Care Coordinator

Dover Town Primary Care Network

Information:

This job is now closed

Job summary

This is an exciting time for Dover Town Primary Care Network. As a result of multiple local GP practices working collaboratively to provide improved healthcare interventions to Dovers local patient population, we are recruiting for core administrative roles that will work across our network.

Dover Town PCN has a culturally and socially diverse population of around 40,000 patients. You will be an integral part of the currently expanding administrative team, helping to provide an effective service to our patients as well as developing a forward-thinking primary care network and an encouraging environment Are you a motivated coordinator looking for a challenge in primary care? If so read on

Main duties of the job

Full-Time Care Coordinator We are looking for an exceptional care coordinator to join our friendly, supportive, and progressive organisation. Dover Town PCN has three practices and our care coordinator will be a key member of the administration team in providing person centered care for our patients.

You will support the clinical team to provide services which put the patients needs at the heart of the care discussion. Your role will enable patients to access healthcare services in a timely manner and support the Network to improve the health of the local population.

You will be working with our partner health and social care organisations, patients, relatives, carers and voluntary organisations to manage the administration of Multi-Disciplinary Team meetings.

You will need to have great interpersonal skills, be a good listener and have experience of working positively with people facing complex social and emotional challenges.

About us

We offer competitive salaries, a generous annual leave entitlement, access to the NHS Pension scheme, NHS Staff Discount and Blue Light Card Scheme and a commitment to developing the skills of our workforce as part of our overall remuneration package. If you are a positive, confident and an organised individual who adopts a flexible can do attitude to your work coupled with a focus on high quality service delivery then this role could be just right for you.

Candidates will be contacted only if the application is taken forward.

We will close the vacancy early if we receive enough suitable applications.

Job description

Job responsibilities

Job Summary

The Care Coordinator role plays a pivotal part in improving the quality of seamless coordinated care across the Primary Care Network (PCN), that enables Multi-Disciplinary Teams (MDT) to advance in their ways of working and ultimately contributes to the effectiveness of patient care provided.

As a Care Coordinator the job holder will work closely with the practices and the MDT, as a pivotal role for ensuring all patients across the locality receive the best possible care and service. This role will support the Clinical Director and other key stakeholders in coordinating all activity including access to services, advice, and information, and ensuring health and care planning is timely, efficient and patient-centred.

This will involve coordinating the work of healthcare professionals and non-clinical staff including volunteers involved in the care of patients registered at GP practices within the wider PCN population.

A large proportion of this role will be focused on the Enhanced Health in Care Homes MDT: improving the current level of primary medical care by moving away from traditional reactive models of care delivery towards proactive care that is centred on the needs of individual residents, their families and care home staff. Such care can only be achieved through a whole-system, collaborative approach.

The care coordinator will support the MDT with the weekly virtual home round through identification of people in need of review, or collation of information on people requiring an MDT review in addition to providing coordination, secretarial and administrative support to the MDTs..

Primary Duties and Areas of Responsibility

Multi-Disciplinary Teams

Overall responsibility for arranging the weekly PCN led MDT meetings (including the weekly virtual Care Home(s) MDT) and the smooth running of integrated care within the team setting. The key role of the Care Coordinator will be to schedule the weekly MDT meetings in conjunction with the Health and Social Care Coordinator and in liaison with Clinical Lead as necessary, manage the meeting agenda items; ensuring that all new referrals are identified, and information circulated to team members in advance of the meeting.

Coordinate and manage the administrative functions of MDT meetings.

Liaise with all clinical and non-clinical members in the MDT to ensure effective MDT function.

Take minutes of MDT meetings and disseminate; chase progress against actions identified in these meetings and ensure follow up where necessary.

Manage reporting required and associated within the DES specifications for required services.

Patient Identification

Receive and collate information from transfers of care (including hospital admissions and discharges) plus out of hours calls and prepare MDT case notes for lead clinician to review before submission to MDT.

Liaise with service providers and clinicians to identify frequent flyers, and new service users utilising risk stratification tools provided and present this information to the weekly MDT meetings.

Support the completion of new referrals by checking criteria, and where criteria have been met, direct referral to the MDT.

Signpost team members, service users and carers to relevant services

Maintenance of IT based information systems and responsibility for key performance data:

Ensure accurate notes are transcribed into relevant practice clinical systems (EMIS) for each patient during the MDT, or within 3 hours after, to ensure patient records are up to date and all clinicians can access correct information

To ensure the IT requirements for recording activity are adhered to in collaboration with other team members

To provide agreed performance/activity data within the MDT and PCN and wider OHP organisation.

Communication and collaborative working relationships

Demonstrates ability to work as a member of a team.

Can recognise personal limitations and refer to more appropriate colleague(s) when necessary.

Actively work toward developing and maintaining effective working relationships both within and outside the PCN or group of PCNs.

Liaises with other stakeholders as needed for the collective benefit of patients including but not limited to Patients GP, Nurses, other practice staff and other healthcare professionals including pharmacists and pharmacy technicians from provider and commissioning organisations.

Work with service users, PCN practices and partners e.g., Care Homes to ensure new referrals are logged and allocated

Develop excellent working relationships with all partners, wider service networks including the voluntary sector, GP practices, adult social care, hospitals, community pharmacists and other members of the MDT

Acting as a point of contact for residents, families and professionals who visit the care home, such as MDT members and in-reach specialists.

Meet regularly with the clinical lead and review case load and MDT function.

Keep the MDT and Dover Town PCN organisation abreast of good news stories.

Provide background information about individuals for the weekly MDT meetings

Communicate effectively with service users and their families/carers, other staff both internal and external and members of the public

Manage and prioritise workload daily and deal with the competing demands of the MDT

Other responsibilities

To always act in an anti-discriminatory manner

To be able to plan and respond to workload according to operational priorities

To support the delivery of these functions across wider locality areas where necessary

To undertake any training required to maintain competency including mandatory training

To contribute to, and work within a safe working environment.

