PCN Care Coordinator (Care Homes) - Ashfield South PCN

Primary Integrated Community Services

This job is now closed

Job summary

We have an exciting opportunity for a PCN Care Co-ordinator to join our dynamic team. Working closely with Care Homes, General Practices and other services. You will provide coordination and administrative support to other members of the PCN.

You will be based within Ashfield South Primary Care Network, with a patient population of approx. 39,000. The below details the location of the GP Practices in Ashfield South PCN. The role will require the successful candidate to attend the GP practices in the surrounding areas when required.

Ashfield House Surgery, Ashfield House, 194 Forest Road, Annesley Woodhouse, Kirkby in Ashfield, NG17 9JB
Family Medical Centre, 56a Lowmoor Road, Kirkby in Ashfield, NG17 7GB
Health Care Complex, 52 Lowmoor Road, Kirkby in Ashfield, NG17 7BG
Jacksdale Medical Centre, Main Road, Jacksdale, NG16 5JW
Kirkby Community Care Primary Care Centre, Portland Street, Ashfield Health Village, Kirkby in Ashfield, NG17 7AE

You will be part of a wider team of PCN Care Coordinators supported by our Care Navigation Team Leader, who is on the PICS leadership team.

Main duties of the job

KEY RESPONSIBILITIES

Coordinate Multi-Disciplinary Team meetings for people living in care homes
Utilise Population Health Intelligence to proactively identify care home residents and work with the PCN team to enable the PCN team to deliver personalised care
Utilise Population Health Intelligence tools where needed to support other patients in the PCN

KEY REQUIREMENTS

Good standard of education GCSE or equivalent in English and Mathematics
Experience of office procedures working at a high level as part of an administration team / within an administration role
Understanding and able to deal with confidential and sensitive issues when liaising with team members / other professionals

About us

We offer a comprehensive package which includes:

Part of a team of experienced practitioners and supported by a Care Navigation Team Leader, who will help support your professional development
Part of the NHS Pension Scheme or an alternative government based scheme (based on eligibility) with generous employer contributions
Competitive salaries with clear progression pathways referenced to NHS Agenda for Change
Fully integrated with NHS IT systems
Generous annual leave entitlement which references NHS Agenda for Change and recognises previous NHS service

On appointment - 27 days plus 8 days bank holiday entitlement
After 5 years - 29 days plus 8 days bank holiday entitlement
After 10 years - 33 days plus 8 days bank holiday entitlement

Competitive leave entitlement that includes sickness pay and maternity leave
Join a caring culture and a company of can do experts

Date posted

14 September 2021

Pay scheme

Other

Salary

Depending on experience Reference to Agenda for Change Band 4

Contract

Permanent

Working pattern

Full-time, Flexible working

Reference number

E0220-21-0168

Job locations

Ashfield South Primary Care Network

Family Medical Centre

56A Low Moor Road

Kirkby-in-Ashfield

NG17 7BG

Job description

Job responsibilities

JOB SUMMARY:

The post holder will work within the PCN Team, providing coordination, administrative and support to the Clinical teams and other members of the PCN.

This is a new and evolving role and additional administrative responsibilities as deemed necessary for the PCN working maybe given. This will include but not limited to administration support to the Clinical Director.

The post holder will work closely with Care Homes, General Practices and existing services to support the coordination and delivery of multidisciplinary team meetings for care home residents.

The post holder will support the PCN to proactively identify residents in care homes who require a personalised care and support plan.

ROLE OBJECTIVES:

The post holder, working closely with the PCN team, Care Home, GPs and existing community services will:

Coordinate Multi-Disciplinary Team meetings for people living in care homes
Utilise Population Health Intelligence to proactively identify care home residents and work with the PCN team to enable the PCN team to deliver personalised care
Utilise Population Health Intelligence tools where needed to support other patients in the PCN.

ADDITIONAL RESPONSIBILITIES:

