Responsible to:                 Senior Federated Services Manager
Location:                             Sunderland Primary Care Networks /Neighbourhood Integrated Teams
Contract Type:                  Permanent
Hours:                                   Full-time 37.5 per week but applications for part time will be considered
Salary:                                  £49,728.00 - £51,800.00 dependent upon experience

Benefits include:

·         NHS pension scheme

·         33 days holiday plus bank holidays,

·         Working hours aligned to core General Practice hours

·         Lease car scheme

·         Cycle to work scheme

Are you ready to be at the forefront of addressing the challenges posed by our frail and ageing population and make a lasting impact on the NHS?

We are seeking a dedicated and passionate Frailty Community Specialise Nurse to join our dynamic team and work closely with Primary Care Networks, integrating with the wider community nursing teams.  As a Frailty Nurse, you will play a vital role in improving patient outcomes and shaping the future of healthcare provided to our ageing population.

Frailty is a long-term condition and a clinically recognised state of increased vulnerability among older adults.  With an increasingly ageing population, Primary Care Networks and Sunderland Community Nursing Teams are joining forces to develop an integrated frailty team.

Advanced communication, problem-solving and decision-making skills will be used to assess and provide on-going patient care.  Working within local and nationally agreed protocols and guidelines, the Frailty Nurse exercises independent judgement to assess, investigate, diagnose, plan, implement and evaluate the clinical care and management of community patients.

The post holder will be part of a team that leads non-medical models of care across primary and community-based settings, including care homes and within community teams.  The Frailty Nurse will play a crucial role in step up, step down and proactive care through timely assessment, referral, responsive intervention and care planning.

Working as part of a community-based nursing team and closely aligned to Primary Care Networks and General Practice, the successful candidate will be key in leading and delivering the pro-active, personalised care required to patients living with frailty, nurturing collaborative working across Health and Social care to maximise the opportunity for timely identification of frailty in older patients.

Brief Responsibilities:

• Collaborate with Primary Care Networks and a diverse multidisciplinary team to develop and implement comprehensive care plans for frail patients.
• Work closely with the wider Frailty Team such as the Frailty Advanced Clinical Practitioners, Community Frailty Team, Social Prescribing , Social Workers and General Practice Teams
• Conduct thorough geriatric assessments to identify the unique physical, cognitive, and psychosocial needs of the ageing population.
• Provide expert clinical assessment and management of complex medical conditions associated with frailty, including falls, polypharmacy, and cognitive impairment.
• Support the development of and implement innovative strategies to optimise care and enhance the well-being of frail patients, all while considering the impact on the NHS.

·         Support primary care practices in identifying and managing patients at risk of frailty, and proactively intervene to prevent complications, playing a lead role in the MDT focussing on ageing well and frailty

·         Foster effective communication and coordination between primary care, community services, and secondary care services to ensure seamless patient care.

Please find attached the job description & person specification.

For information enquiries, please contact Victoria Muller, Senior Federated Services Manager on victoria.muller@nhs.net  or 07852 828211

·         Deadline for applications: 5pm, Monday 5^th January 2026

·         Interview Date TBC

Note: Only shortlisted candidates will be contacted for an interview.

Together, let's make a difference in the lives of our ageing population and shape the future of healthcare in the NHS.