Job summary This is the right time to enhance our team and offer the role of Care Co-ordinator. This is a first-class opportunity that you can apply for. A role that would see you working across our PCN. To be successful, you will demonstrate an understanding of the personalised care approach; the needs of older people/adults with disabilities/long terms conditions in particularly in relation to promoting their independence; the Caldicott Principles and Data Protection Act 2018 and how to appropriately protect an individuals personal data, disclosing where appropriate only. Equally, you will have experience in collating data and using tools to demonstrate the impact of services, alongside having previously worked in health, social care or other support roles in direct contact with people, families or carers, paid or unpaid. Main duties of the job On a day-to-day basis, you could make a real difference by proactively identifying and working with people, including the frail/elderly and those with long-term conditions, to coordinate and navigate care and support across health and care services, including making referrals where appropriate to deliver personalised care, supporting patients to utilise decision making tools to prepare for shared decision-making conversations and crucially working holistically to bring together their identified care and support needs to explore options and meet these within a single personalised care and support plan. By working alongside a multidisciplinary health team offering an all-encompassing approach to personalised care, we can build capacity and facilitate more effective support for our patients, and their families/carers. About us Panacea PCN is a group of 8 GP Practices serving the population of Grimsby and Cleethorpes with a list size of 47000 Date posted 14 March 2025 Pay scheme Other Salary £13 an hour Contract Permanent Working pattern Full-time, Flexible working Reference number A3750-25-0000 Job locations 65-69 Stirling Street Grimsby North East Lincolnshire DN31 3AE Clee Medical Centre 323 Grimsby Road Cleethorpes DN35 7XE Doctor Matthews Surgery Stirling Street Grimsby DN31 3AE Birkwood Medical Centre Westward Ho Grimsby DN34 5DX Job description Job responsibilities Proactively identify and work with cohorts of patients to deliver personalised care. Support patients to utilise decision making tools to prepare for shared decision-making conversations. Working holistically, bring together their identified care and support needs and explore options to meet these within a single personalised care and support plan (PCSP). Help people to manage their needs by answering their queries, making and managing appointments, providing good quality written or verbal information to inform decision making and enhancing their knowledge, skills and confidence. Support people to take up employment and training and to access appropriate benefits through referral to the Social Prescribing Link Workers. Connect patients with tools to support them, such as self-management education, peer support and the adoption of healthy behaviours. Provide co-ordination and navigation for people and their carers across health and care services, working closely with the Social Prescribing Link Worker, Health and Wellbeing Coaches and other health professionals. Support the co-ordination of MDTs across the PCN. Raise awareness of the benefits of shared decision making and decision support tools, how to use these and how to identify patients who may benefit from this approach. Ensure all VCSE organisations have appropriate safeguarding procedures in place and are genuine opportunities for patients to develop a sense of belonging, build knowledge, skills, and confidence. Discuss concerns with a relevant GP to ensure safeguarding procedures are followed appropriately. Job description Job responsibilities Proactively identify and work with cohorts of patients to deliver personalised care. Support patients to utilise decision making tools to prepare for shared decision-making conversations. Working holistically, bring together their identified care and support needs and explore options to meet these within a single personalised care and support plan (PCSP). Help people to manage their needs by answering their queries, making and managing appointments, providing good quality written or verbal information to inform decision making and enhancing their knowledge, skills and confidence. Support people to take up employment and training and to access appropriate benefits through referral to the Social Prescribing Link Workers. Connect patients with tools to support them, such as self-management education, peer support and the adoption of healthy behaviours. Provide co-ordination and navigation for people and their carers across health and care services, working closely with the Social Prescribing Link Worker, Health and Wellbeing Coaches and other health professionals. Support the co-ordination of MDTs across the PCN. Raise awareness of the benefits of shared decision making and decision support tools, how to use these and how to identify patients who may benefit from this approach. Ensure all VCSE organisations have appropriate safeguarding procedures in place and are genuine opportunities for patients to develop a sense of belonging, build knowledge, skills, and confidence. Discuss concerns with a relevant GP to ensure safeguarding procedures are followed appropriately. Person Specification Behaviours Essential Good interpersonal skills Good communication skills Evidence of continued professional development Desirable IT Skills Qualifications Essential Good standard of education Organised and with good attention to detail Ability to prioritise workload. Enrolled/in progress/qualified from appropriate training as set out by the Personalised Care Institute (PCI) Demonstrable understanding of the personalised care approach Understands how the NHS works including primary care and PCNs Desirable NVQ level 2 in Health & Social Care Has safeguarding knowledge either level 2 or the equivalent experience Experience Essential Liaise with other colleagues to promote the success of the PCN and its Partner organisations in primary care Experience of working with vulnerable patients Experience of working with Social Prescribing Link Workers Experience of working with Health & Wellbeing coaches Working with IT software packages used in general practice Proficient with S1 and Emis To deliver outcomes based on set targets Work to perpetuate a culture that is transparent and open Has collated data and used tools to demonstrate the impact of services Working well with others to deliver goals Being motivated to deliver excellent services to support Primary Care in our region Experience of working directly in a care coordinator role, in adult health, social care, learning support or public health/health improvements Desirable Working with Multi Disciplinary Teams Working in Primary Care/General Practice Experience of working in health, social care and other support roles in direct contact with people, families or carers (in a voluntary or paid capacity) Experience of working in multidisciplinary professional team environments Experience or training in personalised care and support planning Other Essential Drive and have access to transport to attend visits or sites across the PCN, this may include home visits Immunisation status for Covid -19 (unless exempt in accordance with regulations) Person Specification Behaviours Essential Good interpersonal skills Good communication skills Evidence of continued professional development Desirable IT Skills Qualifications Essential Good standard of education Organised and with good attention to detail Ability to prioritise workload. Enrolled/in progress/qualified from appropriate training as set out by the Personalised Care Institute (PCI) Demonstrable understanding of the personalised care approach Understands how the NHS works including primary care and PCNs Desirable NVQ level 2 in Health & Social Care Has safeguarding knowledge either level 2 or the equivalent experience Experience Essential Liaise with other colleagues to promote the success of the PCN and its Partner organisations in primary care Experience of working with vulnerable patients Experience of working with Social Prescribing Link Workers Experience of working with Health & Wellbeing coaches Working with IT software packages used in general practice Proficient with S1 and Emis To deliver outcomes based on set targets Work to perpetuate a culture that is transparent and open Has collated data and used tools to demonstrate the impact of services Working well with others to deliver goals Being motivated to deliver excellent services to support Primary Care in our region Experience of working directly in a care coordinator role, in adult health, social care, learning support or public health/health improvements Desirable Working with Multi Disciplinary Teams Working in Primary Care/General Practice Experience of working in health, social care and other support roles in direct contact with people, families or carers (in a voluntary or paid capacity) Experience of working in multidisciplinary professional team environments Experience or training in personalised care and support planning Other Essential Drive and have access to transport to attend visits or sites across the PCN, this may include home visits Immunisation status for Covid -19 (unless exempt in accordance with regulations) 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 Panacea Collaborative Address 65-69 Stirling Street Grimsby North East Lincolnshire DN31 3AE Employer's website https://www.drmathewsgp.nhs.uk/ (Opens in a new tab)