Be responsible for daily updating of patients on e-HealthScope Workflow to identify care home residents to support the PCN team with identifying community pathways that might prevent hospital admission and for identifying potential gaps in care
Be responsible for arranging, attending and minuting Care home Multi-Disciplinary Team Meetings
Proactively prepare any actions prior to the care home MDT meetings ensuring all relevant clinicians are present
To record patient interventions on relevant electronic database systems (e.g. SystmOne) and contribute to report generation, analysis and production
Follow up on all forward actions resulting from MDT discussions
Be responsible for logging and making referrals
To contribute to the integration of health and social care by maintaining up to date recording systems for all agencies within the PCN Team and providing information to any member of the PCN Team in order to ease processes and communication in agreement with data protection protocol
To be responsible for recording, reporting and producing evaluation reports which will include evaluation detailing effectiveness outcomes of new roles.
To be customer (patient, carer, GP) focused when representing the service
To work collaboratively with other teams and services to maintain an effective and efficient service
To offer appropriate support and guidance to patients and their families/carers
To plan / organise work using own initiative, whilst being able to work as a valuable member of a team
To have excellent IT skills, to include Microsoft Office, Outlook and Excel
To undertake general office duties to support the role
To work effectively as part of a team to provide cover for Care Coordination Teams when required and to be flexible regarding working hours to meet the needs of the service
To ensure all electronic records are updated and complete within the agreed time-scales
To use a range of verbal and non-verbal communication tools to communicate effectively with patients, carers and families and colleague
Provide coordination of and participate in relevant internal and external working groups and provide project advice, expertise and support where requested
Support the PCN team by inputting into the overall strategy development and programming of work streams by applying knowledge and understanding of programme and project management
Work with key personnel in the PCN to develop & support collective general practice projects including areas of federated working
Work towards completing the appropriate training to deliver and support the Comprehensive Model for Personalised Care
Work closely and in partnership with the Social Prescribing Link Worker(s)
Provide coordination of and participate in relevant internal and external working groups and provide project advice, expertise and support where requested
To participate in the review and appraisal process
To carry out any other reasonable duties as requested by a manager to ensure quality of service
To participate in any relevant training/courses/conferences
Complete mandatory training
Use clinical systems for record keeping, audit and evaluation
Develop and implement data collection systems that will provide accurate and timely data.
Maintain confidentiality

PROFESSIONAL DEVELOPMENT / PERSONAL PERFORMANCE:

Identify learning needs, plan, implement and evaluate programmes of education to meet identified need.
Establish own support mechanisms to enable structured reflection, including supervision, development of supportive networks mentoring and coaching.
Participate in and undertake supervision of colleagues on an individual or group
Participate in the Divisional appraisal System and demonstrate the achievement of agreed personal objectives.

PHYSICAL AND MENTAL SKILLS:

The post holder should be physically fit for the role with the necessary keyboard and IT skills.
Required to communicate across the health community and with patients / carers where the nature of the information given may be sensitive and could be disputed.
The post holder should be empathetic and skilled in listening, persuasion and negotiation, and recognizes Care, Compassion, Courage, Competency, Communication, and Commitment in their role.

EFFORT AND ENVIRONMENT:

Physical effort

Frequent long periods of time spent writing up patient related information within agreed time limits. There is a need for speed and accuracy. This is a continuous requirement throughout each day.
Prolonged periods of time spent in a sitting position at a computer screen when answering the telephone and writing clinical information in patients notes at the same time.
Frequent periods through the day of standing and walking to liaise with other Health and Social Professionals.
The post holder is occasionally required to lift equipment several times throughout the week e.g. files or boxes or stationery.

Mental Effort

Prioritising work is essential, as often many tasks are required to be undertaken simultaneously. The post holder is required to work under pressure and meet deadlines.

Emotional Effort

Potential distressing situations e.g. liaising with terminally ill patients and their carers/families. Exposure to vulnerable groups.

WORKING CONDITIONS:

To function effectively across a variety of environments
Occasionally the post holder may be exposed to aggressive verbal abuse/physical aggression from patients, relatives and other health and social care professionals over the telephone or face to face.

Please download the supporting documentation for full role details and to assist with your application.

Job description

Job responsibilities

JOB SUMMARY:

The post holder will work within the PCN Team, providing coordination, administrative and support to the Clinical teams and other members of the PCN.

The post holder will work closely with Care Homes, General Practices and existing services to support the coordination and delivery of multidisciplinary team meetings for care home residents.

The post holder will support the PCN to proactively identify residents in care homes who require a personalised care and support plan.

ROLE OBJECTIVES:

The post holder, working closely with the PCN team, Care Home, GPs and existing community services will:

Coordinate Multi-Disciplinary Team meetings for people living in care homes
Utilise Population Health Intelligence to proactively identify care home residents and work with the PCN team to enable the PCN team to deliver personalised care
Utilise Population Health Intelligence tools where needed to support other patients in the PCN.

