Job summary
Exciting post - Integrated Transfer of Care Coordinator (ITOC). Are you caring and compassionate and a natural problem solver motivated by making a difference to peoples lives? Are you resilient, organised and creative with a passion to think differently to overcome complex issues?
East Coast Community Healthcare (ECCH) are proud to be partnering with our local Integrated Care Systems to introduce another full time ITOC role in our Transfer of Care team.
The successful candidate will need a range of experience, which may include hands on care, or similar experience in a Health and/or social Care setting, but the primary requirement is that the candidate must be passionate about providing effective support to our people to ensure they get the best care.
You will need to enjoy learning from colleagues and enjoy supporting people to access the right care, at the right time and in the right place.
As an ITOC you will be at the heart of the team supporting team members to be efficient, effective and get the best results for the people within the service. This is a Full time post and applicants will be required to work a variety of shifts across different locations.
If you are the person described above and relish the opportunity for career development, we want to hear from you!
Under
current UK immigration rules, this role does not meet the eligibility
requirements for sponsorship under either the Health and Care Worker visa or
the Skilled Worker visa routes.
Main duties of the job
Being an integrated role, the post holder will work closely with East Place Great Yarmouth and Waveney system partners (Norfolk and Suffolk Adult Social Services, James Paget University Hospital, ECCH, ICB), such that, the post holder's, work and views are representative of the five organisations working collaboratively and together.
This post is a key part of the Integrated Transfer of Care Team supporting safe transfers of care for patients who live in the Great Yarmouth and Waveney Locality (East Place). The post holder will, using the Home First ethos and effective communication proactively promote community patient flow with system partners.
- Join our Team to coordinate seamless patient care across health ad social care services. Review referrals, manage patiet flow from hospital to community, working closely with multidisciplinary teams, care agencies and voluntary services.
- This role requires strong communication, decision making and problem -solving skills to ensure timely transfers of care and optimal use of resources.
- Be able to work flexibly and independently meeting the demands of the role and East place systems - supporting integrated working across health and Social care, and optimising bed capacity and transfer pathways.
- Contribute and analyse performance data and sensitive information to support transformation within the East Place.
- Confident with using IT systems and digital programmes.
About us
ECCH is well established health care provider and has been successfully delivering NHS care within the community since 2011. We provide a range of NHS, community health and social care services predominantly across the easterly region of the Norfolk/Suffolk borders.
We are aligned to NHS terms and conditions, and offer many employee benefits, to find out more about us visit our website - www.ecch.org. We are a social enterprise and staff owned organisation which means staff can opt to be shareholders and have a real say in how ECCH is run and evolves to deliver healthcare for the future.
At the heart of our ambition, we work in partnership with and for the community to become the provider and employer of choice for community healthcare.
We encourage you to apply as early as possible as this job may close earlier than the advertised closing date once enough applications have been received.
We are a small and friendly team who are privileged to work alongside great colleagues within the integrated Care system. Our team is passionate about our local population and ensuring we always follow our 'home first ethos' with the patient being in the right place at the right time of their health and social care journey.
If you feel you have the right skills and knowledge and want to make a difference please apply or contact the named person in the advert for a informal discussion.
Job description
Job responsibilities
Communication
Review all
referrals for appropriateness ensuring all relevant information and assessments are completed and signpost on where needed.
To receive and
interpret/analyse sensitive information and accurately document information
Excellent communication
skills. Aim to develop and maintain effective interpersonal relationships with
all members of the multidisciplinary team
and East place
Actively give and receive
constructive feedback
Manage patient information
and analyse referral information to make an informed decision
Have a
thorough understanding and knowledge of transfer of care pathways, criteria to
reside and criteria for transfer of care
Liaise with Operations
centre and Virtual Transfer of Care Hubs
Network and liaise with
Social Care Colleagues and Care Agencies to source packages of care.
Liaise with voluntary
services, housing and charities to support patients needs on transfer of care
To maximise patient flow,
admissions and transfer of cares and to utilise bed stock to maximum capacity
according to referrals received
Updates wards/PCH/ToC hub re-referrals
accepted/declined verbally and on IT systems.
Patient Care
Work as part of a team
whilst taking independent responsibility for
referrals
Liaise with
Health and Adult Social Services colleagues, able to use escalation routes when
delays occur e.g. awaiting Social Worker allocation, waiting a Mental Capacity
Assessment (MCA)
Contribute to daily board rounds for the East
Place Intermediate care units, support transfer of care planning meetings,
identify and discuss potential transfer of care issues at the earliest
opportunity. Ensuring Estimated Dates of Transfer of care are reviewed and
updated accordingly.
Organise and facilitate
planning meetings as required
Participate
in East place calls giving clear and concise information on admissions. Liaise
with NHS Continuing Healthcare (CHC) team regarding packages of care and placements
Contribute to supporting evidence
to meet the Care Quality
Commission (CQC) fundamental standards as required
Understanding
of multidisciplinary and integrated working proactively manage patient flow
Acute to community
Meet the demands of the pace
of patient flow in the wider system
Contribute to a professional
working environment
Professional
Proactively Reviews acute
Hospital waiting list to seek out appropriate referrals for rehabilitation
Be able to analyse dashboard
data and identify trends for onward discussion with service leads
Communicate effectively,
develop, and maintain productive working relationships with East place partners
Provides timely and accurate
information re admission/referral information to daily system calls
To facilitate early transfer
of care from Pathway 2 intermediate care beds
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
Demonstrate a sound
knowledge of the Care Act 2014 and NHS CHC.
