K2 Healthcare Ltd

Personalised Care Lead

Information:

This job is now closed

Job summary

Do you share the Lincolnshire Health and Care Home First principles? Do you have experience of working within integrated health, care and community services and are looking for a new and exciting challenge? If so, we are looking for a Team Lead for Personalised Care delivery across our two Primary Care Networks. You will be responsible for providing the leadership for our Social Prescribing Link Workers and Health and Wellbeing Coaches teams. You will coach and support the team to meet their set objectives and KPIs as well as providing effective support and the best possible care for patients. You will be experienced with Social Prescribing and hold your own small case load. You will engage with the leadership of other providers (health, social care and third sector) supporting the Partnerships to deliver collaborative solutions that improve patient outcomes and sustainability of PCN / GP services. You will work with the clinical team and senior management team to identify new solutions for improving patient health and wellbeing. This is a great development opportunity for an experienced and exceptional leader to influence the design of integrated, personalised services. The post will complement existing roles within our Care Coordination Model who champion local high-quality integrated care. The post holder will work alongside colleagues within our well-established care coordination model and established integrated Neighbourhood Team.

Main duties of the job

The Personalised Care roles (Social Prescribing Link Workers, Health & Wellbeing Coaches and Care Coordinators) play an important part in providing extra time, capacity, and expertise to support patients to be actively involved in managing their health and to make choices that are right for them. Working to the What Matters To Me model, personalised care delivered is focused on the strengths and needs of the individual. The successful candidate will be responsible for the day-to-day supervision and support of Social Prescribing Link Workers and Health & Wellbeing Coaches within the PCN; evolving and developing business as usual processes and working with the Neighbourhood Team Lead to develop new initiatives to optimise the care options available for the PCN patients and communities. A first line of contact and guidance

for site leads on the introduction and induction of new personalised care roles into the PCN.

About us

K2 Healthcare is a forward-thinking Federation of 16 GP practices, working to support a population of 135,000 better together.

We provide transformational change to deliver a better patient experience. Working with our member practices we provide a supportive working environment which can offer you: Excellent work / Life balance Flexible working Supportive environment NHS Discount & Support Schemes Employee Assistance Program NHS Pension

Details

Date posted

29 January 2025

Pay scheme

Other

Salary

Depending on experience

Contract

Permanent

Working pattern

Full-time

Reference number

B0238-PCL

Job locations

47 Boston Road

Sleaford

Lincolnshire

NG34 7HD


Grantham Health Clinic

St. Catherines Road

Grantham

Lincolnshire

NG316TT


Job description

Job responsibilities

The Personalised Care roles (Social Prescribing Link Workers, Health & Wellbeing Coaches and Care Coordinators) play an important part in providing extra time, capacity, and expertise to support patients to be actively involved in managing their health and to make choices that are right for them. Working to the What Matters To Me model, personalised care delivered is focused on the strengths and needs of the individual.

The successful candidate will be responsible for the day-to-day supervision and support of Social Prescribing Link Workers and Health & Wellbeing Coaches within the PCN; evolving and developing business as usual processes and working with the Neighbourhood Team Lead to develop new initiatives to optimise the care options available for the PCN patients and communities. A first line of contact and guidance for site leads on the introduction and induction of new personalised care roles into the PCN.

DUTIES & AREAS OF RESPONSIBILITY

Key Responsibilities

Supervision and daily line management of Social Prescribing Link Workers and Health & Wellbeing Coaches; being a first point of contact or escalation for the team.

Develop appropriate induction plans for new members of the team; identify training requirements of existing team members.

Undertake regular supervision meetings with team members, undertaking case reviews and discussions around best practice.

Encourage development of team through overseeing regular peer support sessions.

Through feedback, support practices with developing processes to utilise personalised care team members roles to reduce capacity demands.

Working with practice sites to establish and maintain appropriate referral processes.

Working with local management teams coordinate and support the deployment of the team within the PCN member practices.

Monitor Social Prescribing Link Workers and Health & Wellbeing Coaches outputs using appropriate health and wellbeing scoring matrices.

To manage and support patients through the personalised care model in the role of either a Social Prescribing Link Worker, or Health and Wellbeing Coach.

