PCN Social Prescriber

Job description

Job responsibilities

The PCN Social prescriber will review all referrals and allocate appropriate referrals

Hold own case load of complex cases

Introduce or coordinate an appropriate group support session

Make referrals directly to external providers e.g., DWP, VSC, Help Hub Manage dedicated caseload of complex cases:

Develop trusting relationships, giving individuals time and focus on what matters to them.

Support individuals to identify the wider issues that impact their health and Wellbeing, such as debt, poor housing, unemployment, isolation, and caring responsibilities.

Co-produce a simple personalised care and support plan to improve health and wellbeing.

Where appropriate introduce individuals to appropriate community groups, activities, and statutory services, ensuring they feel comfortable, valued, and respected.

Hold 1-1 appointment with individuals at the most appropriate location to meet individual needs, making home visits where appropriate within PCN policies and procedures.

Work with individuals their families and carers to maintain or regain independence through living skills, adaptations, enablement, and simple safeguards.

Have an awareness and understanding of when it is appropriate or necessary to refer individuals back to other health professionals/agencies, when there are additional needs such as mental health that requires a trained practitioner.

Where people are eligible for a personal health budget, support them to explore this option as a way of providing funding to enhance personalised support, to be independent and gain skills for meaningful employment, where appropriate.

Seek advice and support from the GP supervisor to discuss patient related concerns (e.g., abuse, domestic violence, and support with mental health) referring to the GP or other suitable health professional. Support population health management projects:

Work as part of the PCN project team to pilot new ways of working in response to population health data, delivering any aspect relating to social prescribing, and advising on community and voluntary sector services that should be included in the solution

Be proactive in developing strong links with the PCN practice teams to encourage referrals and raise awareness on what other services are available within the community and how patients can access them

Expanding the referral criteria to include wider agencies such as pharmacies, hospital discharge teams, allied health professionals, fire service, job centres, social care services, housing associations, VCSE organisations, the list is not exhaustive.

Work in partnership with all local agencies to educate and raise awareness of social prescribing and how partnership working can reduce pressure on statutory services.

Provide referral agencies with regular updates about social prescribing, including training their staff and how to access information, and seek their feedback

Be proactive in encouraging equality and inclusion, through self-referrals and connecting with all diverse local communities particularly those that statutory agencies may find hard to reach.

Work with commissioners and local partners to identify unmet diverse needs within the community and gaps in community provision.

Encourage individuals their families and carers to provide peer support and do things together such as setting up new community groups or volunteering. Oversee the data capture, reporting and evaluation for the service

By working sensitively with individuals, their families, and carers, use a suitable evaluation tool to capture key information to demonstrate the impact of social prescribing on their health and wellbeing.

Encourage individuals, their families, and carers to provide feedback and to share their personal stories about the impact of social prescribing on their lives.

Work closely within the multi-disciplinary team to ensure relevant data is captured efficiently throughout the process and relevant reports are completed and reviewed

Work as part of the healthcare team to seek feedback and continually improve the service and contribute to business planning Professional Development

Work with Clinical Director and line manager to undertake continual personal and professional development, taking an active part in reviewing and developing the roles and responsibilities

Adhere to organisational policies and procedures, including confidentiality, safeguarding, lone working, information governance, equality, diversity and inclusion training and health and safety.

Elements of this role will include projects with patients and their carers suffering from Dementia.

Person Specification

Experience

Essential

• Experience of working directly in a community development context, adult health, and social care, learning support or public health/health improvement (including unpaid work)
• Experience of data collection and using tools to measure the impact of services
• Experience of supporting individuals, their carers, and families
• Experience of leading a team; coordinating workload and troubleshooting issues

Other

Essential

• Meet DBS reference standards and criminal record checks
• Willingness to work flexible hours when required to meet work demands
• Access to own transport, ability to travel across the locality on a regular basis, including visiting individuals in their own homes
• Valid Full UK driving licence and business use insurance

Skills & Knowledge

Essential

• Knowledge of the personalised care approach
• Understanding of the wider determinants of health including social, economic, and environmental factors and their impact on communities, individuals their families and carers
• Understanding of equality, diversity, and inclusion
• Knowledge of IT systems, including ability to use word processing skills, emails, and the internet to create simple plans and reports
• Local knowledge of VCSE and community services in the locality
• Knowledge of how the NHS works, including primary care

Personal Qualities & Attirbutes

Essential

• Ability to actively listen, empathise with people and provide person-centred support in a non-judgemental and culturally sensitive way
• Ability to communicate effectively, both verbally and in writing, with individuals, their families, carers, community groups, partner agencies and stakeholders
• Ability to Identify risk, assess and manage risk when working with individuals
• Ability to maintain effective working relationships and to promote collaborative practice with all colleagues
• Commitment to collaborative working with all local agencies including VCSE organisations and community groups, able to find creative solutions to traditional barriers
• Can demonstrate personal accountability, emotional resilience, and ability to work well under pressure
• Ability to organise, plan and prioritise on own initiative, including when under pressure and meeting deadlines

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.

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).

Employer details

Employer name

Cygnet PCN

Address

Bartholomew Medical Group

Woodland Avenue

Goole

DN146RU

Employer's website

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