Clinical Care CoOrdinator (Health Care Assistant)

Synergy Health PCN

The closing date is 07 March 2025

Job summary

Job summary

The Clinical Care Coordinator will be employed by Synergy Health PCN to work on behalf of the three member practices. Synergy Health PCN has a sizeable cohort of patients eligible for an NHS health Check, as well as using population health management to target patients for preventable measures. The role would also work within the PCN team and provide administration support to the practices and support in the coordination and delivery of multidisciplinary team meetings.

Primary Care Networks (PCN) are local neighbourhoods where all health and social care services work together to deliver a better experience for their citizens.

Main duties of the job

Core Duties

To provide the PCN with support to identify patients and engage patients to attend for an NHS health check and support in practice clinics. (To include basic clinical skills such as taking blood tests, blood pressure, height, weight, urine dip and lifestyle questions).

Coordinate Multi-Disciplinary Team meetings for people living in the community. Be responsible for arranging, attending and minuting Multi-Disciplinary Team Meetings. Follow up on all forward actions resulting from MDT discussions

Utilise Population Health Intelligence to proactively identify patients at risk and work with the PCN team to enable the PCN team to deliver personalised care

Utilise Population Health Intelligence tools where needed to support other patients in the PCN.

Support the achievement of the IIF targets through reporting and communication

About us

Synergy Health PCN covers three practices in Gedling, Jubilee Park Medical Partnership in Carlton with a branch site in Lowdham, West Oak on Westdale Lane, Mapperley and Trentside Medical Group in Netherfield and Carlton.

We are a standalone PCN with a lead practice. We have a population of 36,000 patients.

The PCN has care co-ordinators, social prescribing link workers and are recruiting for a health and wellbeing coach. These roles will work closely together as the PCN holistic care team.

Our vision is to build and develop collaborative working across member practices and stakeholders, to support and strengthen the delivery of Primary Care services and improve health outcomes for the local population we serve.

Date posted

07 February 2025

Pay scheme

Other

Salary

£24,000 to £25,650 a year

Contract

Permanent

Working pattern

Flexible working

Reference number

A5713-25-0000

Job locations

Trentside Medical Group

Knight Street

Netherfield

Nottingham

NG4 2FN


West Oak Surgery

319 Westdale Lane

Mapperley

Nottingham

NG3 6EW


Park House Medical Centre

61 Burton Road

Carlton

Nottingham

NG4 3DQ


Job description

Job responsibilities

RESPONSIBILITIES

Core Duties

To provide the PCN with support to identify patients and engage patients to attend for an NHS health check and support in practice clinics. (To include basic clinical skills such as taking blood tests, blood pressure, height, weight, urine dip and lifestyle questions).

Coordinate Multi-Disciplinary Team meetings for people living in the community. Be responsible for arranging, attending and minuting Multi-Disciplinary Team Meetings. Follow up on all forward actions resulting from MDT discussions

Utilise Population Health Intelligence to proactively identify patients at risk and work with the PCN team to enable the PCN team to deliver personalised care

Utilise Population Health Intelligence tools where needed to support other patients in the PCN.

Support the achievement of the IIF targets through reporting and communication

Additional Duties

Be responsible for daily updating of patients on e-HealthScope Workflow to identify patient to support the PCN team with identifying community pathways that might prevent hospital admission and for identifying potential gaps in care

To record patient interventions on relevant electronic database systems (e.g. SystmOne) and contribute to report generation, analysis and production

To contribute to the integration of health and social care by maintaining up to date recording systems for all agencies within the PCN Team and providing information to any member of the PCN Team in order to ease processes and communication in agreement with data protection protocol

Use clinical systems for record keeping, audit and evaluation

To be customer (patient, carer, GP) focused when representing the service

To work collaboratively with other teams and services to maintain an effective and efficient service

To offer appropriate support and guidance to patients and their families/carers

To plan / organise work using own initiative, whilst being able to work as a valuable member of a team

To work effectively as part of a team to provide cover for Care Coordination Teams when required and to be flexible regarding working hours to meet the needs of the service

To ensure all electronic records are updated and complete within the agreed time-scales

To use a range of verbal and non-verbal communication tools to communicate effectively with patients, carers and families and colleagues.

To support and work with key personnel in the PCN to develop & support collective general practice projects.

Professional Development / Personal Performance

Work towards completing the appropriate training to deliver and support the Comprehensive Model for Personalised Care.

