PCN Care Coordinator

Job description

Job responsibilities

Proactively identify and work with cohorts of patients to deliver personalised care.

Support patients to utilise decision making tools to prepare for shared decision-making conversations.

Working holistically, bring together their identified care and support needs and explore options to meet these within a single personalised care and support plan (PCSP).

Help people to manage their needs by answering their queries, making and managing appointments, providing good quality written or verbal information to inform decision making and enhancing their knowledge, skills and confidence.

Support people to take up employment and training and to access appropriate benefits through referral to the Social Prescribing Link Workers.

Connect patients with tools to support them, such as self-management education, peer support and the adoption of healthy behaviours.

Provide co-ordination and navigation for people and their carers across health and care services, working closely with the Social Prescribing Link Worker, Health and Wellbeing Coaches and other health professionals.

Support the co-ordination of MDTs across the PCN.

Raise awareness of the benefits of shared decision making and decision support tools, how to use these and how to identify patients who may benefit from this approach.

Ensure all VCSE organisations have appropriate safeguarding procedures in place and are genuine opportunities for patients to develop a sense of belonging, build knowledge, skills, and confidence.

Discuss concerns with a relevant GP to ensure safeguarding procedures are followed appropriately.

Person Specification

Behaviours

Essential

• Good interpersonal skills
• Good communication skills
• Evidence of continued professional development

Desirable

• IT Skills

Qualifications

Essential

• Good standard of education
• Organised and with good attention to detail
• Ability to prioritise workload.
• Enrolled/in progress/qualified from appropriate training as set out by the Personalised Care Institute (PCI)
• Demonstrable understanding of the personalised care approach
• Understands how the NHS works including primary care and PCNs

Desirable

• NVQ level 2 in Health & Social Care
• Has safeguarding knowledge either level 2 or the equivalent experience

Experience

Essential

• Liaise with other colleagues to promote the success of the PCN and its Partner organisations in primary care
• Experience of working with vulnerable patients
• Experience of working with Social Prescribing Link Workers
• Experience of working with Health & Wellbeing coaches
• Working with IT software packages used in general practice
• Proficient with S1 and Emis
• To deliver outcomes based on set targets
• Work to perpetuate a culture that is transparent and open
• Has collated data and used tools to demonstrate the impact of services
• Working well with others to deliver goals
• Being motivated to deliver excellent services to support Primary Care in our region
• Experience of working directly in a care coordinator role, in adult health, social care, learning support or public health/health improvements

Desirable

• Working with Multi Disciplinary Teams
• Working in Primary Care/General Practice
• Experience of working in health, social care and other support roles in direct contact with people, families or carers (in a voluntary or paid capacity)
• Experience of working in multidisciplinary professional team environments
• Experience or training in personalised care and support planning

Other

Essential

• Drive and have access to transport to attend visits or sites across the PCN, this may include home visits
• Immunisation status for Covid -19 (unless exempt in accordance with regulations)

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

Panacea Collaborative

Address

65-69 Stirling Street

Grimsby

North East Lincolnshire

DN31 3AE

Employer's website

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