Job summary To lead and manage the Social Prescribing Team in providing a range of services to patients across Huntingdon PCN. Working as an autonomous practitioner within a variety of community and healthcare settings providing high quality social prescribing services to patients. Offering holistic service to patients, developing where appropriate an ongoing plan of care/support, with an emphasis on prevention & self-care whilst being professionally and legally responsible and accountable for all aspects of own professional activity. Social prescribing empowers people to take control of their health and wellbeing through referral or direct access to non-medical link workers who give time, focus on what matters to me and take a holistic approach, connecting people to community groups and statutory services for practical and emotional support. Link workers support existing groups to be accessible and sustainable and help people to start new community groups, working collaboratively with all local partners. Social prescribing can help to strengthen community resilience, personal resilience, and reduces health 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. Main duties of the job 1.Undertaking regular supervisions with team to address performance, concerns and provide support. 2.Ensuring staff adhere to Standard Operating Procedures for the team. Communicating regularly with staff and providing team. 3.Process referrals from the wider practice team. Updating SOPs as required. 4.Coach and motivate patients through multiple sessions to identify their needs, set patient focused goals and support them 5.Ensure all interventions and coaching are designed to empower patients to be active participants in their own healthcare, 6.Support and deliver group consultations, with clinical and non-clinical colleagues, implementing new approaches. 7. Provide updates of teams work to Senior Leadership Team, attending meetings regularly and undertaking paperwork as required as part of PCN. 8.Work with the broader MDT to maximise the support available to patients 9. The role will require managing and prioritising your own caseload, in accordance with the needs, priorities and any urgent support required by individuals. 10. It is vital that you have a strong awareness & understanding of when it is appropriate or necessary to refer people back to other health professionals/agencies. 11.Work with social prescribing colleagues to draw on & increase the strengths and capacities of local communities 12. Work together with all local partners to collectively ensure that local VCSE organisations and community groups are sustainable and that community assets are nurtured About us OUR VISION AND VALUES Huntingdon PCNs vision is to bring GP practices together with other local services to provide the best care in the right place. This role will support Huntingdon PCN which covers 4 GP Practices and have a patient population of just under 47,000 patients. Our values are: Integrity - We promise to conduct ourselves with the upmost integrity, staying open and honest with colleagues and patients. Empathy - We strive to take perspective of and feel emotions of another person, taking action to alleviate stress and pain of others showing kindness and care in our approach. Putting ourselves in other peoples shoes, both patients and colleagues, establishing anempathetic connection. Empowerment - We seek to champion positive relationships and build trust whilst empowering others Date posted 03 April 2025 Pay scheme Other Salary Depending on experience Contract Permanent Working pattern Full-time, Flexible working Reference number W0017-25-0001 Job locations Huntingdonshire District Council St. Marys Street Huntingdon Cambridgeshire PE29 3TN Charles Hicks Centre 75 Ermine Street Huntingdon Cambridgeshire PE29 3EZ Priory Fields Doctors Surgery Nursery Road Huntingdon Cambridgeshire PE29 3RL The Surgery Chequers Lane Cambridge CB23 3QQ Acorn Surgery Huntingdon PE29 7HN Roman Gate Surgery 1 Pinfold Lane Godmanchester Huntingdon Cambridgeshire PE29 2JH Job description Job responsibilities Act as a point of contact for the Social Prescribing Team. Responsible for the Social Prescribing team caseload, maximising efficiency and effectiveness to secure the best service for patients. Including analysts and management of changing clinical situations. Act as a change agent and innovator, planning, implementing and evaluating change to facility high quality health outcomes. Support in the development of colleagues including up-skilling colleagues, mentoring and feedback Assist in the development of policies, procedures and guidelines to support the case management process Participate in the evaluation of the service and service development including relevant audits and research, providing reports as required. To ensure all necessary records are maintained in line with Huntingdon PCN and NHS guidelines. To act as all times as a positive role model and advocate for individuals and the service, networking with a variety of forums as appropriate. Investigate accidents, incidents and complaints, implementing correcting actions where necessary. Work strategically with PCN practices to develop Assisting with other PCN Projects as required. To monitor the referrals to the service and intervene if the patient does not meet the criteria. Ensure that standards of care are monitored. To continuously update existing policies and guidance for the service to ensure current practice of all staff are up to date and according to best practice To work with all staff to ensure that clinical practice is standardised to a high level across the service, and ensure that all professional standards are maintained in relation to communication and negotiation with the child and their families so that treatments plans progress and that all adult and child safeguarding standards are adhered to To listen to and act on patient feedback to continually improve the service To maintain a clinical working day as part of visible leadership and to role model and review patient care Take an active part in the organisations review process identifying own learning and developmental needs Take an active part in the organisations clinical supervision process. To act as a mentor to other staff where appropriate, providing education, training and support. Identify and facilitate strategies for service improvement, develop initiatives and organisational change, contributing to the clinical governance and risk management agenda by ensuring best practice is evident. To continually act as a highly credible professional clinical leader being a strong professional role model for others to emulate at all times. SERVICE DELIVERY 1. Take referrals, provide consultations with people (and possibly carers or appointed chaperone) within GP Practices, private addresses, public places and other community settings 2. Assessing patient needs, evaluating risk and providing welfare checks. Providing personalised support to individuals, their families and carers to take control of their wellbeing, live independently and improve their health outcomes. 