Nursing Associate, Dementia & Frailty

Job summary
Make a Real Difference to Older People in Sunderland

Are you a compassionate and motivated Registered Nursing Associate looking for a rewarding role where you can make a genuine impact on the lives of older people living with frailty and dementia?

Sunderland GP Alliance is seeking a dedicated Nursing Associate to join our Frailty Team, delivering holistic health checks and supporting some of the most vulnerable patients in our communities.

This is an exciting opportunity to work within an innovative multidisciplinary team, helping to identify health concerns early, improve patient outcomes, support carers and enable people to remain independent for longer.

Please note that if we receive a high volume of applications, we reserve the right to close this vacancy earlier than the advertised closing date.

Main duties of the job
As a Nursing Associate within our Dementia & Frailty Service, you will provide structured, person-centred health checks for patients living with frailty and dementia. Working closely with Advanced Nurse Practitioners, GPs, pharmacists and wider community services, you will play a key role in supporting proactive care and preventing avoidable deterioration.

You will manage a caseload of lower-risk frailty patients and undertake community-based assessments covering physical health, wellbeing, falls risk, nutrition, continence, medication adherence and overall quality of life.

This role provides the opportunity to build strong relationships with patients and carers whilst working as part of a supportive and experienced multidisciplinary team.

About us
Join an award-winning organisation. For the third consecutive year, Sunderland GP Alliance has been named in The Sunday Times Best Places to Work and holds the Better Health at Work Gold Award with Continuing Excellence status. In addition, we offer 33 days' annual leave and a comprehensive range of employee benefits.

Sunderland GP Alliance is a not-for-profit collaboration of GP practices in Sunderland.

All GP Practices in Sunderland are members of the organisation, covering approximately 285,000 patients.

The Alliance also runs three practices: Monument Surgeries, South Hylton and New Silksworth.

Details
Date posted: 16 September 2026
Pay scheme: Other
Salary: £30,470.40 a year
Pro-rata for part-time
Contract: Permanent
Working pattern: Full-time, Part-time
Reference number: U0012-26-0038
Job locations: North East BIC, Wearfield, Sunderland, Tyne and Wear, SR5 2TA, United Kingdom

Job responsibilities
Clinical assessment and care delivery

• Deliver dementia holistic health checks using agreed clinical templates within EMIS.
• Undertake physical health assessments including blood pressure, pulse, body mass index (BMI), falls risk, Malnutrition Universal Screening Tool (MUST) nutrition screening, pain and continence.
• Carry out Clinical Frailty Scale (CFS) reviews and accurately record findings.
• Undertake blood pressure, weight, urinalysis, non-urgent ECG and other agreed investigations, and venepuncture where trained and assessed as competent.
• Monitor and document mental health status, including mood, behaviour and signs of delirium, escalating concerns promptly.
• Identify risks related to medication, adherence and side effects and escalate appropriately.
• Undertake falls and continence assessments and contribute to risk stratification, prevention interventions and management plans.

Caseload management and care coordination

• Manage a caseload of lower-risk frailty patients previously assessed by the PCN frailty team, with diary and appointment support provided by that team.
• Provide follow-up visits for lower-risk frail patients as directed by the frailty team, supporting care planning, treatment compliance and review.
• Support medication reviews by checking compliance, adherence and the patient's understanding of medication changes.
• Chase and follow up clinical results, investigations, outstanding tasks and care plans.
• Monitor and follow up equipment requests and orders to ensure timely provision, and confirm that recommended equipment or adaptations are in place.
• Support patients to access services and interventions, helping to ensure appointments are attended and not missed.
• Make appropriate onward referrals and connect patients to appropriate services, including social prescribing and Age UK.

Safeguarding, consent and mental capacity

• Recognise and respond to safeguarding concerns for adults at risk, escalating and reporting in line with local safeguarding policy and the postholder's level of safeguarding training.
• Apply the principles of the Mental Capacity Act 2005, obtaining and recording valid consent and, where a patient lacks capacity, supporting best interests decision making and recognising when Deprivation of Liberty Safeguards may apply.
• Undertake carer wellbeing conversations, provide signposting, and remain alert to carer strain and safeguarding indicators.

Communication and relationships

• Document personalised care discussions ('what matters to me') and support advance and anticipatory care planning within scope in conjunction with the Frailty Practitioner team.
• Communicate sensitively and effectively with vulnerable adults, families and carers, adjusting communication to individual needs.
• Participate in multidisciplinary team (MDT) discussions and contribute to care planning.
• Cope with occasional exposure to distressing and emotional situations while maintaining professionalism, compassion and resilience.

Information, recording and reporting

• Ensure accurate, contemporaneous and timely data recording and reporting in line with EMIS templates and information governance requirements.
• Maintain confidentiality and handle personal data in accordance with data protection legislation and local policy.

Professional responsibilities

• Practise in accordance with the NMC Code and within the NMC standards of proficiency for nursing associates, which form the ceiling of the role.
• Maintain NMC registration, complete revalidation, and undertake preceptorship where newly qualified.
• Escalate clinical concerns to the GP, pharmacist or frailty clinician without delay.
• Undertake mandatory and role-specific training and participate in clinical supervision and appraisal.

