Senior Integrated Transfer of Care Co-ordinator

Job description

Job responsibilities

Project Management and Operational Responsibilities

Lead on small scale projects.

Information/analyst advice, support and to maintain data collection systems for its effective use by the team.

Analyse and report on data and monitor the processing of data and information.

Provides information to project lead on projects and statistical information matters.

Participate in relevant internal and external working groups/projects, services, and initiatives to provide, information and analytical advice to strategic leads.

Contribute to effective information management within the team.

Undertake auditing of projects, services, and initiatives.

Support with the development of admission/transfer of care processes/polices proposing any changes to the benefit of patient pathways.

Propose changes to own project, service, initiative work, informing policy and making recommendations for more effective delivery.

Lead the implementation of services and initiatives in accordance with the agreed priorities of the East Place.

Review and develop existing project information management systems and contribute to the development of an integrated approach to project management.

Develop systems to monitor, evaluate and audit service quality to meet nationally and locally set targets and contribute towards the reporting to locality governance groups.

Staff Management

Direct line management for the Integrated Transfer of Care Coordinators including Supervision and annual personal development plans.

Plan staffing rotas and annual Leave within East transfer of care

Provide training, advice and support on own area of responsibility.

Support training and induction of new and existing staff.

Participate in the recruitment process of transfer of care staff.

Deputise for Integrated Transfer of Care Manager with support for Integrated Care Board.

Provide day to day operational leadership to the Transfer of Care system partner teams for example daily tasks, health/ wellbeing and working arrangements and professional supervision.

Patient Care

Work as part of a team whilst taking independent responsibility for referrals.

Liaise with health and social care colleagues, able to use escalation routes when delays occur e.g. awaiting Social Worker allocation, waiting a Mental Capacity Assessment (MCA).

Lead and contribute to daily East place system meetings to support intermediate care beds, transfer of Care, discharge delays, identifying, discussing and escalating issues at the earliest opportunity.

Meet the demand of the pace of patient flow in the wider system.

Ensure patients are following the correct pathways for discharge planning.

Contribute to the East place and partner calls giving clear and concise information on admissions and discharges, including continuing healthcare.

Adhere to trust policies for patient documentation across the East Place.

Professional

Actively develops, supports and contributes to the development of key performance indicators for the successful assessment of performance.

Carry out web based and publications research to support local and national guidance and service development.

Analyse dashboard data and identify trends for onward discussion with service leads.

Have a high level of judgment, acting autonomously within the role.

Communicate effectively, develop, and maintain productive working relationships with system partners.

Ensure early transfer of care from community hospital and Pathway 2 rehabilitation beds.

Able to problem solve and ensure the smooth running of the operational responsibilities within the Transfer of Care Team.

Ability to negotiation ensuring safe and timely transfer of care across system Partners.

Demonstrate a sound knowledge of the Care Act 2014 and NHS continuing Healthcare (CHC).

Able to work flexibly and be able to adjust to constant changing demands of the role.

Act as a resource, advisor and role model to other colleagues in relations to patient flow processes.

Contribute to the effective use of East Place resources.

Act as an ambassador for home first ethos.

All roles within East Coast Community Healthcare CIC (ECCH) require staff to demonstrate our

Values and Signature Behaviours in the care and service they provide to patients, service users, stakeholders and colleagues. All members of staff should consider these as an essential part of their job role.

Our Values outline the core behaviours that we can all achieve and are summarised as an acronym within the word CARE. These stand for: Compassion, Action, Respect and Everyone.

Underpinning our Values are our Signature Behaviours which highlight by taking the right actions we continue to build a strong culture. Our four Signature Behaviours are: Compassion - We Listen, We Learn, We Lead| Action - My Accountability, My Responsibility | Respect - Respect Our Resources: People, Time and Money | Everyone - Work Together, Achieve Together.

Person Specification

Qualifications

Essential

• Current professional registration in clinical subject/practice or equivalent relevant experience in health, Social Care or voluntary sector.
• Evidence of Leadership/ management qualification/training or equivalent relevant experience.
• On-going evidence of continuing professional development.

Desirable

• Information technology training (PRINCE2) or evidence of using IT programmes for project development/data analysis.
• Recognised training/accredited courses in relevant subject.
• Willing to undertake any relevant training/qualifications relevant to the role.

Skills and Knowledge

Essential

• Evidenced experience of negotiating and influencing skills.
• Excellent interpersonal skills, including communication with different stakeholders.
• Evidence of project work and attention to details including analyse of information.
• Proven ability in problem solving.
• Competent IT skills ability to use electronic diary and electronic clinical record systems (SystmOne & OPTICA) and MS Office software.
• Ability to travel accordance with role requirements.
• Advanced communication skills. Ability to communicate complex information to all system
• Partners.
• Able to critique research.
• Ability to lead/implement change.
• Assertive with the ability to challenge situations and manage situations where conflict may arise.

Desirable

• Understanding of Patient discharge pathways and national delay codes
• Experience in using SystmOne and OPTICA (Optimise Patient Tracking & Intelligent Choice Application.

Experience

Essential

• Evidence of leading and decision making in areas where there is no obvious right answer, balancing risk and resources with patient/person centred outcomes.
• Evidence of partnership working. Experience of Coordinating multidisciplinary integrated care for patients.
• Knowledge of all aspects of discharge.
• Knowledge of patient flow and clinical factors that affect flow e.g. length of stay, DTOC.
• Experience of contributing to projects.
• Experience of using an electronic patient record and Microsoft IT software.
• Experience of team leadership.
• Demonstrable leadership experience and mentorship skills.

Desirable

• Experience of Coordinating multidisciplinary integrated care and discharge planning for patients
• Project management experience.

Personal Attributes

Essential

• Ability to manage own workload, time management skills, be punctual and reliable.
• Strong team working skills and able to work collaboratively.
• Self-motivated, innovative and enthusiastic.
• Interested in developing the scope of transfer of care related to discharge planning.
• Able to lead on areas of team, service and organisational development.
• Able to remain effective and efficient under pressure.
• Ability to embrace our Culture, Values and Signature Behaviours:
• (Compassion - We Listen, We Learn, We Lead| Action - My Accountability, My Responsibility | Respect - Respect Our Resources: People, Time and Money | Everyone - Work Together, Achieve Together).
• Willingness and ability to work across different sites and travel to alternative sites and across the community as required.

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

East Coast Community Healthcare CIC

Address

James Paget Hospital

Lowestoft Road

Gorleston

Great Yarmouth

Norfolk

NR31 6LA

Employer's website

https://www.ecch.org/ (Opens in a new tab)