Job summary
Identifyingopportunities and developing and delivering project recommendations forservices and actions needed for active lifestyles that contribute to healthoutcomes, community safety and independent living in the Primary Care Network.
Working alongsidethe Primary Care Network team to enhance individual patient case managementfollow up and ongoing support.
Main duties of the job
We are seeking a dedicated Long-Term Condition (LTC) andHealth/Wellbeing Coach to support the health and wellbeing needs of our PrimaryCare Network (PCN) population. This role involves managing and prioritising acaseload, utilising strong communication skills, and a non-judgmental, holisticapproach.
The coach will work closely with patients, their families, andcarers, empowering them to actively manage their health and set personalisedhealth goals.
Responsibilities include using IT and multi-disciplinarychannels to identify patients in need, providing personalised coaching,supporting self-management, and patient autonomy.
Additionally, the coach willwork with patients to explore personal health budgets, establish communityconnections, and promote healthy behaviours, while collaborating with socialprescribing services and community partners to enhance patient support.
The ideal candidate will actively contribute to PCNobjectives by educating staff on personalised care, engaging inmultidisciplinary meetings, and supporting decision-making tools within thenetwork.
They will also be responsible for data collection to track patientoutcomes and demonstrate improvements, ultimately working toward reducinghealth inequalities within the community.
This is a unique opportunity to makea significant impact on patient health through proactive, patient-centred care.
About us
Bramhall and Cheadle Primary Care Network (PCN) is athriving network of GP practices located in the Stockport area, committed todelivering high-quality, patient care. We aim to provide innovative andcoordinated care, enhancing services for patients while promoting preventativehealthcare and managing long-term conditions.
Our network is built on strong collaboration between memberpractices, local health services, and community partners. By working closelytogether, we aim to streamline patient care and improve access to essentialservices.
Job description
Job responsibilities
Manageand prioritise a caseload, in accordance with the health and wellbeing needs ofthe PCN population through taking an approach that is non-judgemental, based onstrong communication and negotiation skills, while considering the whole personwhen addressing existing issues. Where required and as appropriate, the LTC and Health/Wellbeing Coach will referpeople back to other health professionals within the PCN
Utiliseexisting IT and MDT channels to screen patients, with an aim to identify thosethat would benefit most from health coaching
Providepersonalised support to individuals, their families, and carers to support themto be active participants in their own healthcare; empowering them to managetheir own health and wellbeing and live independently through: Coaching andmotivating patients through multiple sessions to identify their needs, setgoals, and supporting patients to achieve their personalised health and careplan objectives
Providinginterventions such as self-management education and peer support;
Supportingpatients to establish and attain goals that are important to the patient;
Supportingpersonal choice and positive risk taking while ensuring that patientsunderstand the accountability of their own actions and decisions, thusencouraging the proactive prevention of further illnesses
Workingin partnership with the social prescribing service to connect patients tocommunity based activities which support them to take increased control oftheir health and wellbeing
Increasingpatient motivation to self-manage and adopt healthy behaviours;
Workwith patients with lower activation scores to understand their level ofknowledge, skills and confidence (their Activation level), when engaging withtheir health and well- being and subsequently supporting them in shareddecision-making conversations
Utilisehealth coaching skills to support people with lower levels of activation todevelop the knowledge, skills, and confidence to manage their health andwellbeing, whilst increasing their ability to access and utilise communitysupport offers
Exploreand support patient access to a personal health budget, where appropriate, fortheir care and support.
Developcollaborative relationships and work in partnership with health, social care,and community and voluntary sector providers and multidisciplinary teams toholistically support patients wider health and wellbeing, public health, andcontributing to the reduction of health inequalities
Provideeducation and specialist expertise to PCN staff, supporting them to improvetheir skills and understanding of personalised care, behavioural approaches andensuring consistency in the follow up of peoples goals with MDT input
Raiseawareness within the PCN of shared-decision making and decision supporttools.
Promotethe service within the PCN, both for users and clinicians, building positiveworking relationships
Playingan active role in MDT meetings if required (regular practice meetings todiscuss high risk and / or complex patients) by gathering information and beingprepared to update the team on patient progress towards goals etc. (as pertheir care plan)
Activelycollect and maintain data that will demonstrate patient improvement in keyareas.
Ensuredelivery of best practice in clinical practice, caseload management, education,research, and audit, to achieve corporate PCN and local population objectives.
Contributeto PCN meetings and Projects
Person Specification
Experience
Essential
1. Relevant experience of working in an environment dealing with health improvement and healthy lifestyles
2. Understanding of the key issues facing health sector partners
3. Experience of working across agency boundaries and in local partnerships
4. Experience of contract monitoring
5. Ability to communicate effectively in a variety of styles and with a variety of audiences
6. Excellent written and verbal presentation and influencing skills
7. Excellent organisational skills
8. Excellent analysis and extrapolation skills with the ability to analyse, assemble, interpret, monitor and act on information
9. Ability to communicate effectively with people at all levels
10. Good interpersonal skills and ability to team work
11. Excellent computer information technology skills
12. Current knowledge of good practise, legislation and standards for health
13. Devise and implement action plans
14. Driven by customer excellence
15. Commitment to equal opportunities
16. Flexible attitude to working hours including occasional weekend working
17. Ability to work individually and as part of a team
Desirable
18. Managing and delivering projects
19. Experience in financial management and control
20. Knowledge of funding sources and track record of attracting external funds.
21. Performance focused
22. Knowledge of issues affecting peoples quality of life.
23. Experience in writing committee reports
24. Strategic planning
Qualifications
Desirable
25. Educated to degree level in a Public Health related subject.
26. Relevant professional qualification
27. Equal Opportunities training.