Care Co-Ordinator

Job description

Job responsibilities

JOB TITLE: PCN Care Co-ordinator

SALARY: £30,000 - £33,000

HOURS: Full-time, 37.5 hours

LOCATION: The role is practice based at Bedford Hill Family Practice.

ACCOUNTABLE TO: Practice Manager (Operationally) and PCN Manager (HR)

WORKING RELATIONSHIPS: the immediate practice team, the wider PCN team and external organisations including secondary and tertiary care, social care, voluntary services and community organisations.

JOB SUMMARY

The care co-ordinator will work with the primary care team to co-ordinate appointments for a caseload of patients. Looking at patient non-medical needs whilst connecting with additional organisations as necessary to prevent avoidable hospital admissions. They will be based in an individual practice and work closely with the whole team there as well as the PCN. They will have the opportunity to work beyond the PCN, connecting as needed with social prescribing link workers, council, voluntary services and community organisations, ensuring health and care planning is timely, efficient and patient-centred.

MAIN TASKS AND RESPONSIBILITIES

The PCN Care Co-ordinator will,

Work with colleagues within the GP practice and PCN to identify and manage appointments for a stable caseload of patients with long-term conditions, liaising with other health professionals as required, to deliver personalised care

Be the first point of contact for these patients

Proactively support call and recall processes

Build relationships with our community services provider (CLCH)

Work closely with the PCN social prescribing link worker

Work closely with the Admin Team undertaking administrative duties.

Work proactively with the PCN pharmacist to support medication reviews

Proactively support multi-disciplinary team meetings (dates, agenda, papers)

Ensure all co-ordinated activity is documented and coded accurately

Champion the use of MS Teams, and other digital communication platforms

Raise awareness within the PCN of shared- decision making and decision support tools

Raise awareness of how to identify patients who may benefit from shared decision making and support PCN staff and patients to be more prepared to have shared decision-making conversations

PROFESSIONAL INTEGRITY

The PCN Care Coordinator will be supported by a GP to discuss patient related concerns and be supported to follow appropriate safeguarding procedures.

The Care Co-ordinator will be expected to undertake developmental training to support the evolution of this new role.

This job description is not an exhaustive list and may be subject to change as the role develops, in accordance with the requirements of the PCN or the Personalised Care Institute.

The PCN Care Co-ordinator will:

• holistically bring together all of a persons identified care and support needs, and explore options to meet these within a single personalised care and support plan, in line with best practice, based on what matters to the person
• help people to manage their needs through answering queries, making and managing appointments, and ensuring that people have good quality written or verbal information to help them make choices about their care
• support people to take up training and employment, and to access appropriate benefits where eligible
• support people to understand their level of knowledge, skills and confidence (their Activation level) when engaging with their health and wellbeing, including through the use of the Patient Activation Measure
• assist people to access self-management education courses, peer support or interventions that support them in their health and wellbeing and increase their activation level
• explore and assist people to access personal health budgets where appropriate
• provide administrative support to the primary health care team
• provide coordination and navigation for people and their carers across health and care services, working closely with social prescribing link workers, health and wellbeing coaches and other primary care professionals and

support the coordination and delivery of MDTs within the PCN.

GENERAL TERMS

PROBATIONARY PERIOD

This post is subject to a six- month probationary period.

STANDARDS OF BUSINESS CONDUCT

The post holder will be required to comply with the individual Policies and Procedures of the employing practice and at all times work professionally and courteously.

All practice staff may be involved directly or indirectly with people who are receiving a health service. Therefore, this role is subject to a Disclosure & Barring Service (DBS) check.

CONFIDENTIALITY and INFORMATION GOVERNANCE

Staff may have access to confidential information about patients, staff or any practice or Health Service business. On no account must such information be divulged to anyone who is not authorised to receive it. Confidentiality of information must be preserved at all times whether at or away from work. Any breach of such confidentiality is considered a serious disciplinary offence, which could lead to dismissal and/or prosecution under statutory legislation (GDPR) and the practices Disciplinary Procedure. All staff must act within legislation, policies and procedures relating to information governance

GENERAL DATA PROTECTION REGULATION (GDPR)

Everyone responsible for using personal data will follow strict rules called 'data protection principles'. They must make sure information is:

used fairly, lawfully and transparently

used for specified, explicit purposes

used in a way that is adequate, relevant and limited to only what is necessary

accurate and, where necessary, kept up to date

kept for no longer than is necessary

handled in a way that ensures appropriate security, including protection against unlawful or unauthorised processing, access, loss, destruction or damage

All staff who contribute to patients health records are expected to be familiar with and adhere to the practices Records Management Procedure.

