a Level 2 Disability Confident Employer. This means we aim to offer an interview/assessment to every disabled applicant who meets the minimum criteria for the role. We’ll make sure you are treated fairly and offer reasonable adjustments as part of our recruitment process to anyone that needs them. 

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