As part of a multidisciplinary community and outreach team, and in liaison with acute HIV services across North West London, the HIV Re-engagement Clinical Nurse Specialist will enhance the provision of care to people living with HIV who are currently out of care .
The post holder will work within a partnership-led, community-based re-engagement model , delivering a “hospital without walls” approach. This includes working closely with peer support organisations, VCSO partners, the Find and Treat team, primary care, public health and specialist services to identify, trace, engage and re-engage individuals into HIV care .
The role will empower individuals to re-enter and remain in care, addressing clinical, psychological and social needs, and support improved health outcomes, independence and quality of life.
In collaboration with the MDT, manage a caseload of individuals living with HIV who are out of care , including those with highly complex needs.
Work autonomously to assess, plan, implement and evaluate care , including clinical assessment, blood testing and ART initiation/re-initiation within scope of practice.
Deliver care in non-traditional settings , including homes, hostels and community venues, ensuring accessibility and flexibility.
Undertake holistic assessments , including physical, psychological and social needs, addressing wider determinants of health.
Provide specialist adherence support , including assessment of barriers and tailored interventions.
Act as a key contact and advocate for patients, supporting navigation across health and social care systems.
Work closely with peer navigators and VCSO partners to deliver wraparound, person-centred care .
Participate in MDT reviews
Provide advice on treatment, side effects and lifestyle factors impacting care.
Liaise with acute and community services to facilitate rapid access to care and prevent hospital admissions .
Identify safeguarding concerns and act in accordance with policy.
Maintain accurate and timely documentation to support continuity of care and data reporting.
Promote inter-agency collaboration and appropriate referrals to statutory and voluntary services.
Act as an advocate for individuals experiencing stigma, discrimination or barriers to care.
Participate in Clinical Supervision as required
Our Trust is one of England's top-performing and safest trusts. We operate two main acute hospital sites—Chelsea and Westminster Hospital and West Middlesex University Hospital—along with award-winning clinics across North West London.
Our nearly 7,500 staff care for a diverse population of 1.5m, providing full clinical services including maternity, A&E and children’s services, plus specialist HIV and sexual health care. The CQC rates us Good in safety, effectiveness, care and responsiveness, and Outstanding in leadership and resource use.
We continually invest in our facilities, including a £30m expansion of critical care at Chelsea and an £80m Ambulatory Diagnostic Centre at West Mid.
We are delivering sustainable healthcare through our Green Plan. In line with Greener NHS ambitions, we aim for net zero carbon emissions by 2045. Achieving this requires collective effort. We encourage staff to reduce their impact on carbon, waste and pollution wherever possible. Every action counts to create a healthier, more sustainable future.
We are committed to equal opportunities and believe diversity drives innovation and excellence. We welcome applications from the global majority, veterans and underrepresented communities, valuing the perspectives they bring.
If you haven’t heard from us within 3 weeks of the closing date, your application was likely unsuccessful. Employment is subject to a six-month probation. Some roles may require weekend shifts at multiple sites.
In collaboration with the MDT, manage a caseload of individuals living with HIV who are out of care , including those with highly complex needs.
Work autonomously to assess, plan, implement and evaluate care , including clinical assessment, blood testing and ART initiation/re-initiation within scope of practice.
Deliver care in non-traditional settings , including homes, hostels and community venues, ensuring accessibility and flexibility.
Undertake holistic assessments , including physical, psychological and social needs, addressing wider determinants of health.
Provide specialist adherence support , including assessment of barriers and tailored interventions.
Act as a key contact and advocate for patients, supporting navigation across health and social care systems.
Work closely with peer navigators and VCSO partners to deliver wraparound, person-centred care .
Participate in MDT reviews to support case identification, triage and care planning .
Provide advice on treatment, side effects and lifestyle factors impacting care.
Liaise with acute and community services to facilitate rapid access to care and prevent hospital admissions .
Identify safeguarding concerns and act in accordance with policy.
Maintain accurate and timely documentation to support continuity of care and data reporting.
Promote inter-agency collaboration and appropriate referrals to statutory and voluntary services.
Act as an advocate for individuals experiencing stigma, discrimination or barriers to care.
Participate in Clinical Supervision as required
The post holder will contribute to delivery of the following programme outcomes:
Timely identification and engagement of individuals lost to care
Increased rates of re-engagement into HIV services
Rapid ART initiation and improved clinical outcomes (CD4/viral load)
Increased viral suppression at 6 and 12 months
Improved retention in care and reduced disengagement
Reduction in health inequalities and unmet social need
Improved patient wellbeing and experience
High-quality data capture, reporting and contribution to evaluation
Effective partnership working with peer and VCSO organisations
Educational Role
Identify and meet the educational needs of patients, carers and professionals.
Deliver training to primary care, community and VCSO partners to improve HIV knowledge and reduce stigma.
Support mentorship, supervision and development of junior staff and students.
Maintain own professional development in line with NMC requirements.
Audit & Research
Contribute to audit, evaluation and quality improvement initiatives related to re-engagement outcomes.
Support implementation of evidence-based practice.
Participate in data collection and reporting aligned to programme and commissioner requirements.
Maintain up-to-date knowledge of HIV care, outreach models and inclusion health.
Management Responsibilities
Contribute to the development and delivery of the re-engagement programme.
Participate in MDT meetings, governance structures and partnership forums.
Support service improvement, innovation and pathway development.
Contribute to activity reporting, data quality and performance monitoring.
Assist in development of policies, procedures and patient information.
Deputise for senior staff where appropriate.
General Responsibilities
The nature of this post is one of continual development and the duties and responsibilities outlined above may change to reflect service needs.
The post holder will be required to work flexibly across community settings and adhere to lone working and safety policies.
All duties must be carried out within Trust policies and professional scope of practice.
