Care Co-orindator

Job description

Job responsibilities

Care coordinators play an important role within a PCN to proactively identify and work with people, including the frail/elderly and those with long-term conditions, to provide coordination and navigation of care and support across health and care services.

The successful candidate will be working to target non-responders and hard to reach patients to increase screening uptake. Support managing and ensuring that patients are seen and followed up in line with expected timeframes.

Key responsibilities include:

• Home visits
• Organising/minuting multidisciplinary meetings for care homes
• PCN project delivery
• Liaising with other health professionals as required, to deliver personalised care.
• Be the first point of contact for these patients
• Proactively support, call and recall processes, encouraging and supporting patients to attend
• Ensure all co-ordinated activity is documented and coded accurately
• Raise awareness within the PCN of shared- decision making and decision support tools
• Raise awareness of how to identify patients who may benefit from shared decision making and support PCN staff and patients to be more prepared to have shared decision-making conversations
• Help people to manage their needs through answering queries, making and managing appointments, and ensuring good quality written or verbal information availability to help individuals make choices about their care;
• provide coordination and navigation for people and their careers across health and care services, working closely with social prescribing link workers, health and wellbeing coaches and other primary care professionals.
• Enable people to access the services and support they require to meet their health and wellbeing needs, helping to improve peoples quality of life.

Working in a multi-disciplinary team, you will work closely with GPs and practice teams to manage a caseload of patients, acting as a central point of contact to ensure appropriate support is made available to them and their carers; supporting them to understand and manage their condition and ensuring their changing needs are addressed.

This is achieved by bringing together all the information about a persons identified care and support needs and exploring options to meet these within a single personalised care and support plan, based on what matters to the person.

Care coordinators review patients needs and help them access the services and support they require to understand and manage their own health and wellbeing, referring to social prescribing link workers, health and wellbeing coaches, and other professionals where appropriate.

Care coordinators could potentially provide time, capacity and expertise to support people in preparing for or following-up clinical conversations they have with primary care professionals to enable them to be actively involved in managing their care and supported to make choices that are right for them. Their aim is to help people improve their quality of life.

The successful candidate will be based in a local cluster of General Practices as part of the Primary Care Network (PCN). They will be caring, dedicated, reliable and person-focussed and enjoy working with a wide range of people. They will have good written and verbal communication skills and strong organisational and time management skills. They will be highly motivated and proactive with a flexible attitude, keen to work and learn as part of a team and committed to providing people, their families and carers with high quality support.

This role is intended to become an integral part of the PCNs multidisciplinary team, working alongside social prescribing link workers and health and wellbeing coaches to provide an all-encompassing approach to personalised care and promoting and embedding the personalised care approach across the PCN.

There may be a need to work remotely depending on the requirements of the role. Please note that the role of a care coordinator is not a clinical role.

Person Specification

Experience

Essential

• Experience of working in health, social care and other support roles in direct contact with people, families or carers (in a paid or voluntary capacity)

Desirable

• Knowledge of Safeguarding Children and Vulnerable Adults policies and processes
• Experience of working in Primary Care

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

Maidenhead Primary Care Network

Address

St. Marks Hospital

112 St. Marks Road

Maidenhead

Berkshire

SL6 6DU

Employer's website

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