Cwmtawe Cluster Network Complex Needs Service

The Provider will need to:Develop the Complex Needs Service across the Cwmtawe Cluster Network, identifying unmet need and bethe central point of contact for referrals to the service- work with individuals from primary care settings to undertake initial assessments. Identify and co-producemeaningful interventions to address identified issues with regard to domestic abuse, mental health and/orsubstance misuse- work with colleagues as an advocate for patients with complex needs across the Cwmtawe Cluster area toidentify and ensure all patients gave full and equitable access to help and support- using a 'Team Around the Family' approach, lead and broker staff in specialist roles and from partner organisations to ensure effective outcomes- to work with third sector providers and service commissioners to ensure that adequate qualityassurance/clinical governance/performance management systems are in place to underpin safe referralprocesses- to implement procedures for signposting and referral to third sector and partner organisations underpinnedby sound information sharing protocols- strengthen and develop links and pathways with other services including but not exclusively private sectorlandlords and specialist providers to increase collaborative working- work closely with local housing teams to ensure communications are clear and people who need help areidentified at the earliest opportunity- help people to maintain their independence, health and wellbeing through innovative interventions thatfully recognise and incorporate each person's strengths- to participate in multi-disciplinary team meetings and input into clinical reviews as deemed appropriate- to manage a budget which can be utilised to fund resources, community activities and therapeuticinterventions as identified- to maintain accurate records and produce regular reports to ensure effective monitoring procedures- to manage a case load