HEALTH AND SAFETY

All staff must undertake statutory/mandatory training as instructed. All staff must act within legislation, policies and procedures relating to Health and Safety. Staff must be familiar with the Health and Safety Policy, including a thorough understanding of personal responsibilities for maintaining own health and safety and that of others. This applies not only to working on-site, but also when working off-site for example at another practice.

RISK MANAGEMENT

All practice employees are accountable, through the terms and conditions of their employment, professional regulations, clinical governance and statutory health and safety regulations. Staff are responsible for reporting incidents, handling patient feedback and complaints appropriately, being aware of the risk management strategy and emergency procedures, and attendance at any relevant training as required.

The post holder will ensure compliance with practices risk management policies and procedures. These describe practices commitment to risk management, the recognition that our aim is to protect patients, staff and visitors from harm and stress and that all staff have a responsibility to minimise risk.

INFECTION CONTROL

All staff are required to be familiar with practice's infection control policies and procedures and national guidance in relation to infection control. All staff whose normal duties are directly or indirectly concerned with patient care must ensure that they complete mandatory infection control training and are compliant with all measures known to be effective in reducing Healthcare Associated Infections.

SAFEGUARDING

Safeguarding is covered during induction and staff will be required to undertake additional training regarding safeguarding relevant to the position and role. Ensuring the safeguarding of vulnerable adults and children in our care is a top priority. All employees are required to be familiar with their responsibilities and to raise concerns.

EQUALITY, DIVERSITY AND HUMAN RIGHTS

The post holder will treat all colleagues, patients and members of the public with respect and dignity regardless of their gender, age, race, religious beliefs, religion, nationality, ethnic origin, social background, sexual orientation, marital status, disability, criminal background and Trade Union status. It is the responsibility of all staff to ensure that the Equality & Diversity policy is implemented and contribute to its success.

HARASSMENT AND BULLYING

All forms of harassment and bullying is condemned and practices actively seek ways to promote a workplace where employees are treated with dignity, respect and without bias. All staff are requested to report any form of harassment and bullying to their manager or any other Manager within practice.

QUALITY

It is the responsibility of all staff to adhere and support the delivery of high quality care at all times.

TRAINING

All staff must attend statutory /mandatory training as instructed. This may be a mixture of face to face and e- learning.

NO SMOKING POLICY

There is a smoke free policy in operation in all practices. In accordance with this policy smoking is discouraged and is not permitted anywhere within the buildings or within 15 metres of practice sites.

Person Specification

Skills

Essential

• Excellent communication skills, telephone manner, active listening and negotiation skills.
• Excellent IT skills across all MS Office packages
• Meeting co-ordination - calendar invitations, agenda and note taking
• Resourceful and solutions focused. Able to research possible options and present possible solutions
• Ability to prioritise, plan and focus on deadlines, work under pressure and against agreed timeframes and performance targets

Desirable

• NHS.net
• EMIS Web - coding and reporting
• MS Teams - remote meetings
• DocMan
• Writing emails and drafting reports
• Key Performance Indicator - KPI reporting

Experience

Essential

• Working with others to deliver quality services to patients
• Establishing and maintaining productive collaborations both in and outside the organisation in a multi-professional environment
• Working with volunteers and link workers
• Meeting co-ordination and note taking

Desirable

• Experience developing a new role or process
• Work within health or social care settings eg. healthcare coordination, advocacy or planning
• Experience of working with patient records; accurate data entry
• Care plan co-ordination and shared decision making process
• Multi-disciplinary team meeting management

Knowledge

Essential

• Personalised Care agenda
• Role of the Primary Care Institute
• Role of Primary Care Networks
• Emis Web

Desirable

• Knowledge of public and voluntary services in Wandsworth
• Population health awareness
• Issues affecting older people and carers
• Referral and care pathways in Wandsworth

Qualifications

Essential

• Good standard of education eg. functional skills Maths, English, ICT
• Apprenticeship qualification level 2 or above
• Evidence of continuous professional development
• MS Office packages (incl MS Teams)

Desirable

• NHS statutory and mandatory training (e-learning for health)
• Managing Clinical Correspondence
• Coding
• Medical Terminology

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

Bedford Hill Family Practice

Address

120 Bedford Hill

Balham

London

SW12 9HS

Employer's website

https://www.bedfordhillfamilypractice.co.uk/ (Opens in a new tab)