Job summary
We are seeking two motivated,
innovative and experienced Care Co-ordinators with proven skills to work in
primary care, in autonomous positions, to join our professional and friendly
multidisciplinary team which includes Complex Care Nurses, Mental Health
Practitioners, Clinical Pharmacists and a Social Prescribing Link Worker,
General Practitioners, Practice Nurses, Health Care Assistants, Practice
Managers and others.
This is a great opportunity to work
in a professional and wider multi-disciplinary team. You shall be accountable
to the PCN Board though you will take day to day instructions from GP surgeries
Main duties of the job
The post holder will be employed by
Millbrook Medical Practice (which is being run by Go To Doc Ltd), the Lead
practice for SMD PCN, on behalf of nine practices in Stalybridge Primary Care
Network. Initially for 12 months but likely to become permanent.
The role involves working very
closely with the practices and the multidisciplinary team (MDT) within the PCN,
though external relations will also be important. The role is pivotal in
ensuring all patients, home-bound, care home residents and complex chronic
disease patients, receive the best possible care and service. The Care
Coordinators role will support the Clinical Director of the PCN and member
practices in coordinating all key activity including access to services,
advice, and information, and ensuring health and care planning is timely,
efficient, and patient-centred. The role will include supporting digital
initiatives and includes responsibilities for the co-ordination of the patient’s
journey through primary care. The care coordinators appointed will be based
within the Complex Care Team which is a Frailty Service for older people aged
65 and over. The Team proactively support older people to ensure the right care
and the right services are involved. The team support those with worsening
frailty to make their wishes known and discuss future care planning and Advance
Care planning.
About us
Stalybridge Primary Care Network
(PCN) consists of 9 GP surgeries in Stalybridge, Tameside. We cover a
population size of just over 40,000 patients. We pride ourselves on being a
dynamic and learning PCN which in turn looks to teach others.
Job description
Job responsibilities
Job responsibilities
Key Duties & Responsibilities:
The Care Coordinator responsibilities
include but are not limited to the following:
1. To work with the GPs and other
primary care professionals within the PCN to identify and manage a caseload of
patients
2. To work closely and in partnership
with the Social Prescribing Link Worker, complex care nurses, mental health
practitioners and Clinical Pharmacist, General Practitioners and a host of
other professionals
3. To support patients to utilise
decision aids, help create single personalised care and support plans, in line
with the best practice
4. To support the Clinical Director
and member practices in the delivery of the DES specifications, issued by NHS
England
5. To help people to manage their
needs through answering queries, making, and managing appointments
6. To provide coordination and
navigation with the aid of digital tools for people and their carers across
health and care services
7. To support the coordination and
delivery of MDTs within the PCN
8.To reach out to people who dont
find it easy to access care, i.e. to help address health inequalities and to
co-ordinate social chaos, debt support and other social determinants of health
Job description
Job responsibilities
Job responsibilities
Key Duties & Responsibilities:
The Care Coordinator responsibilities
include but are not limited to the following:
1. To work with the GPs and other
primary care professionals within the PCN to identify and manage a caseload of
patients
2. To work closely and in partnership
with the Social Prescribing Link Worker, complex care nurses, mental health
practitioners and Clinical Pharmacist, General Practitioners and a host of
other professionals
3. To support patients to utilise
decision aids, help create single personalised care and support plans, in line
with the best practice
4. To support the Clinical Director
and member practices in the delivery of the DES specifications, issued by NHS
England
5. To help people to manage their
needs through answering queries, making, and managing appointments
6. To provide coordination and
navigation with the aid of digital tools for people and their carers across
health and care services
7. To support the coordination and
delivery of MDTs within the PCN
8.To reach out to people who dont
find it easy to access care, i.e. to help address health inequalities and to
co-ordinate social chaos, debt support and other social determinants of health
Person Specification
Qualifications
Essential
- Participate in clinical governance activity and contribute to the improvement in quality of health outcomes through audit, risk management and Quality Improvement Alerts other team members to concerns about risk, quality, and safety Participates in investigation of incidents and events as required Identifies, applies, and disseminates research findings relating to own practice Collects data for audit purposes and uses clinical audit to monitor quality in the service Contributes to the effectiveness of the team by reflecting on own and team activities and making suggestions on ways to improve and enhance the teams performance Works effectively with individuals in other agencies to meet patients needs Effectively manages own time, workload, and resources Meets timescales/deadlines for audits and written returns to ensure that the Practice meets quality standards and receives the designated funding
Desirable
- Knowledge of clinical systems such as Emis Web and SystmOne. Ability to adapt to change within working situations Reflective working Awareness of frailty and chronic conditions Knowledge of 3rd sector working. Understanding of role of patient advocate
Person Specification
Essential
- Current driving licence and access to own vehicle Highly motivated and proactive. Flexibility of working hours / ability to work at desired times which includes working late on an evening to cover extended access, and to include working weekends and bank holidays to cover possible 7 day operation of the service
Person Specification
Qualifications
Essential
- Participate in clinical governance activity and contribute to the improvement in quality of health outcomes through audit, risk management and Quality Improvement Alerts other team members to concerns about risk, quality, and safety Participates in investigation of incidents and events as required Identifies, applies, and disseminates research findings relating to own practice Collects data for audit purposes and uses clinical audit to monitor quality in the service Contributes to the effectiveness of the team by reflecting on own and team activities and making suggestions on ways to improve and enhance the teams performance Works effectively with individuals in other agencies to meet patients needs Effectively manages own time, workload, and resources Meets timescales/deadlines for audits and written returns to ensure that the Practice meets quality standards and receives the designated funding
Desirable
- Knowledge of clinical systems such as Emis Web and SystmOne. Ability to adapt to change within working situations Reflective working Awareness of frailty and chronic conditions Knowledge of 3rd sector working. Understanding of role of patient advocate
Person Specification
Essential
- Current driving licence and access to own vehicle Highly motivated and proactive. Flexibility of working hours / ability to work at desired times which includes working late on an evening to cover extended access, and to include working weekends and bank holidays to cover possible 7 day operation of the service
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).
Employer details
Employer name
Stalybridge, Denton & Glossop PCNs
Address
St Andrews House Surgery
2 Waterloo Road
Stalybridge
Tameside
SK15 2AU
