Job summary
Titan Primary Care Network (PCN) are seeking a dedicated and efficient Care Coordinator to play a pivotal role across our 3 practices. In this role you will become part of an experienced and supportive wellbeing team.
This position involves collaborating with healthcare professionals and community organisations to enhance the quality of care for our patients.
This is a self-directed and rewarding position, ideal for
someone who thrives in both independent and collaborative multidisciplinary
settings.
Interviews will be held 4th August 2026
Main duties of the job
Care Home Coordination:
- Coordinate long-term reviews for residents in care homes.
- Facilitate regular medication reviews to ensure effective management of prescriptions.
- Oversee and coordinate seasonal and routine vaccination programs for care home residents.
- Attend Multi-Disciplinary Team (MDT) meetings to discuss patient care strategies and outcomes.
- Liaise with relevant surgeries or teams to ensure continuity of care and effective information sharing.
Surgery Coordination:
- Work closely with clinical teams in surgeries to coordinate care for patients, ensuring timely access to healthcare services.
- Collaborate with health promotion initiatives and programs, including cancer and non-cancer screening, and other preventive health efforts.
- Assist in the coordination of care services between surgeries and other healthcare providers to enhance patient outcomes.
- Work closely with the social prescriber.
- Communicate and coordinate towards PCN DES 25/26 targets.
This is a new post and will require flexibility to adapt to the needs of the PCN.
About us
Titan PCN is an NHS collaboration covering over 33,000 patients across Houghton Regis Medical Centre, Toddington Medical Centre and Wheatfield Surgery.
Our Wellbeing Team are passionate about providing personalised patient care, building strong community links and delivering innovative population health initiatives.
Titan PCN are committed to supporting our team's health and wellbeing, offering an extensive employee assistance programme.
Job description
Job responsibilities
Care Coordination
-
Identify and proactively engage
patient groups experiencing health inequalities
-
Provide ongoing patient-facing
support to individuals throughout their healthcare journey, ensuring continuity
of care and helping patients understand and engage with their treatment plans
and available services.
-
Act as a central point of
contact for PCN patients, ensuring coordinated and timely support
- Coordinate long-term reviews for residents in care homes.
- Facilitate regular medication reviews to ensure effective
management of prescriptions for residents in care homes.
- Coordinate patient recall
programmes (e.g. Cancer Screening and Vaccinations)
Patient Support
-
Promote shared
decision-making and support patients to make informed choices about their
care
-
Support patients to navigate
healthcare systems and access appropriate services, appointments, and
interventions.
-
Provide information and
guidance to patients and their carers
-
Facilitate appropriate
referrals and connections to services
-
Identify barriers to engagement
and work proactively with patients to improve access, attendance, and health
outcomes
Multidisciplinary Team Working
-
Work collaboratively with GP
practices, MDT colleagues, and the Clinical Director
-
Support delivery of PCN Directed
Enhanced Service (DES) requirements
-
Contribute to the ongoing
development and improvement of PCN services
Administrative and Data Responsibilities
-
Maintain accurate patient
records and ensure appropriate clinical coding (training provided)
-
Ensure all patient information
is handled confidentially and in accordance with UK GDPR, Data Protection
legislation, NHS Information Governance standards, and PCN policies and
procedures.
-
Monitor and track patient
activity, recalls, and outcomes
-
Support data collection,
audits, and reporting requirements
-
Assist with general
administrative duties as required
General Responsibilities
-
Organise and prioritise
workload effectively, working both independently and as part of a team
-
Provide cross-cover for
colleagues during periods of absence
-
Contribute to a positive,
collaborative team environment
Job description
Job responsibilities
Care Coordination
-
Identify and proactively engage
patient groups experiencing health inequalities
-
Provide ongoing patient-facing
support to individuals throughout their healthcare journey, ensuring continuity
of care and helping patients understand and engage with their treatment plans
and available services.
-
Act as a central point of
contact for PCN patients, ensuring coordinated and timely support
- Coordinate long-term reviews for residents in care homes.
- Facilitate regular medication reviews to ensure effective
management of prescriptions for residents in care homes.
- Coordinate patient recall
programmes (e.g. Cancer Screening and Vaccinations)
Patient Support
-
Promote shared
decision-making and support patients to make informed choices about their
care
-
Support patients to navigate
healthcare systems and access appropriate services, appointments, and
interventions.
