Job summary
Our Care Coordinators play an important
role within the PCN to reduce health inequalities and support meeting
our PCN and practice targets. They work closely
with practice and PCN staff to identify,
engage with and coordinate personalised care and support
planning for the most vulnerable people
in our community, including the frail/elderly, patients
with dementia and their carers,
patients diagnosed with
cancer, care home residents and those with long-term health conditions.
As well as being linked with individual practices they will work
together as a team. This includes sharing learning and best practice both
within the team and across the PCN.
Our Care Coordinators support Clinical Leads and the
Multi-Disciplinary team in the organisation and facilitation of MDT meetings
including weekly Care homes meetings.
They run reports
to proactively identify
eligible patients and work to increase uptake
of health checks,
cancer screening, vaccinations and other services including
self-management services. Support with patient engagement, which includes
ensuring that information is accessible for all and having conversations with
patients and carers to increase understanding, alleviate concerns and increase
engagement and self-management.
Find more information attached.
Main duties of the job
Coordinate multidisciplinary meetings
across local care organisations including identifying patients in need of review and collating any information required to
facilitate their review prior to the meeting.
Provide admin support
to multidisciplinary meetings
including taking minutes.
Utilise GP Practice
clinical systems (SystmOne) and population health
data to proactively identify relevant
cohorts of patients to deliver personalised care
Support patients within
these cohorts to access health
checks and other health services including conducting blood pressure (BP)
checks and phlebotomy (blood sample collection) where appropriate.
Assist with the collection of clinical observations such as BP, pulse, oxygen saturation, and other basic health
indicators to support patient
monitoring.
Find more information attached.
About us
York Road Primary Care Network includes 3 practices working across 5
sites:
The PCN has a patient population of approx. 33,000 including
patients living across 2 care homes.
We believe in providing a holistic approach to managing patient care
and supporting individuals to meet their own needs and aspirations. You will be part of an organisation whose leadership team are supportive and innovative, focused
on change and transforming services.
Our team
currently includes ANP, Occupational Therapist, Care Coordinators, Social
Prescribers, Physiotherapists and Pharmacists. , with the aim of supporting our practices and improving
health outcomes for our patients. We do this through the integration of PCN
teams and services with our practices, continuous evaluation, and ongoing development
of our services and projects, looking for opportunities for innovation and
transformation and sharing best practice.
To address
the healthcare needs of our local population we are hoping
to employ a clinical
care coordinator
to join our PCN team.
Job description
Job responsibilities
Our Care Coordinators play an important
role within the PCN to reduce health inequalities and support meeting
our PCN and practice targets. They work closely
with practice and PCN staff to identify,
engage with and coordinate personalised care and support
planning for the most vulnerable people
in our community, including the frail/elderly, patients
with dementia and their carers,
patients diagnosed with
cancer, care home residents and those with long-term health conditions.
Find more information attached
Job description
Job responsibilities
Our Care Coordinators play an important
role within the PCN to reduce health inequalities and support meeting
our PCN and practice targets. They work closely
with practice and PCN staff to identify,
engage with and coordinate personalised care and support
planning for the most vulnerable people
in our community, including the frail/elderly, patients
with dementia and their carers,
patients diagnosed with
cancer, care home residents and those with long-term health conditions.
Find more information attached
Person Specification
Experience
Essential
- Experience of working in health, social care or other support roles which are in direct contact with people, families or carers
Desirable
- Experience of working in a primary care setting
- Use of clinical systems
- Experience of working with people who may face health inequalities e.g. living with frailty, people with living with learning disabilities or severe mental
- illness, and/or carers
Qualifications
Essential
- GCSE grade A-C in Maths and English or skills level 2 in Maths and English (or equivalent)
Desirable
- NVQ level 3 in healthcare
- ECDL or other equivalent IT qualification
Personal Qualities
Essential
- Flexibility and adaptability to develop the role within PCN business needs.
- Demonstrate the ability to value others
- Punctual and reliable
- Highly motivated and enthusiastic
- High levels of integrity and loyalty
- Team player
- Ability to work under pressure and timescales
- Ability to work in an environment of change to meet the needs of primary care
Knowledge and Skills
Essential
- Administrative duties including preparing for meetings and writing minutes
- Has attention to details, able to work accurately, identifying errors quickly and
- easily
- Has a planned and organised approach with an ability to priority their own workload to meet strict deadlines
- Excellent communication skills, verbal and written, with the ability to adjust
- communication style and content to suit the audience
- An excellent understanding of data protection and confidentiality issues
- Self-motivated, pro-active and able to work independently
- Continued commitment to improve skills and abilities in new areas of work
- Able to undertake the demands of the post with reasonable adjustment if required
- Able to access transport to work across the practices within the PCN and attend meetings in other locations
- Excellent time keeping and prioritisation skills
- Professional attributes and appearance
- Excellent IT skills and the ability to run reports and interpret / analyse and present data
Desirable
- Understanding of medical technology around frailty, population health management and long term conditions
- Perform venepuncture
- Perform basic physiological observations including BP, Pulse checks, Sats, respiration and Peak Flow Readings
Other Requirements
Essential
- Flexibility to work outside of core office hours including extended hours services
- Disclosure Barring Service (DBS) check
- Hold a Valid UK Driving Licence and have access to own transport with business insurance and ability to travel across the locality on a regular basis, including visiting people in their own home or care home.
Person Specification
Experience
Essential
- Experience of working in health, social care or other support roles which are in direct contact with people, families or carers
Desirable
- Experience of working in a primary care setting
- Use of clinical systems
- Experience of working with people who may face health inequalities e.g. living with frailty, people with living with learning disabilities or severe mental
- illness, and/or carers
Qualifications
Essential
- GCSE grade A-C in Maths and English or skills level 2 in Maths and English (or equivalent)
Desirable
- NVQ level 3 in healthcare
- ECDL or other equivalent IT qualification
Personal Qualities
Essential
- Flexibility and adaptability to develop the role within PCN business needs.
- Demonstrate the ability to value others
- Punctual and reliable
- Highly motivated and enthusiastic
- High levels of integrity and loyalty
- Team player
- Ability to work under pressure and timescales
- Ability to work in an environment of change to meet the needs of primary care
Knowledge and Skills
Essential
- Administrative duties including preparing for meetings and writing minutes
- Has attention to details, able to work accurately, identifying errors quickly and
- easily
- Has a planned and organised approach with an ability to priority their own workload to meet strict deadlines
- Excellent communication skills, verbal and written, with the ability to adjust
- communication style and content to suit the audience
- An excellent understanding of data protection and confidentiality issues
- Self-motivated, pro-active and able to work independently
- Continued commitment to improve skills and abilities in new areas of work
- Able to undertake the demands of the post with reasonable adjustment if required
- Able to access transport to work across the practices within the PCN and attend meetings in other locations
- Excellent time keeping and prioritisation skills
- Professional attributes and appearance
- Excellent IT skills and the ability to run reports and interpret / analyse and present data
Desirable
- Understanding of medical technology around frailty, population health management and long term conditions
- Perform venepuncture
- Perform basic physiological observations including BP, Pulse checks, Sats, respiration and Peak Flow Readings
Other Requirements
Essential
- Flexibility to work outside of core office hours including extended hours services
- Disclosure Barring Service (DBS) check
- Hold a Valid UK Driving Licence and have access to own transport with business insurance and ability to travel across the locality on a regular basis, including visiting people in their own home or care home.
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.
