Remote Mental Health Practitioner - Home basedNHS

Job summary

This is a home based post

• Home based, you will work from your home in the UK, delivering consultations by telephone and video.
• UK only, you must live in the UK and carry out all work from within the UK.
• In person at the start, you must be willing to travel to MBPCC head office to collect your equipment and attend a face to face induction.
• Suitable environment, you must have a private, secure and suitable space to work from, with reliable broadband.
• Audit and monitoring, your home working arrangements, records and information governance compliance will be audited and monitored.

The Mental Health Practitioner is the Enable team's specialist for working age adults whose mental health affects their ability to work. Working from home, you will see patients referred through Enable triage by telephone and video, assess their mental health, risk and work situation, and agree a time limited, work focused plan that supports them to stay in or return to work.

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You will also be the team's source of mental health expertise. You will advise and upskill colleagues completing workability plans, and help shape how the pilot manages mental health presentations. This is a primary care, early intervention role; it is not a crisis or secondary care service. Patients needing longer term or specialist treatment are referred on through agreed pathways.

Main duties of the job

• Carry out holistic bio psychosocial assessments of adults referred with common mental health problems for example anxiety, depression and work related stress by telephone or video.
• At the start of every remote consultation, confirm the patient's identity, current location and a contact number, so that urgent help can be directed to them if needed.
• Complete a structured risk assessment at every contact. Escalate urgent risk the same day through the crisis, safeguarding and GP pathways, and record the decision and rationale.
• Agree a time limited, work focused plan with each patient, typically an assessment and up to three follow up contacts. Draw on evidence based approaches such as motivational interviewing, behavioural activation, problem solving, guided self help and graded return to work.
• Use validated outcome measures at agreed points, PHQ-9, GAD-7 and the Work and Social Adjustment Scale to track progress and inform decisions.
• Refer or signpost to NHS Talking Therapies including employment advisers, community mental health teams, Access to Work, the Enable Social Prescriber and voluntary sector services, and follow up that the referral was received.
• The post holder is not expected to independently request diagnostic investigations unless specifically authorised through professional registration, local policy and competency assessment.

Job description

Key responsibilities

Clinical assessment and intervention

• Carry out holistic bio psychosocial assessments of adults referred with common mental health problems for example anxiety, depression and work-related stress by telephone or video.
• At the start of every remote consultation, confirm the patient's identity, current location and a contact number, so that urgent help can be directed to them if needed.
• Complete a structured risk assessment at every contact. Escalate urgent risk the same day through the crisis, safeguarding and GP pathways, and record the decision and rationale.
• Agree a time limited, work focused plan with each patient, typically an assessment and up to three follow up contacts. Draw on evidence based approaches such as motivational interviewing, behavioural activation, problem solving, guided self help and graded return to work.
• Use validated outcome measures at agreed points PHQ 9, GAD 7 and the Work and Social Adjustment Scale to track progress and inform decisions.
• Refer or signpost to NHS Talking Therapies including employment advisers, community mental health teams, Access to Work, the Enable Social Prescriber and voluntary sector services, and follow up that the referral was received.
• Provide clear, concise feedback to the referring clinician and the patient's GP, including any recommendations on medication for the prescriber to consider.
• The post holder is not expected to independently request diagnostic investigations unless specifically authorised through professional registration, local policy and competency assessment. Where investigations are indicated, recommendations will be communicated to the patient's GP or an appropriately authorised clinician for consideration.
• Work within the limits of your professional competence and seek advice from the Enable Clinical Lead where required.

Work and health

• Complete workability assessments and workability plans for patients whose main barrier to work is their mental health, within the standard appointment time.
• Demonstrable ability to build therapeutic rapport and undertake comprehensive mental health assessments via telephone and video consultation.
• Identify workplace factors that affect mental health, using recognised frameworks such as the HSE Management Standards, and recommend practical adjustments, phased return, amended hours or duties, workplace adaptations.
• With the patients explicit agreement only, communicate with employers by telephone, video or in writing to support adjustments and a sustainable return to work.
• Where your registration permits and once signed off as competent by the Clinical Lead, assess fitness for work and issue fit notes in line with DWP guidance. Registered Mental Health Nurses and Occupational Therapists are legally able to certify fit notes.
• Meet the service turnaround standards for fit notes and workability plans, raising early any capacity pressures that put them at risk.

Multidisciplinary working and advice

• Act as the mental health lead within the Enable team, giving same day advice by Teams or telephone to Occupational Health Nurses, the ANP and other colleagues on mental health presentations and risk.
• Take part in virtual multidisciplinary case discussions and present complex cases.
• Develop and deliver short virtual training sessions for the team on mental health, risk and work focused conversations.
• Build working relationships with local mental health services, NHS Talking Therapies, the participating practices and voluntary sector partners so that referral routes in and out of Enable are clear.

Records, data and governance

• Keep accurate, contemporaneous clinical records in EMIS, using the agreed Enable templates and codes, and use AccuRx and Florey questionnaires as the service requires.
• Record the data items needed for the DWP evaluation fully and on time. Data accuracy is a condition of the pilot's funding.
• Check that each patient's consent and eligibility for the service and for DWP data sharing are in place before completing a workability plan, and follow the Enable privacy notice.
• Report incidents, near misses and safeguarding concerns through MBPCC processes, and take part in audit, case review and service evaluation.

