All-Age Complex and Continuing Care are a team of clinical, business, commissioning specialists who provide continuing healthcare (CHC) children and young people’s continuing care (CYPCC) and complex care commissioning to individuals across the Thames Valley footprint.
Our operating model has three main areas of activity,
Neighbourhood teams work alongside health and social care partners within the community assessing, reviewing and case managing care for adults and children within Oxford, Buckinghamshire or Berkshire, working directly with individuals and families.
Central services teams act as the front door and end to end service delivery, managing referrals into the service, business, administration and invoicing functions. Working closely with individuals and their families.
Commissioning Contracting and Brokerage team work closely with care providers and social care to commission individualised care for individuals.
The post holder will act as the Complex Care Manager for individualised commissioning outside of CHC and CYPCC, having responsibility for the clinical case management and oversight of:
- Delegated Health Care Tasks
- Interim Health Funding
- Acquired Brain Injury and Neurological Rehabilitation
- Complex Care assessments and reviews
- Care Planning/Clinical Commissioning
- Children in transition to adult services with complex needs
The role will require travel on occasions; Access to transport is therefore necessary, be it personal or public.
Please note it is proposed that this post will be in scope to transfer to Frimley Health NHS Foundation Trust (FHFT) on the 1 September 2026. If you are appointed prior to 1 September 2026, you will join Thames Valley ICB initially, but it is proposed that your employment will then transfer to FHFT in accordance with TUPE/ CoSOP regulations. If your start date is on or after the 1 September 2026 it is planned that you will be employed directly by FHFT from commencement.
- To work as part of a complex care team with close working alongside the CHC and CYPCC services.
- To provide direction to and maintain clear oversight of complex care individualised commissioning functions.
- To work alongside commissioners to identify themes and pathways for individuals to ensure the appropriate funding routes are explored and developed for individualised commissioning.
- To be part of eligibility validation and decision-making panels as required.
- To undertake the role of Clinical Case Manager for a cohort of individuals and lead the assessment and reviews process, ensuring the most effective care pathway for the individual and the organisation, whilst considering Personal Health Budgets (PHBs) and clinical case management.
- To ensure that a consistent approach is adopted in relation to applying the funding criteria for indvidulised commissioning, applying expert and highly specialist knowledge to all stakeholders.
- To prioritise individuals who may be cared for in a range of settings such as at home, hospice, community hospitals, care homes (residential / nursing) and specialist out of area placements.
- To facilitate the assessment and decision-making process for people referred to the ICB for individual commissioning.
- To be responsible for processes regarding care planning, case management, and reviews, ensuring patients' care pathways are suitable.
- To undertake audit relating and service improvement initiatives for all AACC workstreams
- To work as appropriate with the children’s continuing care team around appropriate transition cases within a time frame as described in various frameworks.
- To liaise and address concerns raised by patients and their representatives regarding the application of individualised commissioning funding.
- To work closely with commissioners of care providing clinical and quality assurance oversight to care packages.
- Assist the AACC Senior Leadership team to inform and respond to complaints.
Project Management
Contribute to performance improvement, taking a lead for identified areas where agreed.
Provide coordination of and participate in relevant internal and external working groups and provide project advice, expertise and support as requested.
Provide relevant and timely specialist advice and guidance on own portfolio of projects/function
Work with members of the Team to investigate the causes of any variance from target/plan and proactively contribute to the implementation of solutions.
Management of a risk and issues tracking mechanism and its proactive resolution and escalation processes.
Financial and Physical Resources
Provide regular reporting on the targeting of resources and monitoring their implementation from a value for money perspective.
Provide oversight and monitoring of all aspects of team budgets
Evaluate projects/function within identified portfolio for delivery against financial recovery/savings plans through providing sophisticated, high quality project analysis.
Management
Take a lead in the coordination of training, development, and recruitment activities across the team.
Manage colleagues, including undertaking appraisals, recruitment and induction processes, and progressing any informal and formal processes as necessary e.g. disciplinary or capability issues.
Information Management
Devise and provide improvements to current management information, analyzing, reporting and suggesting procedures to enhance decision making processes.
Ensure timely and accurate information analysis and reporting to management on agreed areas of work.
Research and Development
Contribute to the development of key performance indicators for the successful assessment of individual and workstream success.
Delegate aspects of research and development activities, collating information, analysing and reporting findings.
Planning and Organisation
Contribute to the strategic planning of team projects, identifying interdependencies across projects/functions, potential impacts on wider organisation, resource requirements and building in contingency and adjustments as necessary.
Contribute to the development of performance and governance strategies and the development and implementation of improvement programmes, in accordance with ICB and regional priorities.
Contribute to short, medium and long-term business plans, achieving quality outcomes.
Policy and Service Development
Contribute to the review and development of existing information management systems and contribute to the development of an integrated approach to service or initiative management.
Develop policies and procedures in own work function with an impact on the wider organisation, as required.
The job description is an outline of the tasks, responsibilities and outcomes required of the role. The postholder will carry out any other duties as may reasonably be required by their line manager. The job description will be reviewed on a regular basis in accordance with the changing needs of the department and the organisation.