Communications and Key Working Relationships

Create and maintain constructive relationships with a range of stakeholders, internally and externally including health, voluntary, social, financial and education sectors.

Work collectively with local partners and agencies; maintain database and oversight of available services to ensure a sustainable offering for patients.

Attend local and national personalised care meetings to provide feedback on local roles and have an understanding of national initiatives.

Participate and engage with stakeholders across the PCN, providing input and guidance to neighbourhood initiatives where applicable.

Liaise, communicate effectively, and collaborate with member practices within the PCNs to ensure smooth running of Personalised Care Teams and their outputs.

Communicate effectively with outside agencies sharing appropriate, relevant information to support best practice for ongoing patient care.

Knowledge and Skills

Post holder must have a strong understanding of the Personalised Care roles, Social Prescribing Link Workers, Health and Wellbeing Coaches.

Knowledgeable in Safeguarding interventions and awareness of the Mental Health Capacity Act.

Excellent understanding and knowledge of person-centred approaches in health and social care in general practice.

Good understanding of handling patient information and the importance of maintaining confidentiality.

Experience in providing supervision

Strong administrative skills and competencies to fulfil tasks requirements such as reporting and interpreting data for quality and service improvements.

IT literate with confidence in using GP systems and Microsoft office packages such as word, excel and Outlook. (SOCIAL RX Desirable)

Other

Be willing to undertake frequent travel to various locations across South West Lincolnshire to carry out duties of the post as required.

To safeguard the health, well-being, and safety of the patients we work with, some of whom maybe classed as vulnerable people or adults at risk. In the event of a risk to a Patient becoming apparent or if concerns arise about a vulnerable persons welfare, to immediately report these concerns in line with the appropriate policy and procedure

NB. in addition to these responsibilities, employees are required to carry out such other duties as may be reasonably required. K2 Healthcare reserves the right to vary this job description from time to time in line with business needs.

Your responsibilities to K2, our patients, and staff:

Confidentiality:

In the course of seeking treatment, patients entrust us with, or allow us to gather, sensitive information in relation to their health and other matters. They do so in confidence and have the right to expect that staff will respect their privacy and act appropriately.

In the performance of the duties outlined in this job description, the post-holder may have access to confidential information relating to patients and their carers, practice staff and other healthcare workers. They may also have access to information relating to the practice as a business organisation. All such information from any source is to be regarded as strictly confidential.

Information relating to patients, carers, colleagues, other healthcare workers or the business of the practice may only be divulged to authorised persons in accordance with the practice policies and procedures relating to confidentiality and the protection of personal and sensitive data.

Health & Safety:

The post-holder will assist in promoting and maintaining their own and others health, safety and security as defined in the practice Health & Safety Policy, the practice Health & Safety Manual, and the practice Infection Control Policy and published procedures. This will include:

Using personal security systems within the workplace according to Practice guidelines

Identifying the risks involved in work activities and undertaking such activities in a way that manages those risks

Making effective use of training to update knowledge and skills

Using appropriate infection control procedures, maintaining work areas in a tidy and safe way and free from hazards

Actively reporting of health and safety hazards and infection hazards immediately when recognised

Keeping own work areas and general / patient areas generally clean, assisting in the maintenance of general standards of cleanliness consistent with the scope of the job holders role

Undertaking periodic infection control training

Reporting potential risks identified

Equality and Diversity:

The post-holder will support the equality, diversity and rights of patients, carers and colleagues, to include:

Acting in a way that recognises the importance of peoples rights, interpreting them in a way that is consistent with practice procedures and policies, and current legislation

Respecting the privacy, dignity, needs and beliefs of patients, carers and colleagues

Behaving in a manner which is welcoming to and of the individual, is non-judgmental and respects their circumstances, feelings priorities and rights

Personal/Professional Development:

The post-holder will participate in any training programme implemented by the practice as part of this employment, such training to include:

Participation in an annual individual performance review, including taking responsibility for maintaining a record of own personal and/or professional development

Taking responsibility for own development, learning and performance and demonstrating skills and activities to others who are undertaking similar work

Quality Assurance & Governance:

