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Job overview

The post holder will have a lead role with respect to NHS Continuing Healthcare (CHC) appeals and retrospective reviews. The role will involve the review of relevant health and social care records, coordination of meetings with families/solicitors and the completion of eligibility reviews that includes outcome letters/reports.

Previously unsuccessful applicants should not apply. 

Main duties of the job

• Provide clinical expertise for CHC Appeals, and retrospective reviews.
• Ensure the National Framework and local processes have been robustly applied within the dispute and retrospective review process, with evidence to support CHC eligibility recommendations and decision making.
• Co-ordinate and Chair both local resolution and retrospective claim meetings and provide the expert clinical CHC advice at the meetings where patients/families have disputed decisions or requested back dated reviews of eligibility.
• Attend regular clinical supervision with Line manager.
• Line manage and support clinicians and administrators working in the appeal/retrospective team.
• Support Line manager in representing Lancashire and South Cumbria Integrated Care Board (ICB) at local and regional meetings about CHC appeals or retrospective claims.
• Attend (to present and defend) CHC cases at NHS England's 'Independent Review Panels' on behalf of the ICB.
• Support Line Manager to review CHC appeals and retrospective review processes to identify any opportunities to improve pathways as appropriate to enhance quality and effectiveness.

Working for our organisation

• Adhere to and uphold the ICB’s vision and values.
• Observe the provisions of and adhere to all ICB policies and procedures.
• Complete ICB Statutory and Mandatory training as required and any other training courses relevant to the post.
• Abide by the ICB’s commitment that all staff will be treated with respect by management, colleagues, patients and visitors and equally staff will treat management, colleagues, patients and visitors with the same level of respect. Staff will be supported to challenge any discriminatory behaviour that may be based on differences in race, disability, language, culture, religion, sexuality, age, and gender or employment status.
• Adhere to relevant Code of Practice of Professional body (if appropriate).
• The post holder must be flexible in the duties performed and it is expected that similar duties, not specifically listed above, will be carried out as required and may be cross site.