To participate in any relevant training/courses/conferences

Complete mandatory training

Adhere to organisational policies and procedures, including confidentiality, safeguarding, lone working, information governance, equality, diversity and inclusion training and health and safety.

Job description

Job responsibilities

RESPONSIBILITIES

Core Duties

To provide the PCN with support to identify patients and engage patients to attend for an NHS health check and support in practice clinics. (To include basic clinical skills such as taking blood tests, blood pressure, height, weight, urine dip and lifestyle questions).

Coordinate Multi-Disciplinary Team meetings for people living in the community. Be responsible for arranging, attending and minuting Multi-Disciplinary Team Meetings. Follow up on all forward actions resulting from MDT discussions

Utilise Population Health Intelligence to proactively identify patients at risk and work with the PCN team to enable the PCN team to deliver personalised care

Utilise Population Health Intelligence tools where needed to support other patients in the PCN.

Support the achievement of the IIF targets through reporting and communication

Additional Duties

Be responsible for daily updating of patients on e-HealthScope Workflow to identify patient to support the PCN team with identifying community pathways that might prevent hospital admission and for identifying potential gaps in care

To record patient interventions on relevant electronic database systems (e.g. SystmOne) and contribute to report generation, analysis and production

To contribute to the integration of health and social care by maintaining up to date recording systems for all agencies within the PCN Team and providing information to any member of the PCN Team in order to ease processes and communication in agreement with data protection protocol

Use clinical systems for record keeping, audit and evaluation

To be customer (patient, carer, GP) focused when representing the service

To work collaboratively with other teams and services to maintain an effective and efficient service

To offer appropriate support and guidance to patients and their families/carers

To plan / organise work using own initiative, whilst being able to work as a valuable member of a team

To work effectively as part of a team to provide cover for Care Coordination Teams when required and to be flexible regarding working hours to meet the needs of the service

To ensure all electronic records are updated and complete within the agreed time-scales

To use a range of verbal and non-verbal communication tools to communicate effectively with patients, carers and families and colleagues.

To support and work with key personnel in the PCN to develop & support collective general practice projects.

Professional Development / Personal Performance

Work towards completing the appropriate training to deliver and support the Comprehensive Model for Personalised Care.

To participate in any relevant training/courses/conferences

Complete mandatory training

Adhere to organisational policies and procedures, including confidentiality, safeguarding, lone working, information governance, equality, diversity and inclusion training and health and safety.

Person Specification

Experience

Essential

  • Please refer to the job description and person specification attached to the job advert.

Desirable

  • Please refer to the job description and person specification attached to the job advert.

Qualifications

Essential

  • Please refer to the job description and person specification attached to the job advert.

Desirable

  • Please refer to the job description and person specification attached to the job advert.
Person Specification

Experience

Essential

  • Please refer to the job description and person specification attached to the job advert.

Desirable

  • Please refer to the job description and person specification attached to the job advert.

Qualifications

Essential

  • Please refer to the job description and person specification attached to the job advert.

Desirable

  • Please refer to the job description and person specification attached to the job advert.

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

Synergy Health PCN

Address

Trentside Medical Group

Knight Street

Netherfield

Nottingham

NG4 2FN


Employer's website

https://healthandcarenotts.co.uk/care-in-my-area/south-nottinghamshire-pbp/south-nottinghamshire-pcns/synergy-health/ (Opens in a new tab)

Employer details

Employer name

Synergy Health PCN

Address

Trentside Medical Group

Knight Street

Netherfield

Nottingham

NG4 2FN


Employer's website

https://healthandcarenotts.co.uk/care-in-my-area/south-nottinghamshire-pbp/south-nottinghamshire-pcns/synergy-health/ (Opens in a new tab)

For questions about the job, contact:

Digital & Transformation Lead

Laura Wilcock

nnicb-nn.synergy-health-pcn@nhs.net

Date posted

07 February 2025

Pay scheme

Other

Salary

£24,000 to £25,650 a year

Contract

Permanent

Working pattern

Flexible working

Reference number

A5713-25-0000

Job locations

Trentside Medical Group

Knight Street

Netherfield

Nottingham

NG4 2FN


West Oak Surgery

319 Westdale Lane

Mapperley

Nottingham

NG3 6EW


Park House Medical Centre

61 Burton Road

Carlton

Nottingham

NG4 3DQ


Supporting documents

Privacy notice

Synergy Health PCN's privacy notice (opens in a new tab)