PCN Frailty GPNHS

Job summary

We are seeking an experienced and enthusiastic General Practitioner to join our Frailty Hub on a locum contract for 1 to 2 sessions per week. This is an exciting opportunity to play a key role in delivering high-quality, proactive care for people living with frailty.

What we offer:

• Opportunity to shape and develop an innovative Frailty Hub service.
• Collaborative multidisciplinary working environment.
• Clinical support from an FHFT Consultant Geriatrician.
• Opportunity to make a meaningful difference to the lives of older people and their families.
• Professional development and continued learning opportunities.

Main duties of the job

The successful candidate will work collaboratively within a multidisciplinary team and alongside neighbourhood partners to improve outcomes for patients experiencing frailty, enabling them to maintain independence and remain safely at home wherever possible.

This innovative role is supported by a Frimley Health Foundation Trust (FHFT) Consultant Geriatrician and offers the opportunity to influence service development while delivering person-centred care to some of our most vulnerable patients.

Job description

• Provide proactive, patient-centred care for people living with frailty.
• Assess the healthcare needs of patients with complex and multiple long-term conditions.
• Undertake and contribute to Comprehensive Geriatric Assessments (CGAs).
• Lead and participate in advanced care planning and personalised care discussions.
• Offer clinical leadership, advice, and support to the wider Frailty Hub and multidisciplinary team.
• Provide clinical supervision, mentorship, and support to Physician Associates and other Additional Roles Reimbursement Scheme (ARRS) staff if and when required, ensuring safe, effective, and evidence-based practice.
• Work collaboratively with community services, secondary care colleagues, social care, voluntary sector organisations, and other neighbourhood partners.
• Support the coordination of care across organisational boundaries.
• Contribute to reducing avoidable hospital admissions and improving patient outcomes.
• Promote care approaches that enable patients to remain safely at home where clinically appropriate.
• Work closely with the FHFT Consultant Geriatrician to support best practice in frailty management.

Key Performance Indicators (KPIs)

The Frailty GP will contribute to achieving the following outcomes:

• Reduction in falls among the frail patient population through proactive assessment, intervention, and care coordination.
• Reduction in unplanned hospital admissions and emergency department attendances for patients living with frailty.
• Increase in advance care planning and RESPECT discussions, ensuring patients' wishes and preferences are documented and reviewed appropriately.
• Reduction in inappropriate polypharmacy, evidenced by regular structured medication reviews and deprescribing where clinically appropriate.

About us

9 Practices, 82,000 Patients

Maidenhead Primary Care Network (PCN) is a progressive healthcare organisation comprising nine practices serving 82,000 patients across Maidenhead. Operating as a limited company, we balance robust business management with healthcare excellence.