Social Prescribing Link Worker

Job description

Job responsibilities

Key responsibilities:

1. Working with support and day to day line supervision from the existing Lead Social Prescriber, taking referrals from a wide range of agencies, including Newcastle North PCNs GP practices, multi-disciplinary team and in the future: pharmacies, wider multi-disciplinary teams, hospital discharge teams, allied health professionals, fire service, police, job centres, social care services, housing associations, and voluntary, community and social enterprise (VCSE) organisations (list not exhaustive).

2. Provide personalised support to individuals, their families and carers to take control of their health and wellbeing, live independently and improve their health access and outcomes, as a key member of the Newcastle North PCN multi-disciplinary team. Develop trusting relationships by giving people time and focus on what matters to me. Take a holistic approach, based on the persons priorities and the wider determinants of health. The role will require managing and prioritising your own caseload, in accordance with the needs, priorities and any urgent support required by individuals on the caseload. It is vital that you have a strong awareness and understanding of when it is appropriate or necessary to refer people back to other health professionals/agencies, when what the persons needs are beyond the scope of the link worker role e.g. when there is a mental health need requiring a qualified practitioner.

3. Work with a diverse range of people and communities, to draw on and increase the strengths and capacities of local communities, enabling local VCSE organisations and community groups (including faith groups) to receive social prescribing referrals.

4. Alongside other members of the Newcastle North PCN multi-disciplinary team, work collaboratively with all local diverse partners to contribute towards supporting the local VCSE organisations and community groups to become sustainable and that community assets are nurtured, through sharing intelligence regarding any gaps or problems identified in local provision with commissioners and local authorities.

5. Social prescribing link workers will have a role in educating non-clinical and clinical staff within their Newcastle North PCN multi-disciplinary teams on what other services are available within the community and how and when patients can access them. This may include verbal or written advice and guidance.

Key tasks:

Referrals:

Promote social prescribing, its role in self-management, addressing health inequalities and the wider determinants of health.

As part of the Newcastle North PCN multi-disciplinary team, build relationships with staff in GP practices within the local PCN, attending relevant MDT meetings, giving information and feedback on social prescribing.

Be proactive in developing strong links with all local agencies to encourage referrals, recognising what they need to be confident in the service to make appropriate referrals.

Work in partnership with all local agencies to raise awareness of social prescribing and how partnership working can reduce pressure on statutory services, improve health access and outcomes and enable a holistic approach to care.

Provide referral agencies with regular updates about social prescribing, including training for their staff and how to access information to encourage appropriate referrals.

Seek regular feedback about the quality of service and impact of social prescribing on referral agencies.

Be proactive in encouraging equality and inclusion, through self-referrals and connecting with all diverse local communities, particularly those communities that statutory agencies may find hard to reach.

Provide personalised support

Meet people on a one-to-one basis, making home visits where appropriate within organisations policies and procedures. Give people time to tell their stories and focus on what matters to me. Build trust and respect with the person, providing non-judgemental and non-discriminatory support, respecting diversity and lifestyle choices. Work from a strength-based approach focusing on a persons assets.

Be a friendly and engaging source of information about health, wellbeing and prevention approaches.

Help people identify the wider issues that impact on their health and wellbeing, such as debt, poor housing, being unemployed, loneliness and caring responsibilities.

Work with the person, their families and carers and consider how they can all be supported through social prescribing.

Help people maintain or regain independence through living skills, adaptations, enablement approaches and simple safeguards.

Work with individuals to co-produce a simple personalised support plan to address the persons health and wellbeing needs based on the persons priorities, interests, values, cultural and religious/faith needs and motivations including what they can expect from the groups, activities and services they are being connected to and what the person can do for themselves to improve their health and wellbeing.

Where appropriate, physically introduce people to culturally appropriate community groups, activities and statutory services, ensuring they are comfortable, feel valued and respected. Follow up to ensure they are happy, able to engage, included and receiving good support.

Where people may be eligible for a personal health budget, help them to explore this option as a way of providing funded, personalised support to be independent, including helping people to gain skills for meaningful employment, where appropriate.

Seek advice and support from the GP supervisor and/or the Lead Social Prescriber to discuss patient-related concerns (e.g. abuse, domestic violence and support with mental health), referring the patient back to the GP or other suitable health professional if required.

