LS25/26 PCN HCA/Social Prescribing Link Work

Job description

Job responsibilities

PCN

Frail, vulnerable and housebound Care Coordinator / Healthcare Assistant and Social prescriber

Job Description

Assessment

Work as part of the multidisciplinary team making home visit or working in clinics across a population of patients who are mostly frail vulnerable or house bound

Carry out a holistic, person-centred assessment which looks at the health and social needs of the person, conducted in partnership with the individual person, their family and carers. The assessment will be conducted, in the persons own home or in clinic to take account of environmental factors and to fully understand the persons functional ability in a familiar setting.

Carry out agreed specific assessments including a basic falls risk assessment, mental health and dementia assessments training can be provided

Develop and agree care plans and if necessary, reviews for ongoing needs.

Support with information gathering; undertaking CCSP Part 1 as part of long-term condition management.

Intervention

Refer and liaise with a range of statutory and voluntary sector support agencies, ensuring the person has access to a wide range of support : Social prescribing is a large part of the role utilising the resources available to signpost to the right person that can offer help/support.

Facilitate an awareness of the different resources available other than the health care sector that can help individuals holistically.

Building relationships with the wider teams such as the volunteer sector and local councils.

Where necessary identify urgent needs taking relevant action or liaison and familiarise with individual practice protocols.

Refer for relevant equipment including telecare to increase the persons independence.

Offer review and support to implement coping strategies to help manage mental health and dementia needs by referrals and signposting,

Provide guidance and support to increase the use of self-care methods.

Take a holistic approach to supporting the assessment of the health and wellbeing needs of the patient which includes undertaking basic clinical observations to accurately assess and monitor a patients blood pressure, pulse respiratory rate, temperature, oxygen saturations, and take blood samples, and has an awareness of escalation procedures at each individual practice including emergency procedures and when to ring 999.

Carry out low level falls assessment/screening and provide advice and information on falls prevention, including referral for equipment where necessary.

Monitor and review care plans and agreed outcomes in partnership with the person.

Promotion of the benefits of social prescribing and work of local groups and communities including responsibilities to educate other members of the PCN team on what services and support are available in the wider community

Act as an advocate for the person and report to senior staff when required

As this is a developing role there may be a requirement to carry out other tasks dependent on level of training, service need and staffing

Communication

To provide, and receive, information with empathy and understanding, and to adapt communication when barriers to understanding arise seeking senior guidance when necessary.

Take an active role in MDT processes providing input around the persons history, family circumstances etc.

To develop and maintain effective working relationships with other members of the primary care / ICC team.

Administration

Keep timely, accurate and complete electronic patient records and activity data, all of which will be maintained and stored in accordance with professional and organisational standards.

To have responsibility for appropriate documentation related to patients in their care to be disseminated to all relevant professionals in a timely manner and in accordance with operating standards.

Clinical duties

Clinical duties which may be expected in house and at home visits include:

Phlebotomy

Undertaking CCSP1 and dementia reviews

NHS Health Checks

Blood pressure recording

Height/Weight recording

Performing ECGs

Urinalysis

Chaperoning duties

Accurate, legible labelling of all samples to confirm patient identity

Checking patient identification against GP/nurse request and confirming with patient

Recording collection of blood sample in patient record in accordance with practice procedure

Ensuring that samples are dispatched to the appropriate laboratories in a timely fashion

Ensuring that anomalies are reported to a senior member of staff

Notifying the GP/nurse of any significant patient issues

Liaising with and assisting members of the administrative team

Perform health promotion or health education work

Signpost and refer to appropriate services

Other

To participate in discussions about the direction of service developments and improvements.

To participate in service audits and changes.

To participate in discussion for the implementation of policies and procedures

To contribute to the health and safety of others and the environment

To participate in appraisal processes and participate in CPD/ personal development plan.

To pro-actively participate in mandatory training and in-service training.

To participate in mentoring and sharing best practice with colleagues and students

Responsibilities and Confidentiality

The post holder is expected to:

Adhere to practice/PCN policies and procedures and relevant legislation.

Attend/complete mandatory training as identified by the practice/PCN

The post holder must maintain the confidentiality of information about patients, staff and practice business in accordance with the General Data Protection Regulation, Caldicott principles and Practice Information Governance policies and procedures.

Safeguarding

All employees have a duty for safeguarding and promoting the welfare of children and adults at risk. Staff must be familiar with the practice/PCNs Safeguarding Policy and the process for raising concerns about the welfare of anyone with whom they have contact. Staff must also ensure they receive the appropriate level of safeguarding children and adult training.

Staff are expected to access supervision and support from their line managers and/or the locality based safeguarding team when managing complex cases.

Job Description Agreement

This job description is intended to provide an outline of the key tasks and responsibilities only. There may be other duties required of the post holder commensurate with this position as requested by LS25/26 PCN. This description will be open to regular review and may be amended to consider the development of the PCN. All members of staff should be prepared to take on additional duties or relinquish existing duties in order to maintain the efficient running of the PCN/practices.

Person Specification

Other requirements

Essential

• Current driving licence and access to own vehicle
• Highly motivated and proactive.
• Flexibility of working hours

Experience

Essential

• Previous experience working with the general public.
• Evidence of good practice
• Working autonomously and as part of a team

Desirable

• Previous experience working with frail, older people.

Qualifications

Essential

• English and Maths to GCSE Grade C or above or equivalent.

Desirable

• NVQ level 3 or working towards

Skills, Knowledge and Aptitudes

Essential

• Excellent interpersonal, verbal and written communication skills
• Phlebotomy Trained
• Be able to provide high quality care.
• Ability to recognise risk and refer appropriately and safely
• Time management and ability to prioritise workload
• Able to work independently and effectively within a team
• Flexible and motivated
• Excellent computer skills
• Able to recognise and work within own limitations
• Understanding of equal opportunity and diversity issues

Desirable

• Ability to adapt to change within working situations
• Reflective working
• Awareness of frailty and chronic conditions
• Knowledge of the PCN and community working.
• Understanding of role of patient advocate.

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

South and East Leeds GP Group

Address

Hosted employer's address

1st Floor Park Edge Practice

Leeds

West Yorkshire

LS14 1HX

Employer's website

https://www.seleedsgpgroup.nhs.uk/ (Opens in a new tab)