Divisional Governance Lead (FIXED TERM 6 MONTHS)

Job overview

We are seeking an experience nurse/ registered practitioner to support the medical division with governance. The general and specialist Medical division is a busy division with eleven inpatient wards, four ambulatory units/ services  and a busy outpatient delivery service.

The person will support the governance framework and patient experience for the division alongside the leadership and ward teams.

the post is currently being offered as a six month fixed term contract and we welcome interested individuals to get in contact with either Janet McAuley Divisional Chief Nurse  01932 72190 or [email protected] or Emma Reed  Head of Nursing on 07729 079906

Main duties of the job

Take a lead in the Quality  Governance Assurance Framework ensuring that the quality of care in the division, patient experience, patient safety and clinical effectiveness is of the highest standard, meeting national and local outcomes

Provide information relating to the divisional compliance with CQC ensuring that Health Assure is updated in a timely way

Ensure that the Quality, Safety and Risk Management  Framework is embedded in the division

Co-ordinate clinical and non-clinical risk management activities across the division

To report regularly and liaise with Divisional Chief Nurse and Associate Director of Nursing on developments within the division and organisation, learning from incidents, risk management, audit and in-service education

To monitor incidents/events recorded via the Trust reporting system relating to the division in order to co-ordinate and communicate actions taken locally and disseminate appropriately any issues that could promote organisational learning

Prepare reports for discussion relating to the division

To keep abreast of the National Agenda in regards to Patient Safety.  Ensure dissemination of the Patient Safety Alerts from the NPSA and co-ordinate the responses to ensure that appropriate action plans are in place and actione

Take a lead on co-ordinating  Patient Experience , PALs and complaints

Detailed job description and main responsibilities

Internally the post holder will develop effective working relationships with:

• Clinicians and Nursing Staff
• Admin & Clerical Staff
• Quality Department
• MAIN DUTIES AND RESPONSIBILITIES OF THE POST:

Quality Responsibilities:

• In conjunction with the Divisional Chief Nurse, Head of Nursing, Matrons , Lead Nurse for Stroke, Associate Director Operations and Divisional Director assess and review compliance with governance and CQC standards.
• Lead and maintain the PSIRF dashboards and co-ordinate the investigative process supporting wards and leadership team to carry out appropriate meetings.
• Lead on closing and supporting actions and learning across the division
• Identify and cascade to senior leadership team any immediate risk or actions which occur as part of the incident reporting system
• Support the completion of Duty of Candour statutory letters through the division
• In conjunction with the Divisional Chief Nurse, Head of Nursing, Matrons, Lead Nurse for Stroke, Associate Director Operations and Divisional Director take responsibility for tracking all complaints relating to the division
• In conjunction with the Divisional Chief Nurse and Patient Experience Team

assist with investigation and actions as a result of complaints

• Contribute to the development of effective strategies, policies and processes across the Division
• Develop and implement systems to identify opportunities for learning and sharing good practice creating learning opportunities for the division
• Work with senior clinicians to monitor the implementation of NICE guidelines, National Service Frameworks and NCEPOD recommendations
• Support report writing for EPSIP meetings and governance meetings
• Work with all divisional teams to ensure speciality governance meetings are taking place and feed into the divisional governance meetings
• Monitor PSIRF training and compliance

Risk Management responsibilities:

• In conjunction with the leadership team, be responsible for delivering the Quality, Safety and Risk Management Strategy
• Lead and collate the evidence/information required from the division regarding the NHSLA risk management standards
• Be responsible for following up any events causing concern with the appropriate nurse/clinician
• Take the lead in reporting incident events to the Divisional Governance Group, contributing to any action planning as a result of an event and supporting staff to implement the identified actions
• Advise and support staff to undertake Root Cause Analysis Training – investigation process
• Facilitate a proactive approach to risk management through support of risk assessment process in helping to populate the Trust risk register and ensuring regular reviews and updates are maintained
• Ensure recommended action is taken as a result of risk management investigations

Education responsibilities:

• Take a lead role in the provision of governance training within the division
• To ensure all staff are aware of their governance responsibilities
• Oversee achievement of the Trust’s mandatory training requirement across the division
• Work with teams to ensure compliance with incident reporting is taking place and support with any educational needs that may arise
• Ensure all learning and actions are being discussed and disseminated from floor to Board

Audit Responsibilities:

• Work in conjunction with a designated group of clinicians and specialist nurses to make recommendations designed to eliminate or reduce risk and help facilitate the identified changes in practice
• To foster and encourage an environment of clinical audit, acting as a facilitator for audits in conjunction with the clinical leads across the Division
• Take the lead on producing reports for the local governance and quality meetings
• Work with the divisional team to ensure CENARG audits and guidelines are reviewed

Professional Responsibilities:

• Maintain own professional registration
• Act as a role model, maintaining and upholding high standards of professional behaviour
• Be an effective leader of change, embedding a culture of continuous quality improvement, innovation and use of technology that meets the changing needs of patients
• Maintain a flexible approach to working

General responsibilities

• To support the department and organisation by carrying out any other duties that reasonably fit within the broad scope of a job of this grade and type of work.