ADDITIONAL RESPONSIBILITIES:

Be responsible for daily updating of patients on e-HealthScope Workflow to identify care home residents to support the PCN team with identifying community pathways that might prevent hospital admission and for identifying potential gaps in care
Be responsible for arranging, attending and minuting Care home Multi-Disciplinary Team Meetings
Proactively prepare any actions prior to the care home MDT meetings ensuring all relevant clinicians are present
To record patient interventions on relevant electronic database systems (e.g. SystmOne) and contribute to report generation, analysis and production
Follow up on all forward actions resulting from MDT discussions
Be responsible for logging and making referrals
To contribute to the integration of health and social care by maintaining up to date recording systems for all agencies within the PCN Team and providing information to any member of the PCN Team in order to ease processes and communication in agreement with data protection protocol
To be responsible for recording, reporting and producing evaluation reports which will include evaluation detailing effectiveness outcomes of new roles.
To be customer (patient, carer, GP) focused when representing the service
To work collaboratively with other teams and services to maintain an effective and efficient service
To offer appropriate support and guidance to patients and their families/carers
To plan / organise work using own initiative, whilst being able to work as a valuable member of a team
To have excellent IT skills, to include Microsoft Office, Outlook and Excel
To undertake general office duties to support the role
To work effectively as part of a team to provide cover for Care Coordination Teams when required and to be flexible regarding working hours to meet the needs of the service
To ensure all electronic records are updated and complete within the agreed time-scales
To use a range of verbal and non-verbal communication tools to communicate effectively with patients, carers and families and colleague
Provide coordination of and participate in relevant internal and external working groups and provide project advice, expertise and support where requested
Support the PCN team by inputting into the overall strategy development and programming of work streams by applying knowledge and understanding of programme and project management
Work with key personnel in the PCN to develop & support collective general practice projects including areas of federated working
Work towards completing the appropriate training to deliver and support the Comprehensive Model for Personalised Care
Work closely and in partnership with the Social Prescribing Link Worker(s)
Provide coordination of and participate in relevant internal and external working groups and provide project advice, expertise and support where requested
To participate in the review and appraisal process
To carry out any other reasonable duties as requested by a manager to ensure quality of service
To participate in any relevant training/courses/conferences
Complete mandatory training
Use clinical systems for record keeping, audit and evaluation
Develop and implement data collection systems that will provide accurate and timely data.
Maintain confidentiality

PROFESSIONAL DEVELOPMENT / PERSONAL PERFORMANCE:

Identify learning needs, plan, implement and evaluate programmes of education to meet identified need.
Establish own support mechanisms to enable structured reflection, including supervision, development of supportive networks mentoring and coaching.
Participate in and undertake supervision of colleagues on an individual or group
Participate in the Divisional appraisal System and demonstrate the achievement of agreed personal objectives.

PHYSICAL AND MENTAL SKILLS:

The post holder should be physically fit for the role with the necessary keyboard and IT skills.
Required to communicate across the health community and with patients / carers where the nature of the information given may be sensitive and could be disputed.
The post holder should be empathetic and skilled in listening, persuasion and negotiation, and recognizes Care, Compassion, Courage, Competency, Communication, and Commitment in their role.

EFFORT AND ENVIRONMENT:

Physical effort

Frequent long periods of time spent writing up patient related information within agreed time limits. There is a need for speed and accuracy. This is a continuous requirement throughout each day.
Prolonged periods of time spent in a sitting position at a computer screen when answering the telephone and writing clinical information in patients notes at the same time.
Frequent periods through the day of standing and walking to liaise with other Health and Social Professionals.
The post holder is occasionally required to lift equipment several times throughout the week e.g. files or boxes or stationery.

Mental Effort

Prioritising work is essential, as often many tasks are required to be undertaken simultaneously. The post holder is required to work under pressure and meet deadlines.

Emotional Effort

Potential distressing situations e.g. liaising with terminally ill patients and their carers/families. Exposure to vulnerable groups.

WORKING CONDITIONS:

To function effectively across a variety of environments
Occasionally the post holder may be exposed to aggressive verbal abuse/physical aggression from patients, relatives and other health and social care professionals over the telephone or face to face.

Please download the supporting documentation for full role details and to assist with your application.

Person Specification

Qualifications

Essential

Please provide details of your qualifications and training.

Experience

Essential

Please provide detailed information of how you feel that your experience is suitable for this role; please provide examples to support your application referring to the job description and person specification for guidance.

Knowledge, skills and abilities

Essential

Please provide detailed information of how you feel that your knowledge, skills and abilities are suitable for this role; please provide examples to support your application referring to the job description and person specification for guidance.

Personal qualities

Essential

Please provide details for why you would be a great fit for this role and why you have decided to apply.

Person Specification

Qualifications

Essential

Please provide details of your qualifications and training.

Experience

Essential

Please provide detailed information of how you feel that your experience is suitable for this role; please provide examples to support your application referring to the job description and person specification for guidance.

Knowledge, skills and abilities

Essential

Please provide detailed information of how you feel that your knowledge, skills and abilities are suitable for this role; please provide examples to support your application referring to the job description and person specification for guidance.