Critical Care Outreach Lead Nurse

Critical Care Outreach Lead Nurse

Cromwell Hospital, London SW5 0TU

Permanent role

Salary:
Competitive + Bupa Benefits

Full Time - 37.5 hours a week

Shifts of 8am to 8.30pm & 8pm to 8.30am

Monday to Sunday

Any administrative duties associated with the role would be completed on a weekday

As the Critical Care Outreach Lead Nurse, you will provide advanced clinical, professional and operational leadership for the hospital-wide Critical Care Outreach Service. You will lead the early recognition, assessment, stabilisation and escalation of adults who are deteriorating, at risk of critical illness or recovering after critical care, while strengthening ward capability through education, coaching, governance and quality improvement. The role combines autonomous expert practice with service leadership.

You'll be expected to practise within demonstrated competence, professional regulation, approved pathways and local clinical governance arrangements.

• Undertake prompt, structured and holistic assessment of acutely unwell adults, integrating physiological observations, NEWS2, history, examination, investigations, frailty, comorbidity, medicines, mental capacity, patient preferences and clinical trajectory.
• Use advanced clinical reasoning to identify actual or potential organ dysfunction, determine urgency, initiate immediate supportive care within competence and elevate for senior medical review without delay.
• Recommend and, where authorised and competent, initiate investigations and interventions under approved pathways, including blood gas sampling, venous access, 12-lead ECG, oxygen therapy, fluid management, enhanced monitoring and basic airway support.
• Recognise when emergency pathways take precedence and activate the appropriate resuscitation, medical emergency or emergency response process.
• Assess hospital-wide outreach workload and risk, prioritise activity and allocate team resources safely across simultaneous referrals and operational pressures.
• Analyse team capability, competence and skill mix when making deployment decisions, and elevate any inability to provide a safe service.
• Set clear shift and service priorities, maintain situational awareness and proactively manage emerging clinical, workforce and resource challenges.
• Lead the hospital safety huddles at 09:15 and 21:15, ensuring patients of concern, team allocation, escalation status, operational risks, actions and responsible leads are recorded and communicated.
• Lead day‑time delivery of the Outreach Service, including rota coordination, leave planning, staffing review and response to changes in demand and acuity.
• Ensure each shift has an appropriate level of critical care and outreach competence and that contingency arrangements are risk assessed, documented and escalated.
• Lead recruitment, induction, probation, appraisal, objective setting, clinical supervision, wellbeing support, attendance management and professional development for direct reports
• Provide professional leadership for clinical governance, patient safety and quality assurance across the Outreach Service.
• Lead the development and review of outreach, deteriorating‑patient, escalation and post‑critical‑care pathways, policies and standard operating procedures.
• Ensure incidents, near misses, complaints, concerns and emerging risks are reported, reviewed and escalated through the appropriate hospital systems
• Communicate clearly and compassionately with patients and families, recognising individual communication, cultural, spiritual and accessibility needs.
• Listen to and act on patient and family concerns about deterioration and ensure they understand escalation routes and agreed care plans.

• Registered Adult…