Care Coordinator

Job description

Job responsibilities

Accountable to: Head of Projects & Performance; Care Coordinator Team Leader

Reports to: Care Coordinator Team Leader

Role Purpose:

To support the practice in delivering excellent patient care by effectively coordinating different elements of care from multi-disciplinary teams within and outside the practice

Service Co-ordination

Provide coordination and navigation for patients and their carers across health and care services, working closely with Social Prescribing Link Workers, Health and Wellbeing Coaches, and other primary care professionals

Co-ordinate the work of healthcare professionals and non-clinical staff involved in the care of patients registered at the practice

Co-ordinate MDT meetings, collating information on patients requiring review and providing secretarial and administrative support, and ensuring the completion of resulting actions

Act on communications from hospitals, community services, mental health services and other providers

Facilitate inter-agency communication to support the discharge and handover of patients between different health and care settings

Support Lead GPs with the administrative aspects of QOF (Quality Outcomes Framework)

Act as a single point of contact for health professionals and patients within your remit

Active Care Planning

Work with GPs and other primary care professionals to identify and manage a caseload of patients

Develop Personalised Care and Support Plans for defined cohorts of patients, focusing on what matters to the person

Actively manage the implementation of Personalised Care and Support Plans

Patient Support

Help people to manage their health needs through answering queries, making appointments, booking tests and arranging other reviews including long-term condition reviews

Ensuring that actions from review meetings are progressed on behalf of patients

Provide patients with good quality written or verbal information to support them in making choices about their care

Proactively support patients to participate in local and national screening programmes

Support patients in readiness for shared decision-making conversations

Support people to understand their level of knowledge, skills and confidence (their Activation level) when engaging with their health and wellbeing

Assist people to access self-management education courses, peer support or interventions that support them in their health and wellbeing and increase their activation level

Identify and address safeguarding concerns

Identify and support carers of patients to ensure that they also look after their own wellbeing

Development Activity

Actively promote your role within the practice and PCN

Raise awareness of shared decision-making and support tools within the practice and how to identify patients who may benefit from this approach

Contribute to tackling inequalities in health and social care particularly regarding individuals with long-term conditions and complex care needs

Support the development and implementation of projects and initiatives aimed at improving care for patients

Reporting

Maintain effective records of activity and produce reports as required

Provide agreed performance/activity data

This job description is intended to provide an outline of the key tasks and responsibilities only. There may be other duties required of the post-holder commensurate with the position. This description will be open to regular review and may be amended to take into account development within the Practice. All members of staff should be prepared to take on additional duties or relinquish existing duties in order to maintain the efficient running of the Practice.

This job description is intended as a basic guide to the scope and responsibilities of the post and is not exhaustive. It will be subject to regular review and amendment as necessary in consultation with the post holder.

Person Specification

Qualifications

Essential

• Good standard of general education (NVQ Level 2 or equivalent)

Desirable

• NVQ Level 3 or equivalent
• Care Certificate
• E-learning for Health Social Prescribing Certificate

Experience

Essential

• Experience of working in a busy and demanding environment
• Experience of delivering high quality customer or patient care
• Experience of general administration processes and record keeping
• Computer literate with an ability to use the required IT systems and Microsoft Office
• Excellent negotiation skills
• Excellent communication skills, both verbal and written
• Able to effectively manage own workload
• Able to meet deadlines, work under pressure and balance priorities
• Able to build and sustain relationships at all levels

Desirable

• Experience of working in a health or social care setting, ideally general practice
• Experience of EMIS clinical system
• Experience of minute taking
• Understanding of patient care needs
• Knowledge of medical terminology
• An understanding and knowledge of the workings of the NHS
• Knowledge of one or more of the following areas: community services, palliative care, learning difficulties, dementia, care homes, mental health, long-term health conditions, frailty

Additional Criteria

Essential

• Emotionally resilient and able to flag personal support needs to management when required
• Committed to personal development
• Approachable and flexible
• Honest and reliable
• Sensitive to patients needs
• Ability and willingness to work across all Holderness Health sites
• Ability, willingness and self-motivation to work from home environment as and when required

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.

Employer details

Employer name

Holderness Health

Address

Church View Surgery

5 Market Hill House

Hedon

HU12 8JE

Employer's website

https://www.holdernesshealth.nhs.uk/ (Opens in a new tab)