Job summary
Focused Care is a model developed in Primary Care to support
vulnerable and complex patients in areas of high social deprivation. Taking a
whole household, person-centred approach you will have a caseload based of all
ages and conditions, with the aim to unpick problems which hold back a
person's health and social wellbeing.
Focused Care is a highly rewarding role which has been previously described as "Social Prescribing Plus Plus" as it goes much further, unpicking complex issues such as safeguarding, domestic violence, mental health, drug and alcohol misuse, or asylum applications.
Focused Care is a patient-facing role, based in home visiting, providing practical solutions to the causes behind the causes, and bringing services together in order to effect long-term, transformational change.
Main duties of the job
On referral you will complete a full initial assessment then
work with the patient to find lasting solutions for that household. Whilst
being a coach and mentor to patients supporting access to appropriate
appointments, medication and benefits, you will also be a good team player, working
together with the patient, statutory and community services as required, to
produce a care plan, which brings practical solutions to long-term problems.
We are
looking for someone with over 10 years experience, particularly in family work,
with a professional and caring non-judgemental attitude, a committment to
social justice and an understanding of health inequalities.
Understanding
of patient confidentiality and GDPR essential. Bangla and Urdu speaking advantageous
but not essential.
Microsoft Word, Excel and EmisWeb also an advantage as
whilst we aim to keep this at a minimum, efficient note recording and data
collection is required.
COVID-working
risk assessment and full precautions in place.
About us
Workers are placed in GP Surgeries and become part of that team, with access to records and taking part in everyday practice life including reporting to multi-disciplinary meetings.
After a comprehensive induction period, Focused Care Practitioners are also placed in local area teams, with an experienced Hub Lead who will support with one-to-one meetings, suggesting solutions and performance management. You will also receive clinical supervision once a quarter.
Benefits include 35 days annual leave (pro-rata including bank holidays), NHS Pension and 2 weeks paid Company Sick pay.
Pay scale: NHS Band 6 - dependent on experience
Job description
Job responsibilities
ESSENCE OF ROLE
Focused Care has been born out of a response
that in primary care many people come with problems and issues that cannot be
solved in 10 minutes with a GP. Often problems manifest themselves in medical
ways and solving the problems behind the problems brings significant change. At
primary care the most vulnerable are often the most invisible to the system, Focused
Care aims to turn this round and reverse the inverse care law so that the most
vulnerable become the most visible.
This role is hugely rewarding and involves
working with patients and their whole household to unpick the complexity and
find real solutions. You will need to be passionate about seeing change,
creative in finding solutions in complex situations, have excellent skills at
building relationships both with patients, staff members and other agencies.
You will have good networking skills and be able to bring together statutory
and third sector agencies in finding solutions.
You will need to have a background in a
relevant health or social field, being a nurse, health visitor, social worker,
probation worker, youth worker background. The qualification is less important
than your desire and ability to work autonomously, safely and with a huge
passion to bring change and social justice.
JOB SUMMARY
To
manage own caseload of complex and vulnerable cases, appropriately referred
from GPs and other members of the team.
To
assess needs of patients and families in complex/vulnerable situations and to
work as an advocate to develop effective care plans in partnership with the
families, to ensure that these needs can be met.
To help
the practice develop new ways of working to deliver whole person healthcare to
patients, families and the community.
To build
strong relationships between the practice and other statutory bodies, voluntary
organisations and the community.
To
pro-actively seek to build-up the community, in order to offer community as
well as practice solutions, to meet the health needs of individual patients and
their families.
DUTIES & RESPONSIBILITIES
To
attend multi-disciplinary practice meetings.
To
prepare relevant reports based on assessment and case findings.
To
ensure good communications between agencies and attend multi-agency meetings
where appropriate.
To work
transparently and in such a way that any further focused care workers can
easily take on this role.
To
access clinical supervision regularly in order to maintain gold standard of
practice and care.
To
ensure record keeping complies with practice, NMC or other professional
standards and child protection guidelines: to initiate and maintain a gold
standard of records which is accessible to the relevant agencies within patient
confidentiality guidelines.
To maintain accurate, confidential and up-to-date
documentation on all cases of safeguarding and child protection and report
where required.
Encourage GP practice staff to have increased
awareness of households (including adults and children) who may be in need of
safeguarding of have additional vulnerability
When working with adults complete the Initial
assessment on all adults, which provides a structure that identifies adults who
may be at risk.
To work in line with all practice policy and
procedures
Job description
Job responsibilities
ESSENCE OF ROLE
Focused Care has been born out of a response
that in primary care many people come with problems and issues that cannot be
solved in 10 minutes with a GP. Often problems manifest themselves in medical
ways and solving the problems behind the problems brings significant change. At
primary care the most vulnerable are often the most invisible to the system, Focused
Care aims to turn this round and reverse the inverse care law so that the most
vulnerable become the most visible.