Utilise advanced decision
making and problem solving skills when reviewing referrals
Demonstrates
a high level of judgement, acting autonomously within role to accept/decline
referrals
Support with the development
of admission/transfer of care process/polices proposing any changes to the
benefit of patient pathways
Contribute to financial performance
Contribute to efficient use
of our resources
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.
Job description
Job responsibilities
Communication
Review all
referrals for appropriateness ensuring all relevant information and assessments are completed and signpost on where needed.
To receive and
interpret/analyse sensitive information and accurately document information
Excellent communication
skills. Aim to develop and maintain effective interpersonal relationships with
all members of the multidisciplinary team
and East place
Actively give and receive
constructive feedback
Manage patient information
and analyse referral information to make an informed decision
Have a
thorough understanding and knowledge of transfer of care pathways, criteria to
reside and criteria for transfer of care
Liaise with Operations
centre and Virtual Transfer of Care Hubs
Network and liaise with
Social Care Colleagues and Care Agencies to source packages of care.
Liaise with voluntary
services, housing and charities to support patients needs on transfer of care
To maximise patient flow,
admissions and transfer of cares and to utilise bed stock to maximum capacity
according to referrals received
Updates wards/PCH/ToC hub re-referrals
accepted/declined verbally and on IT systems.
Patient Care
Work as part of a team
whilst taking independent responsibility for
referrals
Liaise with
Health and Adult Social Services colleagues, able to use escalation routes when
delays occur e.g. awaiting Social Worker allocation, waiting a Mental Capacity
Assessment (MCA)
Contribute to daily board rounds for the East
Place Intermediate care units, support transfer of care planning meetings,
identify and discuss potential transfer of care issues at the earliest
opportunity. Ensuring Estimated Dates of Transfer of care are reviewed and
updated accordingly.
Organise and facilitate
planning meetings as required
Participate
in East place calls giving clear and concise information on admissions. Liaise
with NHS Continuing Healthcare (CHC) team regarding packages of care and placements
Contribute to supporting evidence
to meet the Care Quality
Commission (CQC) fundamental standards as required
Understanding
of multidisciplinary and integrated working proactively manage patient flow
Acute to community
Meet the demands of the pace
of patient flow in the wider system
Contribute to a professional
working environment
Professional
Proactively Reviews acute
Hospital waiting list to seek out appropriate referrals for rehabilitation
Be able to analyse dashboard
data and identify trends for onward discussion with service leads
Communicate effectively,
develop, and maintain productive working relationships with East place partners
Provides timely and accurate
information re admission/referral information to daily system calls
To facilitate early transfer
of care from Pathway 2 intermediate care beds
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
Demonstrate a sound
knowledge of the Care Act 2014 and NHS CHC.
Utilise advanced decision
making and problem solving skills when reviewing referrals
Demonstrates
a high level of judgement, acting autonomously within role to accept/decline
referrals
Support with the development
of admission/transfer of care process/polices proposing any changes to the
benefit of patient pathways
Contribute to financial performance
Contribute to efficient use
of our resources
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
Experience
Essential
- Working in a Hospital and/or community setting in a multidisciplinary team
- Experience of developing/implementing processes in line with service need
- Good working knowledge of patient flow, The Care Act 2014 and NHS CHC
Skills and Knowledge
Essential
- Excellent communication skills
- Able to interpret /analyse complex patient information which maybe distressing as
- relates to patients diagnosis and prognosis
- Tact and diplomacy
- A team player
- Good ICT skills including word, excel and emails
- Attention to detail with accurate, clear documentation
- Ability to analyse information and use reasoning and problem-solving skills to assess referrals
- Ability to prioritise and plan workload unsupervised
- Assertive with the ability to challenge situations and manage situations where conflict may arise
Qualifications
Essential
- NVQ level 4 in health or social care or equivalent experience in a Health and Social Care setting
Desirable
Personal Attributes
Essential
- Ability to work without supervision
- Ability to work as a team
- Excellent time management skills, punctual and reliable
- Assertive
- Able to remain effective and efficient under pressure
- Able to use own initiative
- Able to negotiate effectively
- Able to contribute to team, service and organisational development
- Aware of requirements for confidentiality
- 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).
Person Specification
Experience
Essential
- Working in a Hospital and/or community setting in a multidisciplinary team
- Experience of developing/implementing processes in line with service need
- Good working knowledge of patient flow, The Care Act 2014 and NHS CHC
Skills and Knowledge
Essential
- Excellent communication skills
- Able to interpret /analyse complex patient information which maybe distressing as
- relates to patients diagnosis and prognosis
- Tact and diplomacy
- A team player
- Good ICT skills including word, excel and emails
- Attention to detail with accurate, clear documentation
- Ability to analyse information and use reasoning and problem-solving skills to assess referrals
- Ability to prioritise and plan workload unsupervised
- Assertive with the ability to challenge situations and manage situations where conflict may arise
Qualifications
Essential
- NVQ level 4 in health or social care or equivalent experience in a Health and Social Care setting
Desirable
Personal Attributes
Essential
- Ability to work without supervision
- Ability to work as a team
- Excellent time management skills, punctual and reliable
- Assertive
- Able to remain effective and efficient under pressure
- Able to use own initiative
- Able to negotiate effectively
- Able to contribute to team, service and organisational development
- Aware of requirements for confidentiality
- 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).
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)