-
Provide information and
guidance to patients and their carers
-
Facilitate appropriate
referrals and connections to services
-
Identify barriers to engagement
and work proactively with patients to improve access, attendance, and health
outcomes
Multidisciplinary Team Working
-
Work collaboratively with GP
practices, MDT colleagues, and the Clinical Director
-
Support delivery of PCN Directed
Enhanced Service (DES) requirements
-
Contribute to the ongoing
development and improvement of PCN services
Administrative and Data Responsibilities
-
Maintain accurate patient
records and ensure appropriate clinical coding (training provided)
-
Ensure all patient information
is handled confidentially and in accordance with UK GDPR, Data Protection
legislation, NHS Information Governance standards, and PCN policies and
procedures.
-
Monitor and track patient
activity, recalls, and outcomes
-
Support data collection,
audits, and reporting requirements
-
Assist with general
administrative duties as required
General Responsibilities
-
Organise and prioritise
workload effectively, working both independently and as part of a team
-
Provide cross-cover for
colleagues during periods of absence
-
Contribute to a positive,
collaborative team environment
Person Specification
Experience
Essential
- Experience of providing support and information in people-facing roles within the health, community, or voluntary sector.
- Experience of dealing with highly emotive issues and strong emotional difficulties within a professional setting.
- Experience of building and maintaining networks and relationships.
- Experience of Multi-Disciplinary working.
Desirable
- Experience of assessing and supporting vulnerable people and those with long term health conditions.
- Experience of working with a range of agencies and sectors including health, local authority, voluntary and business sectors.
- Experience using the electronic patient record system, SystmOne.
Personal Attributes
Essential
- Caring, empathetic, and patient-focused approach.
- Excellent interpersonal and communication skills.
- Commitment to supporting vulnerable individuals.
Skills and Knowledge
Essential
- Understanding of patient-centred care and personalised care approaches.
- Strong organisational and communication skills.
- Ability to work collaboratively within a multidisciplinary team.
- Flexibility to adapt to the dynamic needs of the healthcare environment.
- Ability to identify and support vulnerable populations to ensure equitable access to cancer screening, health promotion, and proactive care.
- Excellent record keeping skills.
- Competent using Microsoft applications, especially Excel.
Desirable
- Able to run regular Ardens searches for identifying target groups.
- A commitment to addressing health inequalities and improving patient outcomes.
- Understanding of care pathways and healthcare processes.
Qualifications
Essential
- Educated to GCSE level (or equivalent), including English and Maths.
- Evidence of continuous professional development
Desirable
- NVQ Level 3, Advanced Level, or equivalent qualification.
- Training in motivational interviewing or health coaching
Person Specification
Experience
Essential
- Experience of providing support and information in people-facing roles within the health, community, or voluntary sector.
- Experience of dealing with highly emotive issues and strong emotional difficulties within a professional setting.
- Experience of building and maintaining networks and relationships.
- Experience of Multi-Disciplinary working.
Desirable
- Experience of assessing and supporting vulnerable people and those with long term health conditions.
- Experience of working with a range of agencies and sectors including health, local authority, voluntary and business sectors.
- Experience using the electronic patient record system, SystmOne.
Personal Attributes
Essential
- Caring, empathetic, and patient-focused approach.
- Excellent interpersonal and communication skills.
- Commitment to supporting vulnerable individuals.
Skills and Knowledge
Essential
- Understanding of patient-centred care and personalised care approaches.
- Strong organisational and communication skills.
- Ability to work collaboratively within a multidisciplinary team.
- Flexibility to adapt to the dynamic needs of the healthcare environment.
- Ability to identify and support vulnerable populations to ensure equitable access to cancer screening, health promotion, and proactive care.
- Excellent record keeping skills.
- Competent using Microsoft applications, especially Excel.
Desirable
- Able to run regular Ardens searches for identifying target groups.
- A commitment to addressing health inequalities and improving patient outcomes.
- Understanding of care pathways and healthcare processes.
Qualifications
Essential
- Educated to GCSE level (or equivalent), including English and Maths.
- Evidence of continuous professional development
Desirable
- NVQ Level 3, Advanced Level, or equivalent qualification.
- Training in motivational interviewing or health coaching
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.