PCN Care Coodinator (B)

Job description

Job responsibilities

PRIMARY RESPONSIBILITIES

a)Management of Carers award & GP-friendly award

b)Group consultation & patient education workshops for LTC

c) Long term condition reviews

d) Physical health checks: Learning Disability reviews, SMI reviews, Diabetic foot-checks, NHS health checks et.c

e) Phlebotomy

f) Blood pressure checks

g) ECG test (but not the reading and assessing of results)

h) Work with practice teams to coordinate care for patients with more complex or ongoing needs, improving the patient journey and expediting care where necessary.

i) Proactively identify patients requiring care coordination using agreed criteria, population health management tools, and clinical input.

j) Vaccination* (if you are not yet prodicient in these, we may be able to offer training).

d) Help patients manage their health by responding to queries and ensuring access to clear, quality information about their care.

e) Coordinate appointments and encourage the uptake of vaccinations among eligible groups.

f) Focus on what matters most to each individual patient, ensuring support is personalised and culturally sensitive, especially for people from diverse backgrounds and those living with disabilities or long-term conditions.

g) Navigate and coordinate care across health and care systemsensuring timely, appropriate referrals and seamless transitions between services.

h) Facilitate and monitor referrals to both clinical and non-clinical services, working closely with healthcare teams and external partners.

i) Empower and enable patients to manage their own care and take an active role in their health and wellbeing.

j) Support people who may be anxious, confused, or overwhelmed by the care system, helping reduce stress and build confidence.

k) Liaise with Adult Social Care when required to raise safeguarding concerns or request care assessments.

l) Uphold all relevant policies and procedures, including safeguarding, confidentiality, lone working, information governance, health and safety, and equality, diversity andinclusion.

SECONDARY RESONSIBILITIES

In addition to the primary responsibilities, the Care Coordinator may be requested to:

a. Support patients in accessing benefits, training, and employment opportunities where appropriate.

b. Manage a caseload of patients, acting as their single point of contact across primary care, community care, secondary care, and care home settings.

c. Participate in local initiatives to enhance service delivery and patient care

d. Support and participate in shared learning across the practice

e.Tackle health inequalities through targeted work with identified population groups, such as those with long-term conditions or multiple health needs.

f. Take personal responsibility for own learning and development, including the requirement to maintain competency, achieving all targets set in own Personal Development Plan (PDP)

Person Specification

Experience

Essential

• Experience of working in a primary care setting /GP practice - either in a clinical role
• Experience in working and communicating with multiple stakeholders.
• Experience in managing patient case load
• Experience of working in health or social care settings without direct supervision
• Experience of organising and prioritising own workload
• Demonstrates awareness of limits to knowledge base

Desirable

• Experience and understanding of evaluating and measuring the performance of health services.
• Experience in using clinical IT systems, in particular Systmone.
• A good understanding of the health and social care environment and the roles and responsibilities within it.
• Knowledge of existing referral pathways to local health, social care and voluntary organisations.

Qualifications

Essential

• Good standard of education with 5 GCSE's or equivalent.
• NVQ Level 3 in Health & Social Care
• Good IT skills, especially a working knowledge of MS Office (Word,
• Excel, Powerpoint and Outlook).
• Commitment to continuing professional development, including the Personalised Care Institute Course(s).

Desirable

• Qualified in Phlebotomy
• Blood pressure taking
• ECG testing
• Experience with vital observations

Skills and Attributes

Essential

• Able to work independently and proactively.
• Be able to manage multiple demands and prioritise appropriately.
• Ability to seek solutions and solve problems using your own initiative.
• Adaptability, flexibility and the ability to cope with uncertainty and change.
• Be able to focus in a busy work environment.
• Demonstrate a strong desire to improve performance and make a difference by focusing on goals.
• Work in a confidential manner and maintain the trust of colleagues and patients.
• Excellent time keeping.

Communication

Essential

• Excellent interpersonal and communication skills.
• Ability and confidence to handle difficult conversations.
• Ability to structure conversations using a coaching approach based on what matters to the person.
• Be able to talk to a wide range of professionals appropriately.
• Ability to nurture key relationships and maintain networks.

Attitude & Behaviour

Essential

• Displays care, compassion, sensitivity and responsiveness to other peoples feelings and needs
• Able to work as part of a team, co-operating to work together and in conjunction with others and willing to help and assist wherever possible and appropriate appreciating the value of diversity in the workplace
• Able to develop, establish and maintain positive relationships with others both internal and external to the organisation and with patients and their carers
• Able to work under pressure, dealing with peaks and troughs in workload.
• Highly motivated and reliable
• Demonstrates values consistent with those of the Trust

Desirable

• Positive and flexible attitude to dealing with change; able to respond to the changing needs of the patient in an appropriate and timely manner;
• willing to change and accept change and to explore new ways of doing things and approaches
• Has a strong degree of personal integrity; able to adhere to standards of conduct based on a culture of equality and fairness

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

North Wilts Border PCN Ltd Company

Address

Tinkers Lane Surgery

Tinkers Field

Royal Wootton Bassett

Swindon

Wiltshire

SN4 7AT

Employer's website

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