North Staffordshire GP Federation

Care Co-ordinator - HIPC PCN

This job is now closed

Job summary

The Care Co-ordinator in HIPC Network will have a key role in supporting Safeguarding Lead GPs to protect our most vulnerable patients.

Work within HIPC GP Practices to provide central co-ordination for safeguarding information and communication to support care planning. The role will be GP facing with the core responsibility of maintaining consistent protocols regarding safeguarding information across the network.

Support the audit and research of safeguarding practice within the PCN and disseminate learning to colleagues to improve safeguarding practice across the PCN.

To oversee safeguarding administration, document handling, record management and communication with partner organisations.

Work within a multi-disciplinary team to aid liaison between the Primary Care Network team, Multi Agency Safeguarding Hub and the ICB.

The PCN Care Coordinator will support GP practices within the Primary Care Network, working within professional and clinical boundaries as part of an established multi-disciplinary team to deliver timely and personalised care for patients, and deliver key objectives of the Primary Care Network DES.

This post will particularly be supporting the early cancer diagnosis and cancer care quality improvement work by supporting practices to improve their processes, achieve their targets and working with patients to help them ensure they have the right support at each stage of their journey.

Main duties of the job

We are looking for someone who is hardworking, organised with great interpersonal skills who will be committed to delivering the highest quality of care for our PCN. If you have what it takes and have the experience as follows, we would like to hear from you:

Experience in a patient focused environment
Evidence of experience in wide range of administrative systems and software programmes
Experience of planning and organising complex meetings/agendas
Evidence of working with IT systems
Evidence of ability to support collation and analysis of data
Excellent verbal and written skills
Ability of provide and receive complex information
Excellent interpersonal skills
Excellent team player

This list is not exhaustive and can be amended as required.

About us

HIPC (Holistic Patient Centred Care) PCN are a group of practices working together to focus on local patient care. We are a small multi-disciplinary team, covering 5 practices across Stoke North area, covering a total population of 42,000+.

We have a strong leadership, led by our PCN Clinical Director and a supportive management team.

We are looking at expanding our team which currently includes clinical pharmacists, a pharmacy technician, dieticians, mental health practitioner, care co-ordinator and a social prescriber.

We are a very forward thinking and innovative PCN who utilises to the full, the skills and experience of our team members. We have a flexible approach and will consider full time/part time or job share opportunities.

We are support of professional development and pride ourselves supporting peer support for this new role whilst working in a supportive and friendly environmnet.

We work collaboratively with our local North Staffordshire GP Federation who support core General Practice and sustaining the future for General Practice. The Federation are facilitating and supporting the recruitment of the new roles within our Primary Care Network.

Date posted

29 August 2024

Pay scheme

Other

Salary

£25,147 a year Starting from £25,147, depending on experience

Contract

Permanent

Working pattern

Full-time

Reference number

B0070-24-0012

Job locations

HIPC PCN

All Practices Within the PCN

st6 6be

Job description

Job responsibilities

Cancer:

Coordinate contact with the practice, ensuring all newly diagnosed cancer patients are aware of the services available to them.

Manage the two week wait cancer referrals and other tests process within the practice which includes monitoring patients who have been referred via the suspected cancer referral pathway into secondary care to ensure they have been seen within the timeframe. Supporting patients and GPs with the management of issues with Secondary care.

Producing information monthly about new cancer diagnosis and any learning that has been identified so it can be presented at the monthly governance meeting.

Making sure patients have the tests they are scheduled to have for example annual prostate tests, FIT tests, blood tests which are necessary to detect or identify changes that may require GP action.

Proactively inviting cervical screening patients in, explaining the importance of screening, allaying fears and increasing uptake.

Following up non responders for Breast Screening and Bowel Cancer screening and trying to increase uptake by explaining the processes and benefits.

Working to target non responders and hard to reach patients to increase all screening uptake.

EOLC/Complex patients

Supporting with the identification of palliative care patients, ensuring they are coded correctly and getting the services they require.

Supporting with the identification of Moderately and Severely Frail patients and ensure they are getting the services they require, at home if needed.

Ensure End of Life care and complex needs patients are getting regular reviews with clinicians and an annual review to assess their needs and things such as resuscitation preference where appropriate.

Ensuring that Do Not Attempt Resuscitation requests are completed correctly and information coded on shared records. Reviewing records of deceased patients with a DNAR to see if their wishes were followed.

Make referral for patients and their carers across health and care services, working closely with social prescribing link workers, health and wellbeing coaches and other primary care professionals.

Learning Disabilities

Work with all patients on the learning disability register to ensure they have their annual reviews and attend for regular testing when appropriate.

Work with carers to facilitate appointments.

Ensure the uptake of screening and vaccinations for these patients is as high as possible.

Ensure literature sent to patients is LD friendly.

On a monthly basis monitor hospitalisations of patients with LD and report data at the monthly governance meeting, liaising with GPs to identify if earlier intervention from the practice could have prevented the hospitalisation.

Organise and participate in any LD Death audits and present findings to clinical team.

Liaise on a weekly basis with the LD Care Home Manager.

Organise the annual review day with the multi disciplinary team including GP, LD Nurse and Pharmacist.

Ensure the LD care home manager is able to access the practice easily about care for the residents.

Safeguarding

To oversee the workflow of safeguarding reports and documents and ensure they are circulated to appropriate clinicians in line with practice safeguarding policies.

To summarise and code the documents into the relevant specific templates, highlighting to patients registered GPs anything significant.

To maintain a register of children on Child Protection Plans, Child in Need plans and those children deemed to cause for concern.

To ensure the correct coding is added to patient records to aid clinicians in identifying those children and adults who are cause for concern.

To add alerts to parent records, those who have a child on a safeguarding plan.

Any other tasks delegated by practices, suitable to the candidates strengths.

To contribute to data collection and audit in relation to safeguarding to support and improve standards for safeguarding practice across the PCN.

Other

Undertake new patient health checks.

Carry out baseline observations such as pulse oximetry, blood pressure, temperature, pulse rate, recording findings accurately.

Support the nursing teams with health promotion programmes and chronic disease clinics.

Assist with answering calls and booking appointments for the first hour on the mornings you start at 8 am.

Support the reception team with cover the reception desk when they are short staffed.

Liaising with other health professionals as required, to deliver personalised care.

Constant review of processes to identify improvements in systems and procedures.

Ensure patients of patient on high risk drugs have regular blood tests.

Support with and undertake the call and recall for vaccination campaigns to ensure the highest possible uptake e.g. COVID, Flu.

Work closely with the PCN social prescribing link worker and Mental Health Practitioner.

Work proactively with the PCN pharmacist to support medication reviews and regular drug monitoring requirements.

Ensure all coordinated activity is documented and coded accurately.

Build relationships with our community service providers.

Raise awareness within the PCN of shared decision making and decision support tools.

Help patients to manage their needs through answering queries, making and managing appointments, and ensuring that people have good quality written or verbal information to help them make choices about their care.

Provide coordination and navigation for people and their carers across health and care services, working closely with social prescribing link workers, health and wellbeing coaches and other primary care professionals.

PROFESSIONAL INTEGRITY

Participate in any training programme implemented by the PCN as part of this employment, such training to include:

Participation in an annual individual performance review, including taking responsibility for maintaining a record of own personal and/or professional development.

Taking responsibility for own development, learning and performance and demonstrating skills and activities to others who are undertaking similar work.

To work in accordance with health and safety policies and procedures including reporting and recording any health and safety incident or accident.

Adhere to host employers adult and children safeguarding policies and procedures.

This job description is not exhaustive, and duties may vary with the requirements of the PCN.