Job summary
Manchester City Centre and Ancoats Primary Care Network are recruiting for a new GP Care Coordinator position based at one of the PCN's practices in Manchester City Centre.
City Health Centre, part of gtd healthcare, one of the largest, not-for-profit, NHS commissioned primary and urgent care providers in North West England, are a large general practice based in the heart of City Centre Manchester.
The practice has a list size of approximately 15000 patients and also operates the Manchester Urgent Primary Care Hub which cares for all patients in Manchester as an urgent treatment centre.
The GP Care Coordinator will form part of the practice's Multi-Disciplinary Team responsible for managing the care of patients. This will involve coordinating the work of healthcare professionals and non-clinical staff involved in the care of patients.
The successful candidate will be friendly, confident, resilient, flexible, have well developed team work, communication, organisational and customer service skills. Experience of working in a GP Practice and using Emis Web & docman would be desirable but not essential.
Main duties of the job
- Provide coordination and navigation for people and their carers across health and care services, working closely with social prescribing link workers, mental health workers and other primary care roles.
- Help people transition seamlessly between secondary and community care services, conducting follow up appointments and supporting people to navigate through the wider health and care system.
- Work alongside the PCN clinicians to identify patients that require additional one-to-one support particularly with mental health issues and provide this support.
- Regularly liaise with the range of multidisciplinary professionals and colleagues involved in the persons care, facilitating a coordinated approach, and ensuring everyone is kept up to date so that any issues or concerns can be appropriately addressed and supported.
- Assist people to access self-management education courses, peer support orinterventions that support them in their health and wellbeing.
- Support the coordination and delivery of MDTs within the PCN.
- Collation of agendas, production of minutes / action logs for PCN / MDT meetingsand ensure all actions are completed including follow up if necessary.
- Specific project work liaising with practice leads on implementation of shared process, and collaboration opportunities to support improved patient care.
For further details, please refer to the job description attached.
About us
At gtd healthcare we believe we do things differently. Our not-for-profit ethos, with a drive to innovate care offers patients the best experience possible and a unique opportunity to transform services.
We are keen to develop and support staff to excel their career aspirations whilst making a positive difference to patients and the community. We put our people at the heart of everything we do. We are a values driven organisation and we are passionate about providing the best possible healthcare for our patients.
Benefits package
As an employee of gtd healthcare, you'll be able to take advantage of our benefits package, including:
- working for a values-driven organisation;
- Real living wage employer;
- access to Wagestream, which provides flexible and on-demand access to stream your pay during the month, in real-time, when picking-up extra shifts;
- 30 days annual leave, rising to 32 after five years of continuous service;
- flexible pension benefits including NHS pension scheme;
- flexible working hours and policies;
- family friendly and carer policies;
- opportunities to apply for innovation and quality awards;
- access to gtd healthcares wellbeing initiatives, which offer a wide range of tools and resources;
- gtd healthcare social and fun activities; cycle to work scheme.
Job description
Job responsibilities
- Provide coordination and navigation for people and their carers across health and care services, working closely with social prescribing link workers, mental health workers and other primary care roles.
- Making and managing appointments for patients related to primary care and voluntary organisations.
- Help people transition seamlessly between secondary and community care services, conducting follow up appointments and supporting people to navigate through the wider health and care system.
- Work alongside the PCN clinicians to identify patients that require additional oneto-one support particularly with mental health issues and provide this support.
- Regularly liaise with the range of multidisciplinary professionals and colleagues involved in the persons care, facilitating a coordinated approach, and ensuring everyone is kept up to date so that any issues or concerns can be appropriately addressed and supported.
- Identify when action or additional support is needed, alerting a named clinical contact in addition to relevant professionals and highlighting any safety concerns.
- Help people to manage their needs and supporting them to make appointments.
- Raise awareness of shared decision making, decision support tools and supporting shared decision-making conversation.
- Assist people to access self-management education courses, peer support or interventions that support them in their health and wellbeing.
- Support the coordination and delivery of MDTs within the PCN.
- Collation of agendas, production of minutes / action logs for PCN / MDT meetings and ensure all actions are completed including follow up if necessary.
