Job summary
Dashwood Primary Care Network
Base: Wye Valley Surgery HP11 2TT
Salary: From £22,500 to £24,150 WTE dependant on experience
Working hours: 37.5 hours per week
NHS Pension
33 days annual leave inclusive of bank holidays
Employee Assistance Programme 24/7 Support
Do you love working with the wider community? Passionate about the services and treatment customers/patients receive? Working in a customer/ patient facing role and looking to to take the next step in your career in developing your skills and experiences in working within GP Practices.
An exciting opportunity has arisen for a care coordinator to join an already established, growing and committed team in providing additional care and services across PCN patient populations, including the provision of support and enhanced care to vulnerable patients and patients in residential and nursing home settings.
Main duties of the job
You will be joining a thriving existing PCN team of care coordinators, social prescribers and be an integral part of the team when it comes to delivering the best patient care.
The Care Coordinator will work as a key part of the Primary Care Network (PCN) multi-disciplinary (MDT) team.
You will work closely with the GPs and other primary care professionals within the PCN to identify and manage a caseload of identified patients, making sure that appropriate support is made available to them and their carers, and ensuring that their changing needs are addressed..
We are looking for a compassionate, collaborative and motivated coordinator to support the delivery of care to vulnerable patients and care homes, coordinating the work of healthcare professionals and non-clinical staff involved in the care of patients.
The successful candidate will possess strong administrative skills with the ability to multi task and ability to communicate well with the patients and wider external agencies. Excellent administration experience, keen eye for detail and sound IT skill are essential for this role such as Microsoft Office, Excel, PowerPoint, Microsoft Teams with the ability to analyse and report data.
Often being the first point of contact for our patients must be able to communicate and listen to patients clearly and effectively, demonstrate empathy putting our patients at ease.
About us
FedBucks
is a federation of 47 GP practices covering a population of over 485,000
patients across Buckinghamshire. We began in 2016 and now employ around 200
members of staff across our head office sites, and our planned and unplanned
care services.
As
a GP Federation, we are proud to represent our member practices and to champion
primary care by working with local general practice and system partners in the
provision of community-based healthcare services. We provide safe and
compassionate care to our patients across our range of planned and unplanned
healthcare services in Buckinghamshire and believe in continuous commitment to
quality service delivery and positive patient outcomes.
Patients
are at the heart of everything we do, and we pride ourselves in ensuring our
patients feel safe, supported, communicated with, and respected, at a time when
they may be feeling vulnerable. Our vision is to provide high quality, seamless
health care that enables people to lead healthier lives, whilst feeling
supported and cared for.
Job description
Job responsibilities
Primary Duties and Areas of Responsibility
utilise population health intelligence to proactively identify and work with a cohort of patients to deliver personalised care.
serve as the contact point, advocate and informational resource for patients, care teams, family /caregivers and community resources, responding with empathy and respect and signposting where appropriate.
ensure regular and consistent communication with care homes regarding patient progress.
support patients to utilise decision aids in preparation for a shared decision-making conversation.
acknowledge patients rights on confidential issues; maintain patient confidentiality at all times.
holistically bring together all of a persons identified care and support needs, and explore options to meet these within a single personalised care and support plan (PCSP), in line with PCSP best practice, based on what matters to the person.
help people 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.
visit patients in community, home or care home setting to assess and discuss their care needs involving carers as appropriate.
support people to take up training and employment, and to access appropriate benefits where eligible.
support people to understand their level of knowledge, skills and confidence (their Activation level) when engaging with their health and wellbeing, including through the use of the Patient Activation Measure.
assist with the identification of high risk patients and keep a register of the teams workload.
assist people to access self-management education courses, peer support or interventions that support them in their health and wellbeing and increase their activation level.
undertake visits or arrange appointments at their Practice for patients on the PCNs case load or otherwise as directed by the Duty Doctor following identification of urgent and non-urgent clinical need to assess, diagnose, treat, prescribe and refer appropriately according to the patients health needs and acting within the PCNs clinical skill set.
explore and assist people to access personal health budgets where appropriate.