3. 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. 4. Co-produce a personalised support plan to improve health and wellbeing, introducing or reconnecting people to community groups and statutory services. 5. Integrate into and form part of General Practice/Primary Care Network teams to provide the support needed in those communities they serve. 6. Liaise and communicate with Patients, Carers, Advocates, Health and Social Care professionals, voluntary sector and stake-holders involved the wellbeing of your caseload and communities. 7. Be proactive in developing strong links with all local organisations to encourage the growth of the Social Prescriber role with the community and connecting patients with services as appropriate. 8. Build relationships with key staff in the GP practices within the local Primary Care Network (PCN), attending relevant meetings, becoming part of the wider network team, providing caseload reports, case studies and feedback on social prescribing. 9. 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 person needs is beyond the scope of the link worker role e.g. when there is a mental health need requiring a qualified practitioner. 10. Accurately recording patient details and your contact with patients on clinical systems. Discussing complex cases and raising safeguarding issues as required whilst maintaining compliance to mandatory and statutory governance, principles and protocols. 11. Attending clinical supervision and peer support networks. Regularly reviewing patient case load and individual patient care plans. Reviewing progress against patient objectives and adjusting as necessary. Job description Job responsibilities Act as a point of contact for the Social Prescribing Team. Responsible for the Social Prescribing team caseload, maximising efficiency and effectiveness to secure the best service for patients. Including analysts and management of changing clinical situations. Act as a change agent and innovator, planning, implementing and evaluating change to facility high quality health outcomes. Support in the development of colleagues including up-skilling colleagues, mentoring and feedback Assist in the development of policies, procedures and guidelines to support the case management process Participate in the evaluation of the service and service development including relevant audits and research, providing reports as required. To ensure all necessary records are maintained in line with Huntingdon PCN and NHS guidelines. To act as all times as a positive role model and advocate for individuals and the service, networking with a variety of forums as appropriate. Investigate accidents, incidents and complaints, implementing correcting actions where necessary. Work strategically with PCN practices to develop Assisting with other PCN Projects as required. To monitor the referrals to the service and intervene if the patient does not meet the criteria. Ensure that standards of care are monitored. To continuously update existing policies and guidance for the service to ensure current practice of all staff are up to date and according to best practice To work with all staff to ensure that clinical practice is standardised to a high level across the service, and ensure that all professional standards are maintained in relation to communication and negotiation with the child and their families so that treatments plans progress and that all adult and child safeguarding standards are adhered to To listen to and act on patient feedback to continually improve the service To maintain a clinical working day as part of visible leadership and to role model and review patient care Take an active part in the organisations review process identifying own learning and developmental needs Take an active part in the organisations clinical supervision process. To act as a mentor to other staff where appropriate, providing education, training and support. Identify and facilitate strategies for service improvement, develop initiatives and organisational change, contributing to the clinical governance and risk management agenda by ensuring best practice is evident. To continually act as a highly credible professional clinical leader being a strong professional role model for others to emulate at all times. SERVICE DELIVERY 1. Take referrals, provide consultations with people (and possibly carers or appointed chaperone) within GP Practices, private addresses, public places and other community settings 2. Assessing patient needs, evaluating risk and providing welfare checks. Providing personalised support to individuals, their families and carers to take control of their wellbeing, live independently and improve their health outcomes. 3. 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. 4. Co-produce a personalised support plan to improve health and wellbeing, introducing or reconnecting people to community groups and statutory services. 5. Integrate into and form part of General Practice/Primary Care Network teams to provide the support needed in those communities they serve. 6. Liaise and communicate with Patients, Carers, Advocates, Health and Social Care professionals, voluntary sector and stake-holders involved the wellbeing of your caseload and communities. 7. Be proactive in developing strong links with all local organisations to encourage the growth of the Social Prescriber role with the community and connecting patients with services as appropriate. 8. Build relationships with key staff in the GP practices within the local Primary Care Network (PCN), attending relevant meetings, becoming part of the wider network team, providing caseload reports, case studies and feedback on social prescribing. 9. 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 person needs is beyond the scope of the link worker role e.g. when there is a mental health need requiring a qualified practitioner. 