The post-holder will strive to maintain quality within the practice, and will:

Alert other team members to issues of quality and risk

Assess own performance and take accountability for own actions, either directly or under supervision

Contribute to the effectiveness of the team by reflecting on own and team activities and

making suggestions on ways to improve and enhance the teams performance

Work effectively with individuals in other agencies to meet patients needs

Effectively manage own time, workload and resources

Safeguarding Adults and Children:

It is the duty of all staff working for K2 Healthcare to safeguard children and adults, report any concerns and undertake safeguarding training at an appropriate level, in line with K2 mandatory training requirements

Communication:

The post-holder should recognise the importance of effective communication within the team and will strive to:

Communicate effectively with other team members

Communicate effectively with patients and carers

Recognise peoples needs for alternative methods of communication and respond

accordingly

Contribution to the Implementation of Services:

The post-holder will:

Apply practice policies, standards and guidance

Discuss with other members of the team how the policies, standards and guidelines will affect own work

Participate in audit where appropriate

This job description is not exhaustive and the post holder may be required to undertake other duties from time to time as are consistent with the responsibility of this role. This job description is subject to periodic review and development.

This advert may close early if there are a sufficient applicants received.

Job description

Job responsibilities

The Personalised Care roles (Social Prescribing Link Workers, Health & Wellbeing Coaches and Care Coordinators) play an important part in providing extra time, capacity, and expertise to support patients to be actively involved in managing their health and to make choices that are right for them. Working to the What Matters To Me model, personalised care delivered is focused on the strengths and needs of the individual.

The successful candidate will be responsible for the day-to-day supervision and support of Social Prescribing Link Workers and Health & Wellbeing Coaches within the PCN; evolving and developing business as usual processes and working with the Neighbourhood Team Lead to develop new initiatives to optimise the care options available for the PCN patients and communities. A first line of contact and guidance for site leads on the introduction and induction of new personalised care roles into the PCN.

DUTIES & AREAS OF RESPONSIBILITY

Key Responsibilities

Supervision and daily line management of Social Prescribing Link Workers and Health & Wellbeing Coaches; being a first point of contact or escalation for the team.

Develop appropriate induction plans for new members of the team; identify training requirements of existing team members.

Undertake regular supervision meetings with team members, undertaking case reviews and discussions around best practice.

Encourage development of team through overseeing regular peer support sessions.

Through feedback, support practices with developing processes to utilise personalised care team members roles to reduce capacity demands.

Working with practice sites to establish and maintain appropriate referral processes.

Working with local management teams coordinate and support the deployment of the team within the PCN member practices.

Monitor Social Prescribing Link Workers and Health & Wellbeing Coaches outputs using appropriate health and wellbeing scoring matrices.

To manage and support patients through the personalised care model in the role of either a Social Prescribing Link Worker, or Health and Wellbeing Coach.

Communications and Key Working Relationships

Create and maintain constructive relationships with a range of stakeholders, internally and externally including health, voluntary, social, financial and education sectors.

Work collectively with local partners and agencies; maintain database and oversight of available services to ensure a sustainable offering for patients.

Attend local and national personalised care meetings to provide feedback on local roles and have an understanding of national initiatives.

Participate and engage with stakeholders across the PCN, providing input and guidance to neighbourhood initiatives where applicable.

Liaise, communicate effectively, and collaborate with member practices within the PCNs to ensure smooth running of Personalised Care Teams and their outputs.

Communicate effectively with outside agencies sharing appropriate, relevant information to support best practice for ongoing patient care.

Knowledge and Skills

Post holder must have a strong understanding of the Personalised Care roles, Social Prescribing Link Workers, Health and Wellbeing Coaches.

Knowledgeable in Safeguarding interventions and awareness of the Mental Health Capacity Act.

Excellent understanding and knowledge of person-centred approaches in health and social care in general practice.

Good understanding of handling patient information and the importance of maintaining confidentiality.

Experience in providing supervision

Strong administrative skills and competencies to fulfil tasks requirements such as reporting and interpreting data for quality and service improvements.

IT literate with confidence in using GP systems and Microsoft office packages such as word, excel and Outlook. (SOCIAL RX Desirable)

Other

Be willing to undertake frequent travel to various locations across South West Lincolnshire to carry out duties of the post as required.

