Clinical Lead PUPoC & Appeals

Ensure the correct legislation is followed within service delivery. Understand the financial elements of contract delivery and work within constraints where needed whilst maintaining clinical safety and quality. Implement quality improvement programmes to ensure compliance and quality. Oversee quality, audit and sign off process to ensure it remains effective in maintaining expected standards of quality. High level overview of National Framework for NHS CHC, NHS FNC, PUPOC & relevant impacting legislation. Complete complex clinical triage across PUPoC-Appeals and highlight potential risks to customers and agree actions. Complete outcome letters where required on behalf of the customer giving decisions on eligibility supported by DST evidence including Four Key Characteristics. Attend Customer meetings as agreed at mobilisation and provide clinical support in risks, process and delivery in line with NHS CHC Framework/PUPOC guidance. Lead in mobilisation of new contracts for PUPoC and
Appeals. Play an active part in ensuring business retention across all PUPoC-Appeal contracts. Support Head of Clinical Operations in the recruitment of Clinicians for Retro/Appeals including selection/interviews/supervision. Lead in the clinical support and development to Clinical Team and admin support. Support staff ensuring quality is established/preserved. Oversee quality improvement programmes and monitor the effectiveness of current process. Safeguarding Service Users through the development & use of systematic processes, reporting & monitoring. Effectively manage incidents and complaints using internal systems. To maintain an awareness of new and updated guidance in NHS Continuing Healthcare in particular that applicable to Retros and Appeals.