PCN Care Coordinator

Job description

Job responsibilities

CARE COORDINATOR RESPONSIBILITIES AND DUTIES

Utilise population health intelligence to proactively identify and work with a cohort of patients to deliver personalised care.

Support patients to utilise decision aids in preparation for a shared decision-making conversation.

Holistically bring together all a persons identified care and support needs and explore options to meet these within a single personalised care and support plan (PCSP), in line with PCSP 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, using tools to understand peoples level of knowledge, confidence in skills in managing their own health.

Support people to take up training and employment, and to access appropriate benefits where eligible for example, through referral to social prescribing link workers.

Assist people to access self-management education courses, peer support or interventions that support them to take more control of their health and wellbeing.

Explore and assist people to access personal health budgets where appropriate.

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.

Work with the GPs and other primary care professionals within the PCN to identify and manage a caseload of patients, and where required and as appropriate, refer people back to other health professionals within the PCN.

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.

Interrogating clinical and operational systems to implement and maintain an effective service offering.

Devise and maintain efficient digital filing and general office systems for the PCN activities undertaken.

Produce & maintain accurate audits and data reports via SystmOne and other digital programmes to provide live status of projects to the PCN management teams.

Person Specification

Experience

Essential

• Ability to develop and maintain good working relationships and communicate with a variety of audiences in a professional manner.
• Experience working across several locations, autonomously and as part of a wider team.
• Ability to demonstrate effective organisational skills and knowledge of working to time-plans.
• Intermediate knowledge of Microsoft Office packages including Word, Outlook, PowerPoint, and Excel.
• Previous experience working in similar role with strict guidelines, organising meetings and other aspects of project work.
• Experience of supporting service improvement using data/digital platforms and negotiating with relative teams in the process.
• Flexibility in approach to tasks undertaken.
• Excellent written, verbal communication and interpersonal skills.
• Ability to use initiative, work independently and as part of a team.
• A car driver and have access to a car.

Desirable

• Basic understanding of SystmOne, including running reports, analysing, and manipulating data and working within appointment systems.
• Safeguarding Level 3 in Adults & Children & Young People.
• Undertaking training or qualified from a care coordination or health coach course by a recognised Personalised Care Institute provider.
• Experience working in general practice/healthcare organisation.

Qualifications

Essential

• Educated to at least GCSE level or equivalent
• Good understanding of health and social care
• Digitally literate with good working knowledge of digital system and processes
• Proven experience of working with the general public in a similar role
• Experience of working in a service provision and/or healthcare organisation

Desirable

• Health and wellbeing qualification or equivalent experience
• Experience working with vulnerable adults
• SystmOne experience
• Microsoft applications including MS Teams
• Project management experience/setting up of a new service

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

Purbeck Primary Care Network

Address

Wareham Surgery

Streche Road

Wareham

Dorset

BH20 4PG

Employer's website

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