To safeguard the health, well-being, and safety of the patients we work with, some of whom maybe classed as vulnerable people or adults at risk. In the event of a risk to a Patient becoming apparent or if concerns arise about a vulnerable persons welfare, to immediately report these concerns in line with the appropriate policy and procedure

NB. in addition to these responsibilities, employees are required to carry out such other duties as may be reasonably required. K2 Healthcare reserves the right to vary this job description from time to time in line with business needs.

Your responsibilities to K2, our patients, and staff:

Confidentiality:

In the course of seeking treatment, patients entrust us with, or allow us to gather, sensitive information in relation to their health and other matters. They do so in confidence and have the right to expect that staff will respect their privacy and act appropriately.

In the performance of the duties outlined in this job description, the post-holder may have access to confidential information relating to patients and their carers, practice staff and other healthcare workers. They may also have access to information relating to the practice as a business organisation. All such information from any source is to be regarded as strictly confidential.

Information relating to patients, carers, colleagues, other healthcare workers or the business of the practice may only be divulged to authorised persons in accordance with the practice policies and procedures relating to confidentiality and the protection of personal and sensitive data.

Health & Safety:

The post-holder will assist in promoting and maintaining their own and others health, safety and security as defined in the practice Health & Safety Policy, the practice Health & Safety Manual, and the practice Infection Control Policy and published procedures. This will include:

Using personal security systems within the workplace according to Practice guidelines

Identifying the risks involved in work activities and undertaking such activities in a way that manages those risks

Making effective use of training to update knowledge and skills

Using appropriate infection control procedures, maintaining work areas in a tidy and safe way and free from hazards

Actively reporting of health and safety hazards and infection hazards immediately when recognised

Keeping own work areas and general / patient areas generally clean, assisting in the maintenance of general standards of cleanliness consistent with the scope of the job holders role

Undertaking periodic infection control training

Reporting potential risks identified

Equality and Diversity:

The post-holder will support the equality, diversity and rights of patients, carers and colleagues, to include:

Acting in a way that recognises the importance of peoples rights, interpreting them in a way that is consistent with practice procedures and policies, and current legislation

Respecting the privacy, dignity, needs and beliefs of patients, carers and colleagues

Behaving in a manner which is welcoming to and of the individual, is non-judgmental and respects their circumstances, feelings priorities and rights

Personal/Professional Development:

The post-holder will participate in any training programme implemented by the practice as part of this employment, such training to include:

Participation in an annual individual performance review, including taking responsibility for maintaining a record of own personal and/or professional development

Taking responsibility for own development, learning and performance and demonstrating skills and activities to others who are undertaking similar work

Quality Assurance & Governance:

The post-holder will strive to maintain quality within the practice, and will:

Alert other team members to issues of quality and risk

Assess own performance and take accountability for own actions, either directly or under supervision

Contribute to the effectiveness of the team by reflecting on own and team activities and

making suggestions on ways to improve and enhance the teams performance

Work effectively with individuals in other agencies to meet patients needs

Effectively manage own time, workload and resources

Safeguarding Adults and Children:

It is the duty of all staff working for K2 Healthcare to safeguard children and adults, report any concerns and undertake safeguarding training at an appropriate level, in line with K2 mandatory training requirements

Communication:

The post-holder should recognise the importance of effective communication within the team and will strive to:

Communicate effectively with other team members

Communicate effectively with patients and carers

Recognise peoples needs for alternative methods of communication and respond

accordingly

Contribution to the Implementation of Services:

The post-holder will:

Apply practice policies, standards and guidance

Discuss with other members of the team how the policies, standards and guidelines will affect own work

Participate in audit where appropriate

This job description is not exhaustive and the post holder may be required to undertake other duties from time to time as are consistent with the responsibility of this role. This job description is subject to periodic review and development.

This advert may close early if there are a sufficient applicants received.