Service development

• Help design and refine the Enable mental health pathway, including triage criteria, referral thresholds and escalation routes, as the pilot moves from the first two practices to all practices in both PCNs.
• Feed patient experience and clinical learning into pilot meetings and DWP reporting.
• Contribute to written protocols, patient information and the final pilot evaluation.
• Ability to contribute to pathway design, quality improvement, audit and service evaluation within a test and learn environment.

Professional development

• Maintain professional registration and meet NMC standards and revalidation requirements.
• Attend monthly clinical supervision, delivered virtually and annual appraisal, and use reflective practice to improve your work.
• Complete MBPCC mandatory training and the DWP fit note training for healthcare professionals.

Working arrangements

Contract and hours

• This is a fixed term post funded through the national pilot. Continuation beyond the pilot period cannot be guaranteed and is subject to national decisions on the future of the model.
• The post holder will be expected to work in a rapidly evolving service where processes, systems and documentation change during the pilot period.

This is a home based post. MBPCC's Homeworking, Hybrid Working and Remote Learning Guidance applies in full, and the post holder remains subject to the same professional, contractual, governance and performance expectations as staff working from MBPCC premises.

Location and in-person attendance

• Live in the UK and carry out all work from a UK address for the duration of employment. Working from outside the UK is not permitted.
• Deliver patient consultations remotely by telephone and video, using MBPCC approved systems only.
• Travel to MBPCC head office at the start of employment to collect MBPCC equipment and to attend a face to face induction.
• Attend MBPCC head office again where equipment needs to be collected, exchanged or returned, including at the end of employment.

Suitable home working environment

• Have a suitable, dedicated workspace that supports concentration, minimises distractions and enables professional communication.
• Ensure consultations and confidential conversations cannot be overheard, and that screens cannot be seen by family members, visitors or anyone else not authorised to view them.
• Have a suitable desk or workstation, appropriate seating, adequate lighting, ventilation and heating, and reliable internet access sufficient for video consultations and clinical systems.
• Use a headset whenever patient or confidential information is being discussed, and use the MBPCC background on video calls.
• Complete the MBPCC Homeworking Self Assessment, including display screen equipment and sign the Employee Homeworking Agreement before starting, and tell your manager of any significant change to your home working arrangements.
• Home working is not a replacement for childcare or dependant care arrangements. Where caring responsibilities affect your ability to work, discuss this with your manager.

Information governance and cyber security

• Use only MBPCC issued devices, organisational accounts and approved systems and video conferencing platforms. Do not store confidential information on personal or unapproved systems.
• Lock screens when away from the workstation, keep passwords, smartcards and fingerprint access to yourself, and do not allow anyone else to use MBPCC devices or systems.
• Verify who is present before discussing confidential information, share only the minimum necessary, and keep patient identifiable information out of chat functions unless clinically necessary and authorised.
• Do not record, screenshot or photograph consultations, meetings or training unless this has been authorised. Do not join patient related calls from public places.
• Secure and dispose of any paper records using approved methods, and report any information governance or cyber security incident immediately.

Audit and monitoring

Because this post involves remote access to patient identifiable clinical information, enhanced governance controls apply. The post holder will be subject to audit and monitoring, including:

• Periodic information governance audits and an annual information governance review.
• Verification that the home working environment is, and remains, secure and suitable.
• Asset and equipment audits, at least annually. MBPCC equipment remains organisational property and must be cared for, faults reported promptly and items returned when requested.
• Compliance monitoring of mandatory training, information governance and cyber security training.
• Monitoring of availability, activity and performance against service standards, through one to ones, work plans, activity schedules, supervision and clinical audit.
• Quarterly one to one and wellbeing reviews, and an annual review of the home working arrangement.

Failure to meet these requirements may be managed under MBPCC's disciplinary, information governance and data protection procedures.

Availability, communication and wellbeing

• Work contracted hours, be visible and contactable during agreed working times, keep your electronic calendar up to date and respond to communications promptly.
• Attend virtual team meetings, huddles, multidisciplinary discussions, supervision and training punctually and in full. Training during working hours is working time and must not be combined with caring or domestic tasks.
• Follow the MBPCC Lone Working Guidance and use agreed routes, Teams or telephone, to escalate clinical risk to the Clinical Lead or Advanced Nurse Practitioner without delay.

About us

Enable is one of four national pilots funded by the Department for Work and Pensions, DWP to test a better fit note process, and it is the most clinical of the four. MBPCC delivers it under an NHS contract across the Barrow and Mid Furness Primary Care Networks.

For participating practices, every fit note is issued by the multidisciplinary Enable service rather than the GP practice. There is no change to fit note legislation, so every patient still needs a valid, signed fit note. Working patients who agree to take part receive a workability assessment and a personalised workability plan that focuses on what they can do and how to stay in, or return to, work. Employers are contacted only with the patient's explicit agreement. The pilot generates data and learning for the DWP to shape future national policy.

The service uses EMIS, AccuRx, X-on Surgery Connect and Florey questionnaires. This post is home based, consultations are delivered by telephone and video, and the post holder works with the Enable team through Microsoft Teams and the service's clinical systems.