- Specific project work liaising with practice leads on implementation of shared process, and collaboration opportunities to support improved patient care.
- Work collaboratively with practices targeting patients with Learning Disabilities (LD) and a Serious Mental Illness (SMI), to ensure they have annual physical health checks.
- Proactively identify and work with people, including the frail/elderly and those with long-term conditions.
- Manage a caseload of patients, working collaboratively with GPs and other primary care professionals within the PCN acting as a central point of contact to ensure appropriate support is made available to the patient.
- Maintain records of referrals and interventions to enable monitoring and evaluation of the service.
- Have positive, empathetic and responsive conversations with the person and their family and carer(s) about their needs.
- Develop an in-depth knowledge of the local health and care infrastructure and know how and when to enable people to access support and services that are right for them.
- Support people to develop and implement personalised care and support plans (PCS).
- Ensure PCS plans are communicated to the GP and any other professionals involved in the persons care and uploaded to the relevant online care records, with activity recorded using the relevant SNOMED codes.
- Keep accurate and up to date records of contacts, appropriately using GP and other records systems relevant to the role, adhering to information governance and data protection legislation.
- Undertake continual personal and professional development, taking an active part in reviewing and developing the role and responsibilities and provide evidence of learning activity as required.
- Adhere to organisational policies and procedures, including confidentiality, safeguarding, lone working, information governance, equality, diversity and inclusion training and health and safety.
- Establish strong working relationships with GPs and practice teams and work collaboratively with other care coordinators, social prescribing link workers and health and wellbeing coaches, supporting each other, respecting each others views and meeting regularly as a team.
- Identify opportunities and gaps in the service and provide feedback to continually improve the service and contribute to business planning.
- The post-holder is required to travel independently between PCN sites, and to attend meetings etc. hosted by other agencies.
- Liaise with service providers and clinicians to identify frequent flyers, and new service users utilising risk stratification tools provided and present this information to the MDT meetings.
- The successful candidate will be expected to work Monday to Friday, with occasional weekend working based on the needs of the service.
Other duties:
- Any other duties, as agreed with the line manager to meet the needs of the organisation. This may include travel to other sites within the organisation.
Job description
Job responsibilities
- Provide coordination and navigation for people and their carers across health and care services, working closely with social prescribing link workers, mental health workers and other primary care roles.
- Making and managing appointments for patients related to primary care and voluntary organisations.
- Help people transition seamlessly between secondary and community care services, conducting follow up appointments and supporting people to navigate through the wider health and care system.
- Work alongside the PCN clinicians to identify patients that require additional oneto-one support particularly with mental health issues and provide this support.
- Regularly liaise with the range of multidisciplinary professionals and colleagues involved in the persons care, facilitating a coordinated approach, and ensuring everyone is kept up to date so that any issues or concerns can be appropriately addressed and supported.
- Identify when action or additional support is needed, alerting a named clinical contact in addition to relevant professionals and highlighting any safety concerns.
- Help people to manage their needs and supporting them to make appointments.
- Raise awareness of shared decision making, decision support tools and supporting shared decision-making conversation.
- Assist people to access self-management education courses, peer support or interventions that support them in their health and wellbeing.
- Support the coordination and delivery of MDTs within the PCN.
- Collation of agendas, production of minutes / action logs for PCN / MDT meetings and ensure all actions are completed including follow up if necessary.
- Specific project work liaising with practice leads on implementation of shared process, and collaboration opportunities to support improved patient care.
- Work collaboratively with practices targeting patients with Learning Disabilities (LD) and a Serious Mental Illness (SMI), to ensure they have annual physical health checks.
- Proactively identify and work with people, including the frail/elderly and those with long-term conditions.
- Manage a caseload of patients, working collaboratively with GPs and other primary care professionals within the PCN acting as a central point of contact to ensure appropriate support is made available to the patient.
- Maintain records of referrals and interventions to enable monitoring and evaluation of the service.
- Have positive, empathetic and responsive conversations with the person and their family and carer(s) about their needs.
- Develop an in-depth knowledge of the local health and care infrastructure and know how and when to enable people to access support and services that are right for them.
- Support people to develop and implement personalised care and support plans (PCS).