Person Specification

Personnel and Organisational Skills

Essential

  • Ability to lead, engage and coordinate teams
  • Excellent interpersonal skills, ability to influence change
  • Excellent communicator with the ability to communicate effectively at all levels, inclusive of patients, carers, outside agencies, GPs and the wider group
  • Good ability to use IT functions such as Microsoft Office Packages
  • Passionate about supporting vulnerable communities in accessing suitable healthcare options
  • Ability to work independently and manage your own workload
  • Ability to review, understand and advise on appropriate policies and procedures for an effective Personalised Care service

Experience

Essential

  • Experience of working with a personalised care role in the NHS.
  • Experience of working with healthcare professionals and/or previous experience in the NHS or Social Care
  • Experience and knowledge of providing support to vulnerable people through lifestyle interventions
  • Experience of providing supervision
  • Designing and implementation of training programmes to support team growth and development for patient care
  • Good understanding of and engagement with the development of voluntary sector, community and well- being services

Desirable

  • Experience of working within a Personalised Care role in primary care
  • Awareness and knowledge of quality improvement activities
  • Awareness and experience of software to support Personalised Care
  • Experience of using a navigation platform such as SOCIAL RX
  • Experience in using SystmOne and its reporting functionalities

Qualifications

Essential

  • NVQ Level 3, Advanced Level or Equivalent experience in health and social care
  • Demonstrates commitment to continuous professional development
  • Training in motivational coaching and interviewing or equivalent experience

Desirable

  • Leadership, or supervision qualification or equivalent experience
  • Training in caseload management

Other Requirments

Essential

  • Ability to travel across the network on a regular basis, independently
  • Enhanced DBS check
  • Willingness to work flexible hours when required to meet work demands
Person Specification

Personnel and Organisational Skills

Essential

  • Ability to lead, engage and coordinate teams
  • Excellent interpersonal skills, ability to influence change
  • Excellent communicator with the ability to communicate effectively at all levels, inclusive of patients, carers, outside agencies, GPs and the wider group
  • Good ability to use IT functions such as Microsoft Office Packages
  • Passionate about supporting vulnerable communities in accessing suitable healthcare options
  • Ability to work independently and manage your own workload
  • Ability to review, understand and advise on appropriate policies and procedures for an effective Personalised Care service

Experience

Essential

  • Experience of working with a personalised care role in the NHS.
  • Experience of working with healthcare professionals and/or previous experience in the NHS or Social Care
  • Experience and knowledge of providing support to vulnerable people through lifestyle interventions
  • Experience of providing supervision
  • Designing and implementation of training programmes to support team growth and development for patient care
  • Good understanding of and engagement with the development of voluntary sector, community and well- being services

Desirable

  • Experience of working within a Personalised Care role in primary care
  • Awareness and knowledge of quality improvement activities
  • Awareness and experience of software to support Personalised Care
  • Experience of using a navigation platform such as SOCIAL RX
  • Experience in using SystmOne and its reporting functionalities

Qualifications

Essential

  • NVQ Level 3, Advanced Level or Equivalent experience in health and social care
  • Demonstrates commitment to continuous professional development
  • Training in motivational coaching and interviewing or equivalent experience

Desirable

  • Leadership, or supervision qualification or equivalent experience
  • Training in caseload management

Other Requirments

Essential

  • Ability to travel across the network on a regular basis, independently
  • Enhanced DBS check
  • Willingness to work flexible hours when required to meet work demands

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

K2 Healthcare Ltd

Address

47 Boston Road

Sleaford

Lincolnshire

NG34 7HD


Employer's website

http://www.k2healthcare.com/ (Opens in a new tab)

Employer details

Employer name

K2 Healthcare Ltd

Address

47 Boston Road

Sleaford

Lincolnshire

NG34 7HD


Employer's website

http://www.k2healthcare.com/ (Opens in a new tab)

Employer contact details

For questions about the job, contact:

CEO

Darren Altus

darren.altus@nhs.net

Details

Date posted

29 January 2025

Pay scheme

Other

Salary

Depending on experience

Contract

Permanent

Working pattern

Full-time

Reference number

B0238-PCL

Job locations

47 Boston Road

Sleaford

Lincolnshire

NG34 7HD


Grantham Health Clinic

St. Catherines Road

Grantham

Lincolnshire

NG316TT


Supporting documents

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