QOF Care Coordinator

Tyntesfield Medical Group

The closing date is 05 May 2025

Job summary

23 hours per week, days to be agreed, but Fridays are required

Candidates will need to be a team player with a passion for giving excellent customer service. This role will be managing our chronic disease register and will require good data awareness and personal skills. A good understanding of Quality outcome Framework (QOF) targets along with a working knowledge of EMIS is desirable. Previous experience gained within the NHS, promoting attendance at Health Promotion clinics, ensuring patients are called for reviews in a timely manner and carry out basic searches is preferred.

Main duties of the job

The purpose of the role is o work as part of the QOF team and support the clinicians at Tyntesfield Medical Group to achieve all QOF targets annually.

About us

Tyntesfield Medical Group in North Somerset is a 13 Partner General Practice with a patient list size currently of around 33,000 split across four sites: Tower House Medical Centre, Brockway Medical Centre, Backwell Medical Centre and Long Ashton Surgery.

We are a friendly and accessible team providing excellent healthcare in our community. We provide a professional, safe, supportive, and efficient working environment for everyone in the practice. We are a forward-thinking organisation with a strong emphasis on teamwork and patient-centred care.

Date posted

14 April 2025

Pay scheme

Other

Salary

£12.48 an hour

Contract

Permanent

Working pattern

Part-time

Reference number

A0519-25-0004

Job locations

Backwell Medical Centre

15 West Town Road

Backwell

Bristol

BS48 3HA

Job description

Job responsibilities

Co-ordinate care for disease prevention and actively promote attendance at Health Promotion clinics

Have a good understanding of QOF targets and ensure patients are called for review in a timely manner

Regularly search for patients with poor disease control and target them for additional support, e.g., for weight loss/drug compliance/overdue blood tests or other investigations

Actively search for patients with a high BMI or smokers to support to change

Refer signpost patients to smoking cessation, exercise and weight loss services

Liaise with the Social Prescribing Team (Wellbeing Team) when required

Utilise population health intelligence to proactively identify and work with a cohort of patients to deliver personalised care

Help patients to manage their needs through answering queries, making and managing appointments

Work with the GPs and other primary care professionals to identify and manage a caseload of patients, and where required and as appropriate, refer patients back to other health professionals

Discuss patient related concerns with a GP where required

Support pre-diabetic patients to ensure annual HbA1c and referral to National Diabetes Prevention Programme education where necessary

To improve the Population Health Management within the practice to enable better clinical outcomes

Ensure the health promotion clinics are used efficiently and effectively by actively managing clinic bookings and patient recall. The support would include:

Ensure early follow up for diabetic review if needed more frequently than annually

Ensure the patient has the most efficient appointment if they have co-morbidities to improve engagement and compliance

Invite patients on the Learning Disability register for the first part of their annual review with the QOF Team and book the second part

Send reminders to patients overdue their cancer screening (breast, bowel, cervical, PSA)

Coordinate long term condition monitoring for housebound patients

Create and edit EMIS searches

Claim on behalf of practice: CQRS, Local Enhanced Services, Public Health, PPA prescriptions