10. Accurately recording patient details and your contact with patients on clinical systems. Discussing complex cases and raising safeguarding issues as required whilst maintaining compliance to mandatory and statutory governance, principles and protocols. 11. Attending clinical supervision and peer support networks. Regularly reviewing patient case load and individual patient care plans. Reviewing progress against patient objectives and adjusting as necessary. Person Specification Personal Qualities and Attributes Essential Polite and confident Ability to listen, empathise with people and provide person-centred support in a non-judgemental way Ability to get along with people from all backgrounds and communities, respecting lifestyles and diversity Ability to support people in a way that inspires trust and confidence, motivating others to reach their potential Ability to work flexibly and enthusiastically within a team or on own initiative Motivated Forward thinker Ability to identify risk and assess/manage risk when working with individuals, have a strong awareness and understanding of when it is appropriate or necessary to refer people to other health professionals/agencies e.g. when there is a mental health need requiring a qualified practitioner High levels of integrity and loyalty, ability to maintain effective working relationships and to promote collaborative practice with all colleagues Knowledge of and ability to work to policies and procedures Aware of NHS policies of confidentiality, safeguarding, lone working, information governance, and health and safety Ability to plan and prioritise on own initiative, including when working under pressure and meeting deadlines Qualifications Essential Educated to GCSE level or equivalent NVQ Level 2 in Health and Social Care or other relevant professional experience Desirable Social Prescribing qualification Skills Essential Excellent communication skills (written and oral) Strong IT skills, including the ability to create simple plans and reports. Competent in the use of Office and Outlook Effective time management (planning and organising) Ability to work as a team member and autonomously Excellent interpersonal skills Problem-solving & analytical skills Ability to follow policy and procedure Desirable Experience of data collection and using tools to measure the impact of services Experience Essential Experience of managing a team Experience of working with the general public Experience of working in a healthcare setting or in the leisure industry / public / voluntary sector Experience of working directly in a community development context, adult health and social care, learning support or public health/health improvement (including unpaid work) Desirable Experience of delivering lifestyle changes interventions Experience of working with vulnerable people Experience of working as a health advisor / trainer Experience of partnership/collaborative working and of building relationships across a variety of organisations Knowledge Essential General understanding of personalised care, well-being, community services and developments. Good understanding of interventions, behavioural and motivational change methodologies Good understanding of social prescribing Knowledge and understanding of environmental factors, and their impact on communities. Person Specification Personal Qualities and Attributes Essential Polite and confident Ability to listen, empathise with people and provide person-centred support in a non-judgemental way Ability to get along with people from all backgrounds and communities, respecting lifestyles and diversity Ability to support people in a way that inspires trust and confidence, motivating others to reach their potential Ability to work flexibly and enthusiastically within a team or on own initiative Motivated Forward thinker Ability to identify risk and assess/manage risk when working with individuals, have a strong awareness and understanding of when it is appropriate or necessary to refer people to other health professionals/agencies e.g. when there is a mental health need requiring a qualified practitioner High levels of integrity and loyalty, ability to maintain effective working relationships and to promote collaborative practice with all colleagues Knowledge of and ability to work to policies and procedures Aware of NHS policies of confidentiality, safeguarding, lone working, information governance, and health and safety Ability to plan and prioritise on own initiative, including when working under pressure and meeting deadlines Qualifications Essential Educated to GCSE level or equivalent NVQ Level 2 in Health and Social Care or other relevant professional experience Desirable Social Prescribing qualification Skills Essential Excellent communication skills (written and oral) Strong IT skills, including the ability to create simple plans and reports. Competent in the use of Office and Outlook Effective time management (planning and organising) Ability to work as a team member and autonomously Excellent interpersonal skills Problem-solving & analytical skills Ability to follow policy and procedure Desirable Experience of data collection and using tools to measure the impact of services Experience Essential Experience of managing a team Experience of working with the general public Experience of working in a healthcare setting or in the leisure industry / public / voluntary sector Experience of working directly in a community development context, adult health and social care, learning support or public health/health improvement (including unpaid work) Desirable Experience of delivering lifestyle changes interventions Experience of working with vulnerable people Experience of working as a health advisor / trainer Experience of partnership/collaborative working and of building relationships across a variety of organisations Knowledge Essential General understanding of personalised care, well-being, community services and developments. Good understanding of interventions, behavioural and motivational change methodologies Good understanding of social prescribing Knowledge and understanding of environmental factors, and their impact on communities. 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 Huntingdon PCN Address Huntingdonshire District Council St. Marys Street Huntingdon Cambridgeshire PE29 3TN Employer's website https://www.huntingdonpcn.nhs.uk/ (Opens in a new tab)