Job responsibilities
Pioneers Integrated
Partnership PCN
JOB DESCRIPTION
JOB TITLE: Temporary Social Prescriber Link Worker
GROUP: Primary Care Network
GRADE: Local Pay Negotiable dep on experience
RESPONSIBLE TO: PCN Clinical Director/PCN &Practice Manager
ACCOUNTABLE
TO: PCN Clinical Director/PCN
&Practice Manager
JOB SUMMARY:
Social prescribing empowers
people to take control of their health and wellbeing through referral to link
workers who give time, focus on what matters to me and take a holistic
approach to an individuals health and wellbeing, connecting people to community
groups and statutory services for practical and emotional support. Link workers
also support existing groups to be accessible and sustainable and help people
to start new community groups, working collaboratively with all local partners.
Social prescribing link
workers will work as a key part of the primary care network (PCN)
multidisciplinary team. Social prescribing can help PCNs to strengthen
community and personal resilience and reduces health and wellbeing inequalities
by addressing the wider determinants of health, such as debt, poor housing and
physical inactivity, by increasing peoples active involvement with their local
communities. It particularly works for people with long term conditions including support for mental health, for people who are lonely or isolated,
or have complex social needs which affect their wellbeing
Key Relationships
(not exhaustive):
Patients, carers and relatives
Partnership Social Prescribing Leads
and ICS Leads
Partnership GPs,Nurses and the wider practice staff
Other members of the wider
Primary Care
multi-disciplinary Team (including
Commissioners)
Other relevant
organisations bodies from time to
time as
required
Main duties and responsibilities:
Working with
direct supervision by a GP, take referrals from a wide range of agencies,
including PCNs GP practices and multi-disciplinary team in pharmacies, wider
multi-disciplinary teams, hospital discharge teams, allied health
professionals, fire service, police, job centres, social care services, housing
associations, and voluntary, community and social enterprise VCSE organisations list not exhaustive.
Provide
personalised support to individuals, their families and carers to take control
of their health and wellbeing, live independently and improve their health
outcomes, as a key member of the PCN multi-disciplinary team. Develop trusting
relationships by giving people time and focus on what matters to me. Take a
holistic approach, based on the persons priorities and the wider determinants
of health. Co-produce a simple personalised care and support plan to improve
health and wellbeing, introducing or reconnecting people to community groups
and statutory services.
The role will
require managing and prioritising your own caseload, in accordance with the
needs, priorities and any urgent support required by individuals on the
caseload. It is vital that you have a strong awareness and understanding of
when it is appropriate or necessary to refer people back to other health
professionals/agencies, when what the persons needs are beyond the scope of
the link worker role e.g. when there is a mental health need requiring a
qualified practitioner.
Draw on and
increase the strengths and capacities of local communities, enabling local VCSE
organisations and community groups to receive social prescribing referrals.
Alongside other
members of the PCN multi-disciplinary team, work collaboratively with all local
partners to contribute towards supporting the local VCSE organisations and
community groups to become sustainable and that community assets are nurtured,
through sharing intelligence regarding any gaps or problems identified in local
provision with commissioners and local authorities.
Social
prescribing link workers will have a role in educating non-clinical and
clinical staff within their PCN multi-disciplinary teams on what other services
are available within the community and how and when patients can access them.
This may include verbal or written advice and guidance. They will also create a
full directory of services available within our local communities
Key Tasks Referrals
Promote social
prescribing, its role in self-management, and the wider determinants of health.
As part of the PCN multi-disciplinary team,
build relationships with staff in GP practices within the local PCN, attending
relevant MDT meetings, giving information and feedback on social prescribing.
Be proactive in
developing strong links with all local agencies to encourage referrals,
recognising what they need to be confident in the service to make appropriate
referrals.
Work in
partnership with all local agencies to raise awareness of social prescribing
and how partnership working can reduce pressure on statutory services, improve
health outcomes and enable a holistic approach to care.
Provide referral
agencies with regular updates about social prescribing, including training for
their staff and how to access information to encourage appropriate referrals.
Seek regular
feedback about the quality of service and impact of social prescribing on
referral agencies.
Be proactive in
encouraging self-referrals and connecting with all local communities,
particularly those communities that statutory agencies may find hard to reach.
Provide personalised support
Meet people on a
one-to-one basis, making home visits where appropriate within organisations
policies and procedures. Give people time to tell their stories and focus on
what matters to me. Build trust with the person, providing non-judgemental
support, respecting diversity and lifestyle choices. Work from a strength-based
approach focusing on a persons assets.
Be a friendly
source of information about health, wellbeing and prevention approaches.
Help people
identify the wider issues that impact on their health and wellbeing, such as
debt, poor housing, being unemployed, loneliness and caring responsibilities.
Work with the
person, their families and carers and consider how they can all be supported
through social prescribing.
Help people
maintain or regain independence through living skills, adaptations, enablement
approaches and simple safeguards.
Work with
individuals to co-produce a simple personalised support plan to address the
persons health and wellbeing needs based on the persons priorities,
interests, values and motivations including what they can expect from the
groups, activities and services they are being connected to and what the person
can do for themselves to improve their health and wellbeing.
Where
appropriate, physically introduce people to community groups, activities and
statutory services, ensuring they are comfortable. Follow up to ensure they are
happy, able to engage, included and receiving good support.
Where people may
be eligible for a personal health budget, help them to explore this option as a
way of providing funded, personalised support to be independent, including
helping people to gain skills for meaningful employment, where appropriate.
Seek advice and
support from the GP supervisor and/or identified individuals to discuss
patient-related concerns e.g. abuse, domestic violence and support with mental
health, referring the patient back to the GP or other suitable health
professional if required.
Support community groups and VCSE organisations to receive referrals
Forge strong
links with local VCSE organisations, community and neighbourhood level groups,
utilising their networks and building on whats already available to create a
menu of community groups and assets.
Develop
supportive relationships with local VCSE organisations, community groups and
statutory services, to make timely, appropriate and supported referrals for the
person being introduced.
Work collectively
with all local partners to ensure community groups are strong and sustainable
Work with
commissioners and local partners to identify unmet needs within the community
and gaps in community provision.
Encourage people
who have been connected to community support through social prescribing to
volunteer and give their time freely to others, building their skills and
confidence and strengthening community resilience.
Develop a team of
volunteers within your service to provide buddying support for people,
starting new groups and finding creative community solutions to local issues.
Encourage people,
their families and carers to provide peer support and to do things together,
such as setting up new community groups or volunteering.
Provide a regular
confidence survey to community groups receiving referrals, to ensure that
they are strong, sustained and have the support they need to be part of social
prescribing.