Job summary
The main purpose of this role is to:
- Support the Aspen Medical Practice (AMP) primary care clinical team to deliver individualised and wrap-around services for people with additional needs. This is envisaged to be chiefly frail older people and those with learning disabilities (LD), but working age adults will also be part of the case management process.
- To improve the wellbeing of registered patients and their carers by working in partnership with Gloucestershire CCG networks, district and county councils and community/voluntary sector organisations to enable the integration of available care services.
- Working with our community matron on case management for patients with complex needs.
Main duties of the job
This role involves working with a broad spectrum of our
patients and third parties, in the practice and in the community. We are therefore
looking for an individual with excellent people and communication skills who can
adapt their approach to each circumstance. You must be highly organised and
able to manage your time, resources, and competing priorities in and structured
and efficient way.
You will be working as part of a small team within the AMP. This
will require you to be a team player and be able to work independently. You
will be curious, willing to research and develop the optimum care plan for each
patient. You will be expected to make and maintain contact with local social
prescribing providers and help develop network and knowledge of referral routes
to and from service providers.
About us
Having merged from four practices in 2018, AMP is now a single practice
with just under 30,000 patients. Operating from a modern surgery in central
Gloucester and two branch surgeries, we work together as one multi-disciplinary
team to provide the best possible service for our patients.
AMP has a strong ethos of encouraging and supporting healthy lifestyles to
achieve wellbeing and prevent illness. Our Eat Real Food programme educates
patients about lower carbohydrate diets to manage and prevent Type 2 diabetes
and metabolic illness. We are seeing an extraordinarily positive impact on participants
lives. We aim to offer wider access to this approach to many more of our
patients.
We are an Active Practice and support our colleagues to be physically
active for their own benefit and to inspire our patients. Sustainability is
also important to us, and we are actively greenifying our practice. We would
be delighted to welcome a social prescriber to our team who shares these
values.
Job description
Job responsibilities
The key responsibilities for this role are:
- To work with patients, using behaviour techniques such as motivational interviewing to support them to identify, set and meet achievable goals to improve their physical and emotional wellbeing.
- To work with patients in their own homes, or in one of our three GP surgeries, to signpost them to local services/organisations which the patient themselves feel would be of benefit to reach their goals. These services may include, befriending, weight management, mental health support, smoking cessation, local social groups, leisure centres and volunteering.
- To work with partner organisations to support the development and delivery of an integrated care plan for the client so all their needs are met in a holistic way.
- To follow up with patients, update their records and support them on an ongoing basis.
- To complete Frailty Plans and Respect forms.
- To be able to do basic set of observations on patients including pulse, blood pressure, temperature, pulse oximetry, urinalysis.
- Recognising sick patient and referring onward appropriately.
- To take blood tests when needed.
- To take part in vaccination programmes including giving flu vaccinations.
- To make and maintain contact with local social prescribing providers and build a network and knowledge of referral routes to and from service providers
- To participate in the Practices frailty multidisciplinary team (MDT) meetings on a regular basis, and safeguarding processes when appropriate.
- To undertake regular training to extend and update own knowledge of health and wellbeing issues
Please download our Job Description for full details of the role and person specification.
Job description
Job responsibilities
The key responsibilities for this role are:
- To work with patients, using behaviour techniques such as motivational interviewing to support them to identify, set and meet achievable goals to improve their physical and emotional wellbeing.
- To work with patients in their own homes, or in one of our three GP surgeries, to signpost them to local services/organisations which the patient themselves feel would be of benefit to reach their goals. These services may include, befriending, weight management, mental health support, smoking cessation, local social groups, leisure centres and volunteering.
- To work with partner organisations to support the development and delivery of an integrated care plan for the client so all their needs are met in a holistic way.
- To follow up with patients, update their records and support them on an ongoing basis.
- To complete Frailty Plans and Respect forms.
- To be able to do basic set of observations on patients including pulse, blood pressure, temperature, pulse oximetry, urinalysis.
- Recognising sick patient and referring onward appropriately.
- To take blood tests when needed.
- To take part in vaccination programmes including giving flu vaccinations.
- To make and maintain contact with local social prescribing providers and build a network and knowledge of referral routes to and from service providers
- To participate in the Practices frailty multidisciplinary team (MDT) meetings on a regular basis, and safeguarding processes when appropriate.
- To undertake regular training to extend and update own knowledge of health and wellbeing issues
Please download our Job Description for full details of the role and person specification.
Person Specification
Qualifications
Essential
- It is essential you are qualified to A - Level standard.
Desirable
- It is desirable you hold Health and wellbeing or motivational interviewing qualifications.
Experience
Essential
- It is essential that you are:
- - Working in a health and wellbeing or leisure and fitness or public or voluntary sector environment
- - Working in a customer-facing role
- - Delivering lifestyle change/brief interventions
Desirable
- It is desirable that you are/have:
- - Using motivational interviewing techniques
- - Working in a health trainer/advisor role
- - Working with vulnerable people
- - Working in partnership with community organisations
- - Promoting and/or marketing services to other organisations / the public
- - An understanding of the processes and procedures for safeguarding adults and children.
Skills and Knowledge
Desirable
- These are skills and knowledge it would be high desirable for you to have:
- - Excellent people skills, interacting with all types of people and able to change communication style to fit the person
- - Ability to work independently and as part of a team
- - Comfortable working with people from public, private and voluntary organisations
- - Good one-to-one interviewing skills
- - Highly organised, managing time, resources and competing priorities in a structured and efficient way
- - Highly motivated and willing to go out of your way to help clients
- - Creative problem solver and willing to search for hard-to-find information
- - Good IT and administrative skills
- - Good understanding of health issues and the wider determinants of health and wellbeing
- - Knowledge of brief interventions, behaviour change, motivational change
- - Knowledge of social prescribing
- - Understanding of health, wellbeing and community services
- - Full driving licence and access to a car
Person Specification
Qualifications
Essential
- It is essential you are qualified to A - Level standard.
Desirable
- It is desirable you hold Health and wellbeing or motivational interviewing qualifications.
Experience
Essential
- It is essential that you are:
- - Working in a health and wellbeing or leisure and fitness or public or voluntary sector environment
- - Working in a customer-facing role
- - Delivering lifestyle change/brief interventions
Desirable
- It is desirable that you are/have:
- - Using motivational interviewing techniques
- - Working in a health trainer/advisor role
- - Working with vulnerable people
- - Working in partnership with community organisations
- - Promoting and/or marketing services to other organisations / the public
- - An understanding of the processes and procedures for safeguarding adults and children.
Skills and Knowledge
Desirable
- These are skills and knowledge it would be high desirable for you to have:
- - Excellent people skills, interacting with all types of people and able to change communication style to fit the person
- - Ability to work independently and as part of a team
- - Comfortable working with people from public, private and voluntary organisations
- - Good one-to-one interviewing skills
- - Highly organised, managing time, resources and competing priorities in a structured and efficient way
- - Highly motivated and willing to go out of your way to help clients
- - Creative problem solver and willing to search for hard-to-find information
- - Good IT and administrative skills
- - Good understanding of health issues and the wider determinants of health and wellbeing
- - Knowledge of brief interventions, behaviour change, motivational change
- - Knowledge of social prescribing
- - Understanding of health, wellbeing and community services
- - Full driving licence and access to a car
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.
Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).
From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).
Additional information
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.
Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).
From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).
