D2A Therapist (OT/PT)
This is an exciting opportunity to join the Hillingdon Discharge to Assess (D2A) / Home First service, a forward-thinking community therapy team embedded within CNWL's Community Health Services.
The postholder will play a central role in supporting timely, safe, and effective discharge from acute hospitals by ensuring patients are assessed and supported in their own homes, in line with NHS England's Discharge to Assess model.
Working as part of an integrated multidisciplinary team (MDT), the Band 6 therapist will undertake comprehensive assessments of patients with complex and diverse presentations, deliver therapeutic interventions in the community, and coordinate care across health, social care, and third sector partners.
The service operates a Home First philosophy, patients are discharged at the earliest clinically appropriate point and assessed for their longer-term needs in their own environment, rather than in an acute bed.
The post holder will manage an autonomous caseload, contribute to the Transfer of Care Hub, and support admission avoidance for those patients who may otherwise deteriorate or require re-admission.
They will work within CNWL's core values of Compassion, Respect, Empowerment, and Partnership, and will be expected to demonstrate these values in all aspects of their practice.
Main duties of the job
Clinical & Therapeutic Responsibilities
- Undertake comprehensive, holistic assessments of patients with complex or diverse presentations in their own homes or usual place of residence.
Discharge Planning & MDT Working
- Collaborate with the acute Transfer of Care Hub and hospital MDT to facilitate timely, safe discharge under the NHS England D2A Pathway 1 framework.
Communication & Patient-Centred Care
- Communicate complex, sensitive, and emotionally challenging information clearly and compassionately to patients, carers, and families.
Professional Accountability & Governance
- Maintain full professional and legal accountability for own clinical practice and caseload, working within HCPC, CSP/RCOT codes of conduct.
Leadership, Supervision & Development
- Provide clinical supervision, support, and guidance to Band 5 therapists, therapy assistants, and student placements.
Continuing Professional Development
- Maintain and develop clinical expertise through reflective practice, self-directed learning, and engagement with current research relating to D2A and crisis response.
Working for our organisation
Central and North West London NHS Foundation Trust (CNWL) is one of the largest NHS trusts in the UK, serving a diverse population across London, the south east, and beyond.
We provide integrated health and social care services across a range of settings, including community, inpatient, primary care, and specialist services.
Hillingdon Community Health Services, delivered by CNWL, provides a broad range of community-based services to the residents of the London Borough of Hillingdon. Our UCR and Discharge to Assess service is at the forefront of system-wide efforts to transform urgent community care and reduce unnecessary hospital admissions and delays, working in close partnership with The Hillingdon Hospital NHS Foundation Trust, London Borough of Hillingdon Adult Social Care, and a range of primary care and voluntary sector partners.
Benefits
We are committed to the ongoing development of our staff. As a Band 6 therapist in our D2A team, you will benefit from:
- Regular clinical and managerial supervision from experienced Band 7 clinicians and the Team Lead
- An annual appraisal and a jointly agreed Personal Development Plan (PDP)
- Access to a range of CPD opportunities, including in-service training, peer supervision, and funded external training
- A supportive, collaborative multi-disciplinary team culture
- The opportunity to contribute to service development and quality improvement in a rapidly evolving area of NHS practice
Detailed Job Description And Main Responsibilities
- Be professionally and legally accountable for all aspects of one's own clinical practice, managing an autonomous caseload of Discharge to Assess patients from initial assessment through to safe discharge, ensuring a high standard of care at all times.
- Undertake comprehensive, holistic assessments of patients with complex and multi-pathology presentations in their own home, applying advanced clinical reasoning skills to formulate accurate diagnoses and individualised, evidence-based management plans.
- Work with the D2A / Home First service to support triage, manage patient care pathways, and share knowledge related to discharge to assess principles and admission avoidance strategies.
- Manage patients through the entirety of their care episode, including symptom management, therapeutic intervention, goal-setting, and discharge, working without direct supervision and providing peer support to MDT colleagues.
- Work autonomously and collaboratively within the MDT, liaising with primary and secondary care, Adult Social Care, social prescribers, and third sector organisations to ensure seamless, high-quality, coordinated care.
- Deliver a broad range of therapeutic interventions flexibly across community settings.
- Promote a holistic, person-centred approach that facilitates self-management, functional improvement, and recovery; acting as an advocate for the patient and signposting to relevant local and national support as appropriate.
- Demonstrate advanced communication skills including motivational interviewing and emotional support techniques, communicating complex and sensitive information clearly to patients, carers, families, and professionals.
- Recognise the signs and symptoms of a deteriorating patient and escalate appropriately in line with Trust and national protocols; carry out risk assessments and ensure all interventions are supported by the available evidence base.
- Keep up to date with current literature and developments in Discharge to Assess and crisis response, contributing to a culture of reflective practice, continuous improvement, and support for junior staff and students.
Qualifications
Essential criteria
- Diploma/degree in Physiotherapy OR diploma /degree in Occupational Therapy
- Registration with HCPC
- Membership of the Chartered Society of Physiotherapy OR Membership of the RCOT
Desirable criteria
- Attendance at recent postgraduate courses
- Evidence of CPD maintained in a portfolio
- Involvement in CSP Special Clinical Interest Groups OR RCOT Special Clinical Interest Groups
Knowledge & Experience
Essential criteria
- Must be able to provide evidence (through appraisals, competencies and reflection from postgraduate study) to demonstrate development of specialist knowledge
- Experience of community work
- Experience with patients with dementia and confusion
- Experience with patients with physical frailty and disability
- Knowledge of validated assessment tools and outcome measures
- Experience of student and therapy assistant supervision
- Specialist knowledge of a broad range of conditions. Experience of working as part of a therapy team and/or multidisciplinary team
Desirable criteria
- Extensive post-qualified experience in the profession, to include acute experience
- Experience in clinical service development.
- Experience in audit or measuring clinical effectiveness.
- Worked in Urgent Community Response or Discharge to assess service.
Skills
Essential criteria
- Excellent interpersonal facilitation, negotiating and communication (written and verbal) skills
- Good team player - Demonstrates initiating own learning and supporting colleagues in their learning.
- Evidence of ability to quickly gain and maintain credibility across the Trust and externally, with a wide range of professions
- Remain updated with professional and evidence-based practice and new research
- Understand the legal responsibilities of the profession
- To be competent in performing complex assessments and treatments with patients with a variety of conditions
- Demonstrates effective leadership skills
Desirable criteria
- Experience of participation in running internal/external courses and supervisory skills.