The Care Coordinator must always carry out duties and responsibilities with due regard to the GP Practices equal opportunity policies and procedures

The Care Coordinator is expected to take responsibility for self-development on a continuous basis, undertaking on-the-job training as required

The Care Coordinator must be aware of individual responsibilities under the Health and Safety at Work Act, and identify and report as necessary any untoward accident, incident, or potentially hazardous environment.

Patient Care

Communicate effectively and sensitively and use language appropriate to a patient and carer/relatives condition and level of understanding

Effectively use all methods of communication and be aware of and manage barriers to communication

Effectively recognise and manage challenging behaviours, carers and or relatives

Provide information to patients, their carers and/or relatives on behalf of the team

Supporting Care Delivery

Be the point of liaison for service users and interface with all health and social care professionals, including keeping everyone informed and updated

Follow through actions identified by the MDT including arranging tests, referrals, signposting, etc.

Follow through with service users and others involved to ensure all services and care arrangements are in place

Autonomy/Scope within Role

The post holder will be required to work within clearly defined organisational protocols, policies and procedures

Key Relationships

Key Working Relationships Internal:

Clinical Lead for the MDT

GPs and General practice teams within the PCN

PCN Clinical Director

MDT members including but not exhaustive: Clinical Pharmacists, Pharmacy Technicians, Physician Associates, Physiotherapists, Paramedics, Social Prescribing Link Workers

Key Working Relationships External:

GPs from neighbouring PCNs

PCN staff from neighbouring PCNs, Care coordinators and MDT staff

Community Nursing team District Nursing, Frailty team, Community Geriatrician

External organisations: Mental Health NHS organisations, local Council, Social Services, Hospices, Voluntary and Independent Sector providers

Service providers including Care Home and Residential Home providers

Patients/service users

Carers/relatives

Health and Safety/Risk Management

The post-holder must always comply with the organisation and Practices Health and Safety policies, by following agreed safe working procedures and reporting incidents using the organisations Incident Reporting System.

The post-holder will comply with the Data Protection Act (1984), The General Data Protection Regulations (2018) and the Access to Health Records Act (1990).

The post-holder will comply with all necessary training requirements relevant to the role as identified by the organisation.

Equality and Diversity

The post-holder must co-operate with all policies and procedures designed to ensure equality of employment. Co-workers, patients and visitors must be treated equally irrespective of gender, ethnic origin, age, disability, sexual orientation, religion etc.

Respect for Patient Confidentiality

The post-holder should always respect patient confidentiality and not divulge patient information unless sanctioned by the requirements of the role.

Special Working Conditions

The post-holder is required to travel independently between practice sites (where applicable), and to attend meetings etc. hosted by other agencies.

Job Description Agreement

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

Experience

Essential

  • Experience of data collection and providing monitoring information to assess the impact of services
  • Experience of data management and reporting requirements to assess the progress and quality of services
  • Experience of partnership/collaborative working and of building relationships across a variety of organisations
  • Working in a multi-disciplinary setting where influence and negotiation is required
  • Working in a busy and demanding environment whilst delivering in a timely manner
  • Experience of driving change forward by effectively engaging all stakeholders to make the right thing happen at the right time

Desirable

  • Primary Care experience would be an advantage
  • Experience of supporting people, their families and carers in a related role (including unpaid work)
  • Demonstrable commitment to professional and personal development
  • Training in motivational coaching and interviewing or equivalent

Knowledge and Skills

Essential

  • Ability to organise, plan and prioritise on own initiative, including when under pressure and meeting deadlines
  • Able to work as part of a team
  • Able to work flexibly to meet developing needs of service
  • Able to support people in a way that inspires trust and confidence
  • Ability to communicate effectively, both verbally and in writing, with people, their families, carers, partner agencies and stakeholders including the delivery of training, representing PCN at meetings, taking minutes, writing protocols
  • Ability to identify risk and assess/manage risk when working with individuals
  • Excellent negotiating skills
  • Ability to maintain effective working relationships and to promote collaborative practice with all colleagues in PCN and the wider system
  • Demonstrates personal accountability, emotional resilience and works well under pressure
  • Ability to read large amounts of information and extract the salient points, to analyse data and report on findings

Desirable

  • Experience of working with or in general practice
  • Experience of supporting people, their families and carers in a related role (including unpaid work)
  • Training in motivational coaching and interviewing or equivalent
  • Knowledge of the personalised care approach
  • Knowledge of the Population Health Management approach to health service management

Qualifications

Essential

  • GCSE grade A-C in English and Maths
  • NVQ Level 3 in Business Administration (or relevant experience)
  • Minimum of 2 years experience of working with healthcare professionals and or previous experience in the NHS or social care or relevant field
  • Proven record of excellent written and verbal communication skills and interpersonal skills

Aptitude and Personal Qualities

Essential

  • Continued commitment to improve skills with further training and development as the role and services develop
  • Demonstrates personal accountability, emotional resilience and works well under pressure

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

Dover Town Primary Care Network

Address

100-106 High Street

Dover

Kent

CT16 1EQ


Employer's website

https://www.dovertownpcn.co.uk/

For help with your application, contact:

Dover Town PCN

skcccg.dovertownpcn@nhs.net

07958417269

Date posted

17 August 2021

Pay scheme

Other

Salary

£21,892 to £23,136 a year

Contract

Permanent

Working pattern

Full-time, Flexible working, Compressed hours

Reference number

A4100-21-7985

Job locations

100-106 High Street

Dover

Kent

CT16 1EQ


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