Scope of Practice

• Work within clearly defined protocols, competencies and delegated tasks agreed with the supervising registered clinician.
• Do not diagnose conditions or prescribe medication.
• Identify and escalate clinical concerns appropriately.
• Work at all times within the NMC standards of proficiency for nursing associates and the NMC Code.

Practice Responsibilities

• Contributes to the evaluation/audit and clinical standard setting with colleagues.
• Records data in patient records systems promptly and accurately and to agreed standards.
• Ensures appropriate use of read codes.
• Participates in the auditing of practice activity as required.
• Responsible for health and safety of themselves and others and actively co-operates with Health and Safety Policies and procedures.
• Processes and actions incoming patient and hospital correspondence.
• Attends in-house meetings, significant event audit meetings and other meetings as deemed necessary.
• Ensures that the practice complaints system is adhered to at all times.
• Awareness and compliance with all relevant guidelines e.g. data protection, confidentiality and health and safety.
• Maintain current CPR and anaphylaxis certification and child/adult safeguarding training in line with local policies.

Measures of Success
The following measures support appraisal and service monitoring. Individual objectives will be agreed through appraisal.

• Completion of assigned health checks.
• Compliance with EMIS documentation templates.
• Frailty scoring completion.
• Carer wellbeing assessments documented.
• Timely escalation of clinical risks.

Training & Development

• Fully participates in training and development
• Engages in a programme of ongoing support and feedback to maximise the benefit of the training and development plan.

Travel
Ability and willingness to travel across multiple sites is essential for this role

Confidentiality
In the course of seeking treatment, patients entrust us with, or allow us to gather, sensitive information in relation to their health. They do so in confidence and have the right to expect that staff will respect their privacy and act appropriately.

Information relating to patients, carers, colleagues, other healthcare workers or the business of the Practice may only be divulged to authorised persons in accordance with the Alliance policies and procedures relating to confidentiality, and the protection of personal and sensitive data.

Health & Safety
The post-holder will assist in promoting and maintaining their own and others health, safety and security as defined in the Practice Health & Safety Policy to include:

• Identifying the risk involved in work activities and undertaking such activities in a way that manages those risks.
• Using appropriate infection control procedures particularly those relating to needlestick injuries, maintaining work areas in a tidy and safe way and free from hazards.
• Ensuring that all accidents or dangerous accidents are reported and investigated, and follow up action taken where necessary.
• Maintain training in line with local policies.

Equality and Diversity
The post-holder will support the quality, diversity and rights of patients, carers and colleagues to include:

• Acting in a way that recognizes the importance of peoples rights, interpreting them in a way that is consistent with current legislation.
• Respecting the privacy, dignity, needs and beliefs of patients, carers and colleagues.
• Behaving in a manner which is welcoming to and of the individual, is non-judgemental and respects their circumstances, feelings, priorities and rights.

Quality
The post-holder will strive to maintain quality within the Practice, and will:

• Assess own performance and take accountability for own actions, either directly or under supervision.
• Contribute to the effectiveness of the team by reflecting on own and team activities and making suggestions on ways to improve and enhanced the teams performance.
• Work effectively with individuals in other agencies to meet patients needs.
• Effectively manage own time, workload and resources.

Communication
The post-holder should recognise the importance of effective communication within the team and will strive to:

• Communicate effectively with other team members.
• Communicate effectively with patients and carers.
• Recognise peoples needs for alternative methods of communication and respond accordingly.

The employer is Sunderland GP Alliance and the post-holder is expected to comply with the Alliances employment policies and procedures.

Person Specification
Other
Essential

• Appointment to this role will be subject to a satisfactory Standard/Enhanced DBS check
• The postholder must be able to travel reliably and independently between multiple sites

Motivation and Skills
Essential

• Compassionate, person-centred and resilient
• Effective team worker within an MDT

Qualifications
Essential

• Nursing Associate Foundation Degree or equivalent
• Current NMC registration as a Nursing Associate
• Completion of, or willingness to complete, training in dementia care and frailty assessment.
• Safeguarding adults training to the level required for the role.

Desirable

• Recognised training in dementia care
• Recognised training in frailty assessment

Experience
Essential

• Experience of delivering clinical observations and health checks
• Experience of working with older or vulnerable adults
• Understanding of dementia and frailty and their impact on patients and carers.
• Competence in clinical observations and health checks.
• Communication skills for working with vulnerable adults and carers.
• Ability to recognise deterioration and escalate concerns.
• Working knowledge of safeguarding adults and the Mental Capacity Act 2005.
• IT skills, including EMIS or similar clinical systems.

Desirable

• Experience in primary care, community or frailty settings
• Experience of caseload or follow-up working

Disclosure and Barring Service Check
This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

UK Registration
Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).

Employer details
Employer name: Sunderland GP Alliance
Address: North East BIC, Wearfield, Sunderland, Tyne and Wear, SR5 2TA, United Kingdom
Employer's website: (Opens in a new tab)

Employer contact details
For questions about the job, contact: Senior Federated Services Manager, Victoria Muller, View email address on meeveem.com

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.
Applicants must have current UK professional registration.