Senior Respiratory Physiotherapist Integrated Care

Overview The successful candidate will be part of the Integrated Respiratory Care team. In line with Sláintecare (2017) and the Department of Health's Capacity review (2018), a shift in healthcare service provision is now required to place the focus on integrated, person-centred care, based as close to home as possible. In order to enable this, the Integrated Care Programme for the Prevention and Management of Chronic Disease (ICPCD) is supporting the national implementation of a model of integrated care for the prevention and management of chronic disease as part of the Enhanced Community Care Programme (ECC). The Model of Care for the Integrated Prevention and Management of Chronic Disease has a particular focus on preventive healthcare, early intervention and the provision of supports to live well with chronic disease. The investment in the ECC programme will be delivered on a phased basis with a view to national coverage being achieved within a two- to three-year period. Three priority areas have been identified as follows:

1. Structural reform of healthcare delivery within the community with Community Health Networks (CHNs) becoming the basic building blocks for the organisation, management and delivery of community services across the country;
2. Creating Specialist Ambulatory Care Hubs within the community to support primary care management of chronic disease and older people with complex needs;
3. Scaling Integrated Care for Older People and Chronic Disease through the recruitment of specialist integrated care teams including Frailty at the Front Door Teams.

The focus is on providing an end-to-end pathway that will reduce admissions to acute hospitals by providing access to diagnostics and specialist services in the ambulatory care hubs in a timely manner. For patients who require hospital admission, the emphasis is on minimising the hospital length of stay, with the provision of post-discharge follow up and support for people in the community and in their own homes, where required. A shared local governance structure across the local acute hospitals and the associated CHO will ensure the development of a fully integrated service and end-to-end pathway for individuals living with chronic disease. The ECC Programme is underpinned by a set of key principles including:

• Eighty percent of services delivered in Primary Care are through the GP and CHNs;
• Identifying and building health needs assessments at a CHN level (approximate population of 50,000) based on a population stratification approach to include identification of people with chronic disease and frequent service users, thereby ensuring the right people get the right service based on the complexity of their health care needs;
• Utilisation of a whole system approach to integrating care based on person centred models, while promoting self-care in the community;
• The Older Persons and Chronic Disease Service Models set out an end to end service architecture for the identification and management of frail older adults with complex care needs and people living with chronic disease;
• Learning from, and delivering services, based on best practice models and the extensive work of the integrated care clinical programmes to date, particularly in the areas of Older Persons and Chronic Disease;
• Embed preventive approach to chronic disease into all services;
• Availability of a timely response to early presentations of identified conditions and the ability to manage appropriate levels of complexity related to same in the community;
• Resources applied intensively in a targeted manner to a defined population, implementing best practice models of care to demonstrate the delivery of specific outcomes and sustainable services;
• The need to frontload investment, coupled with reform to strengthen community services.

Ambulatory care hubs are sites identified outside of the hospital setting that will provide access to specialist services within the community. Each hub will be affiliated with a local hospital and will serve a population of approximately 150,000 and will focus primarily on the prevention and management of chronic disease. These hubs will be established to support the provision of care closer to home and to facilitate ready access to diagnostics, specialist services and specialist opinions in order to enhance the delivery of patient-centred care, support early intervention and avoid hospital admission, where possible. A suite of alternative outpatient pathways, support from multidisciplinary Chronic Disease Specialist Teams and access to diagnostics including spirometry, radiology and laboratory testing will support the Respiratory Consultant's work within each hub and the provision of the right care, in the right place, at the right time. The Integrated Respiratory Service will support:

• A holistic, multidisciplinary approach to the care of individuals with chronic respiratory disease;
• Provision of a reformed outpatient service that utilises telehealth and other ICT measures to facilitate more effective and efficient delivery of care;
• Reduced waiting times for patients for hospital-based outpatient services;
• Timely access to specialist services and specialist opinion for patients with respiratory disease;
• Early intervention pathways/ rapid access clinics for acute, chronic or newly presenting respiratory conditions;
• Development of pathways for the management of chronic conditions. The early assessment and implementation of pathways that will support GP-led primary care, efficient discharge back to the community where appropriate and reduce the need for repeated hospital-based outpatient reviews;
• Provision of oversight and implementation of self-management support services for chronic respiratory disease, including pulmonary rehabilitation, in the ambulatory care hubs;
• Facilitating access and reporting of non-invasive respiratory testing e.g. spirometry for GPs;
• Providing improved integration of early discharge, outreach and potentially admission avoidance programmes;
• Overseeing oxygen assessment clinics.

The person appointed to this post will work in the overall respiratory service with 50% of time based in the acute setting and 50% of time based in community supporting the respiratory consultants as required. The post holder will work as part of a multidisciplinary team delivering coordinated evidence based care for respiratory patients. Please note a portion of the appointees work will be carried out "off site". This means that the appointee will travel to the hubs to perform duties related to the role. Please note more post specific information on services provided, team structures, possible future developments etc will be provided to candidates at the 'expression of interest' stage of the recruitment process. He/She will carry out clinical duties and educational duties as required, while developing the Physiotherapy service in line with National Clinical Care Programmes. The successful candidate will work with the Physiotherapy Manager/Consultants in ensuring the co-ordination, development and delivery of a quality, client centred physiotherapy service across all relevant clinical spheres. For any queries please contact Ciaran Browne, Physiotherapist Manager-In-Charge III at ciaran.brow Essential Criteria Candidates must have at the latest date of application:

1. Statutory Registration, Professional Qualifications, Experience, etc
   1. Candidate for appointment must hold, on closing date of application:
   2. Hold a Physiotherapy qualification recognised by the Physiotherapists Registration Board at CORU. Please see list of acceptable Physiotherapy qualifications:
2. AND
   1. Be registered on the Physiotherapists Register maintained by the Physiotherapists Registration Board at CORU.
3. OR
   1. Applicants who satisfy the conditions set out in Section 91 of the Health and Social Care Professionals Act 2005, must submit proof of application for registration with the Physiotherapists Registration Board at CORU. The acceptable proof is correspondence from the Physiotherapists Registration Board at CORU confirming their application for Registration as a Section 91 applicant.
4. Note: Section 91 candidates are individuals who qualified before 30 September 2016 and have been engaged in the practice of the profession in the Republic of Ireland for a minimum of 2 years fulltime (or an aggregate of 2 years fulltime), between 30th September 2011 and 30th September 2016 are considered to be Section 91 applicants under the Health and Social Care Professionals Act 2005.
5. AND
6. Candidates must have three years full time [or an aggregate of three years full time] post qualification clinical experience.
7. AND
8. All candidates must have the requisite knowledge and ability (including a high standard of suitability, management, leadership and professional ability) to fulfil the duties of the role.

• Annual Registration
  1. On appointment practitioners must maintain annual registration on Physiotherapists Register maintained by the Physiotherapists Registration Board at CORU.
  2. AND
  3. Practitioners must confirm annual registration with CORU to the HSE by way of the annual Patient Safety Assurance Certificate (PSAC).
• Post Specific Requirements
  1. Demonstrate experience in respiratory medicine/ respiratory care notably in adult chronic lung disease and COPD.
  2. Candidate must demonstrate evidence of formal CPD activity relevant to the clinical area of Respiratory Physiotherapy within the past three years.
  3. Candidate must be eligible to participate in week-end/on-call Orthopaedic & Respiratory service provision.
  4. Access to own transport as a significant portion of the appointees work will be carried out "off site". This means that the appointee will travel to the hubs to perform duties related to the role.

See relevant attachment Senior Respiratory Integrated Care Physiotherapist Job Specification Jan 2025#J-18808-Ljbffr