This role is hugely rewarding and involves
working with patients and their whole household to unpick the complexity and
find real solutions. You will need to be passionate about seeing change,
creative in finding solutions in complex situations, have excellent skills at
building relationships both with patients, staff members and other agencies.
You will have good networking skills and be able to bring together statutory
and third sector agencies in finding solutions.
You will need to have a background in a
relevant health or social field, being a nurse, health visitor, social worker,
probation worker, youth worker background. The qualification is less important
than your desire and ability to work autonomously, safely and with a huge
passion to bring change and social justice.
JOB SUMMARY
To
manage own caseload of complex and vulnerable cases, appropriately referred
from GPs and other members of the team.
To
assess needs of patients and families in complex/vulnerable situations and to
work as an advocate to develop effective care plans in partnership with the
families, to ensure that these needs can be met.
To help
the practice develop new ways of working to deliver whole person healthcare to
patients, families and the community.
To build
strong relationships between the practice and other statutory bodies, voluntary
organisations and the community.
To
pro-actively seek to build-up the community, in order to offer community as
well as practice solutions, to meet the health needs of individual patients and
their families.
DUTIES & RESPONSIBILITIES
To
attend multi-disciplinary practice meetings.
To
prepare relevant reports based on assessment and case findings.
To
ensure good communications between agencies and attend multi-agency meetings
where appropriate.
To work
transparently and in such a way that any further focused care workers can
easily take on this role.
To
access clinical supervision regularly in order to maintain gold standard of
practice and care.
To
ensure record keeping complies with practice, NMC or other professional
standards and child protection guidelines: to initiate and maintain a gold
standard of records which is accessible to the relevant agencies within patient
confidentiality guidelines.
To maintain accurate, confidential and up-to-date
documentation on all cases of safeguarding and child protection and report
where required.
Encourage GP practice staff to have increased
awareness of households (including adults and children) who may be in need of
safeguarding of have additional vulnerability
When working with adults complete the Initial
assessment on all adults, which provides a structure that identifies adults who
may be at risk.
To work in line with all practice policy and
procedures
Person Specification
Qualifications
Essential
- Minimum 8 years experience in a Health or Social Care, or community role
- Professional qualifications if required by that previous role
Experience
Essential
- At least 8 years experience working with vulnerable people, in a health, social or community including voluntary setting.
- Experience of working across multi-disciplinary teams to bring a desired outcome for the person
Desirable
- - Experience of working in primary care
- - Experience of Safeguarding or DV work
- - Experience of supporting people with mental health
- - Working with IT / EMIS Web
Person Specification
Essential
- Excellent skills at building relationships with patients, GPs, staff members and other agencies
- Can-do practical attitude and ability to think outside the box.
- Ability to work in line within NHS, company and practice policies and procedures, and with your line manager and local team.
- Desire and ability to work autonomously, safely and manage own caseload
- Be proactive in developing caseload and pulling together support package for patients.
- Understand importance of accurate and timely documentation, confidentiality and safe information sharing.
- Experience and understanding of Safeguarding
- Good knowledge and understanding of IT systems and note recording
- Understanding of issues of diverse communities, particularly protected characteristics and BAME communities
- Current driving licence, business insurance and own car
- DBS Check to be completed on successful application
- Two agreeable references
Desirable
- Languages: Bangla and Urdu and/or use translation services
- Understanding and appreciation of the role of the community and voluntary sector.
- Understanding of long term conditions and preventative medicine
- Experience or knowledge of the services / working in relevant CCG or borough area.
Person Specification
Qualifications
Essential
- Minimum 8 years experience in a Health or Social Care, or community role
- Professional qualifications if required by that previous role
Experience
Essential
- At least 8 years experience working with vulnerable people, in a health, social or community including voluntary setting.
- Experience of working across multi-disciplinary teams to bring a desired outcome for the person
Desirable
- - Experience of working in primary care
- - Experience of Safeguarding or DV work
- - Experience of supporting people with mental health
- - Working with IT / EMIS Web
Person Specification
Essential
- Excellent skills at building relationships with patients, GPs, staff members and other agencies
- Can-do practical attitude and ability to think outside the box.
- Ability to work in line within NHS, company and practice policies and procedures, and with your line manager and local team.
- Desire and ability to work autonomously, safely and manage own caseload
- Be proactive in developing caseload and pulling together support package for patients.
- Understand importance of accurate and timely documentation, confidentiality and safe information sharing.
- Experience and understanding of Safeguarding
- Good knowledge and understanding of IT systems and note recording
- Understanding of issues of diverse communities, particularly protected characteristics and BAME communities
- Current driving licence, business insurance and own car
- DBS Check to be completed on successful application
- Two agreeable references
Desirable
- Languages: Bangla and Urdu and/or use translation services
- Understanding and appreciation of the role of the community and voluntary sector.
- Understanding of long term conditions and preventative medicine
- Experience or knowledge of the services / working in relevant CCG or borough area.
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.