This is an exciting and innovative role which will involve working alongside community GPs, paramedics, pharmacists, district nurses, adult social care, voluntary organisations and community matrons to support the delivery of proactive healthcare and support to people living with frailty, multiple long‑term conditions and/or complex needs to help them stay independent and healthy for as long as possible at home.

• Take clinical responsibility for the patient and work collaboratively with all professionals, carers and relatives to gain a deep understanding of all aspects of the patient's physical, emotional and social situation.
• Conduct physical examination and detailed history taking, diagnosis and treatment planning.
• Develop a personalised care plan for the patient based on the full assessment of medical, nursing and care needs. This includes preventative measures and anticipation of future health needs.
• Plan, implement, monitor and review th...