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.
refer through to the appropriate member of the team, and/or make referrals on behalf of the team.
support the coordination and delivery of multidisciplinary teams (MDTs) within the PCN, to include management of the team diaries and arrangement/planning of team meetings and producing reports as requested.
liaise with members across all practices within the PCN, supporting good communication.
Job description
Job responsibilities
Primary Duties and Areas of Responsibility
utilise population health intelligence to proactively identify and work with a cohort of patients to deliver personalised care.
serve as the contact point, advocate and informational resource for patients, care teams, family /caregivers and community resources, responding with empathy and respect and signposting where appropriate.
ensure regular and consistent communication with care homes regarding patient progress.
support patients to utilise decision aids in preparation for a shared decision-making conversation.
acknowledge patients rights on confidential issues; maintain patient confidentiality at all times.
holistically bring together all of a persons identified care and support needs, and explore options to meet these within a single personalised care and support plan (PCSP), in line with PCSP best practice, based on what matters to the person.
help people 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.
visit patients in community, home or care home setting to assess and discuss their care needs involving carers as appropriate.
support people to take up training and employment, and to access appropriate benefits where eligible.
support people to understand their level of knowledge, skills and confidence (their Activation level) when engaging with their health and wellbeing, including through the use of the Patient Activation Measure.
assist with the identification of high risk patients and keep a register of the teams workload.
assist people to access self-management education courses, peer support or interventions that support them in their health and wellbeing and increase their activation level.
undertake visits or arrange appointments at their Practice for patients on the PCNs case load or otherwise as directed by the Duty Doctor following identification of urgent and non-urgent clinical need to assess, diagnose, treat, prescribe and refer appropriately according to the patients health needs and acting within the PCNs clinical skill set.
explore and assist people to access personal health budgets where appropriate.
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.
refer through to the appropriate member of the team, and/or make referrals on behalf of the team.
support the coordination and delivery of multidisciplinary teams (MDTs) within the PCN, to include management of the team diaries and arrangement/planning of team meetings and producing reports as requested.
liaise with members across all practices within the PCN, supporting good communication.
Person Specification
Skills and Knowledge
Essential
- Capacity to be innovative and develop the role of a care coordinator
- Ability to work with a range of clinical and non-clinical personnel as part of a team
- Ability to work independently and effectively with a high degree of motivation
- Ability to prioritise and work to deadlines
- Ability to define, collate, analyse and interpret data
- Able to utilise databases and information technology, including word processing, spreadsheets and presentation packages effectively
- Ability to communicate information to patients and carers in an appropriate manner, using well developed empathy skills
Desirable
- Understanding of NHS long term plan and priorities relevant to primary care
- Local knowledge of community healthcare and social care
- Understanding of the current issues facing primary care team.
Qualifications
Desirable
- Qualification in Health and Social Care Level 2 desirable
Experience
Essential
- Experience of coordinating patient care
- 1 years of experience in primary care or community setting
Desirable
- Case management experience
Person Specification
Skills and Knowledge
Essential
- Capacity to be innovative and develop the role of a care coordinator
- Ability to work with a range of clinical and non-clinical personnel as part of a team
- Ability to work independently and effectively with a high degree of motivation
- Ability to prioritise and work to deadlines
- Ability to define, collate, analyse and interpret data
- Able to utilise databases and information technology, including word processing, spreadsheets and presentation packages effectively
- Ability to communicate information to patients and carers in an appropriate manner, using well developed empathy skills
Desirable
- Understanding of NHS long term plan and priorities relevant to primary care
- Local knowledge of community healthcare and social care
- Understanding of the current issues facing primary care team.
Qualifications
Desirable
- Qualification in Health and Social Care Level 2 desirable
Experience
Essential
- Experience of coordinating patient care
- 1 years of experience in primary care or community setting
Desirable
- Case management experience
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.