Support community groups and VCSE organisations to receive referrals

Forge strong links with a wide range of local VCSE organisations, community and neighbourhood level groups, utilising their networks and building on whats already available to create a menu of diverse community groups and assets, who promote diversity and inclusion.

Develop supportive relationships with local diverse VCSE organisations, culturally appropriate community groups and statutory services, to make timely, appropriate and supported referrals for the person being introduced.

Work collectively with all local partners to ensure community groups are strong and sustainable

Work with commissioners and local partners to identify unmet diverse needs within the community and gaps in community provision.

Encourage people who have been connected to community support through social prescribing to volunteer and give their time freely to others, building their skills and confidence and strengthening community resilience.

Develop a team of volunteers within your service to provide buddying support for people, starting new groups and finding creative community solutions to local issues.

Encourage people, their families and carers to provide peer support and to do things together, such as setting up new community groups or volunteering.

Provide a regular confidence survey to community groups receiving referrals, to ensure that they are strong, sustained and have the support they need to be part of social prescribing.

Person Specification

Qualifications

Essential

• NVQ Level 3, Advanced level or equivalent qualifications or working towards
• Demonstrable commitment to professional and personal development

Desirable

• Training in motivational coaching and interviewing or equivalent experience

Experience

Essential

• Experience of working directly in a community development context, adult health and social care, learning support or public health/health improvement (including unpaid work)
• Experience of supporting people, their families and carers in a related role (including unpaid work)
• Experience of supporting people with their mental health, either in a paid, unpaid or informal capacity
• Experience of working with the VCSE sector (in a paid or unpaid capacity), including with volunteers and small community groups
• Experience of partnership/collaborative working and of building relationships across a variety of organisations

Desirable

• Experience of data collection and using tools to measure the impact of services

Personal qualities and attributes

Essential

• Ability to actively listen, empathise with people and provide person-centred support in a non-judgemental way
• Able to provide a culturally sensitive service, by supporting people from all backgrounds and communities, respecting lifestyles and diversity
• Commitment to reducing health inequalities and proactively working to reach people from diverse communities
• Ability to communicate effectively, both verbally and in writing, with people, their families, carers, community groups, partner agencies and stakeholders
• Ability to identify risk and assess/manage risk when working with individuals
• Have a strong awareness and understanding of when it is appropriate or necessary to refer people back to other health professionals/agencies, when what the person needs is beyond the scope of the link worker role e.g. when there is a mental health need requiring a qualified practitioner
• Able to work from an asset-based approach, building on existing community and personal assets
• Ability to maintain effective working relationships and to promote collaborative practice with all colleagues
• Commitment to collaborative working with all local agencies (including VCSE organisations and community groups). Able to work with others to reduce hierarchies and find creative solutions to community issues
• Can demonstrate personal accountability, emotional resilience and ability to work well under pressure
• Ability to organise, plan and prioritise on own initiative, including when under pressure and meeting deadlines
• High level of written and oral communication skills
• Ability to work flexibly and enthusiastically within a team or on own initiative
• Understanding of the needs of small volunteer-led community groups and ability to support their development
• Able to provide motivational coaching to support peoples behaviour change
• Knowledge of, and ability to work to, policies and procedures, including confidentiality, safeguarding, lone working, information governance, and health and safety

Skills & Competencies

Essential

• Knowledge of the personalised care approach
• Understanding of the wider determinants of health, including social, economic and environmental factors and their impact on communities, individuals, their families and carers
• Understanding of, and commitment to, equality, diversity and inclusion
• Knowledge of community development approaches
• Knowledge of IT systems, including ability to use word processing skills, emails and the internet to create simple plans and reports and including updating all patient contact on the clinical systems

Desirable

• Local knowledge of VCSE and community services in the locality
• Knowledge of how the NHS works, including primary care

Other

Essential

• Meets DBS reference standards and criminal record checks
• Willingness to work flexible hours when required to meet work demands
• Access to own transport and ability to travel across the locality on a regular basis, including to visit people in their own homes

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

Newcastle North Primary Care Network (PCN)

Address

Kidsgrove Medical Centre

Mount Road

Kidsgrove

Stoke-on-trent

ST7 4AY