- Ensure PCS plans are communicated to the GP and any other professionals involved in the persons care and uploaded to the relevant online care records, with activity recorded using the relevant SNOMED codes.
- Keep accurate and up to date records of contacts, appropriately using GP and other records systems relevant to the role, adhering to information governance and data protection legislation.
- Undertake continual personal and professional development, taking an active part in reviewing and developing the role and responsibilities and provide evidence of learning activity as required.
- Adhere to organisational policies and procedures, including confidentiality, safeguarding, lone working, information governance, equality, diversity and inclusion training and health and safety.
- Establish strong working relationships with GPs and practice teams and work collaboratively with other care coordinators, social prescribing link workers and health and wellbeing coaches, supporting each other, respecting each others views and meeting regularly as a team.
- Identify opportunities and gaps in the service and provide feedback to continually improve the service and contribute to business planning.
- The post-holder is required to travel independently between PCN sites, and to attend meetings etc. hosted by other agencies.
- Liaise with service providers and clinicians to identify frequent flyers, and new service users utilising risk stratification tools provided and present this information to the MDT meetings.
- The successful candidate will be expected to work Monday to Friday, with occasional weekend working based on the needs of the service.
Other duties:
- Any other duties, as agreed with the line manager to meet the needs of the organisation. This may include travel to other sites within the organisation.
Person Specification
Qualifications
Essential
- NVQ Level 2 in relevant qualification (or relevant experience).
- Proficient in MS Office and web-based services.
- Demonstrable commitment to professional and personal development.
Experience
Essential
- Experience of working with healthcare professionals and or
- previous experience in the NHS or Manchester City Centre and Ancoats Primary Care Network social care or relevant field (including unpaid work).
- Experience of data collection and providing monitoring information to
- assess the impact of services.
- Experience of partnership/collaborative working and of building relationships across a variety of organisations.
Desirable
- Experience in use of databases.
- Experience of supporting people, their families and carers in a related
- role (including unpaid work).
- Experience of working with or in general practice.
- Experience or training in personalised care and support planning.
- Experience of working with elderly.
Skills and attributes
Essential
- Ability to organise, plan and prioritise on own initiative, including when under pressure.
- Ability to actively listen, empathise with people and provide personalised support in a nonjudgemental way.
- Commitment to reducing health inequalities and proactively working
- to reach people from diverse communities.
- Ability to provide a culturally sensitive service supporting people from all backgrounds and communities, respecting lifestyles and diversity.
- Ability to communicate effectively, both verbally and in writing, with
- people, their families, carers, partner agencies and stakeholders.
- Ability to maintain effective working relationships and to promote
- collaborative practice with colleagues.
- High level of written and verbal communication skills.
- Demonstrates personal accountability, emotional resilience and works well under pressure.
Person Specification
Qualifications
Essential
- NVQ Level 2 in relevant qualification (or relevant experience).
- Proficient in MS Office and web-based services.
- Demonstrable commitment to professional and personal development.
Experience
Essential
- Experience of working with healthcare professionals and or
- previous experience in the NHS or Manchester City Centre and Ancoats Primary Care Network social care or relevant field (including unpaid work).
- Experience of data collection and providing monitoring information to
- assess the impact of services.
- Experience of partnership/collaborative working and of building relationships across a variety of organisations.
Desirable
- Experience in use of databases.
- Experience of supporting people, their families and carers in a related
- role (including unpaid work).
- Experience of working with or in general practice.
- Experience or training in personalised care and support planning.
- Experience of working with elderly.
Skills and attributes
Essential
- Ability to organise, plan and prioritise on own initiative, including when under pressure.
- Ability to actively listen, empathise with people and provide personalised support in a nonjudgemental way.
- Commitment to reducing health inequalities and proactively working
- to reach people from diverse communities.
- Ability to provide a culturally sensitive service supporting people from all backgrounds and communities, respecting lifestyles and diversity.
- Ability to communicate effectively, both verbally and in writing, with
- people, their families, carers, partner agencies and stakeholders.
- Ability to maintain effective working relationships and to promote
- collaborative practice with colleagues.
- High level of written and verbal communication skills.
- Demonstrates personal accountability, emotional resilience and works well under pressure.
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.
