Key Duties & Responsibilities Utilise GP Practice clinical systems (EMIS) and population health data to proactively identify and work with relevant cohorts of patients to deliver personalised care and the PCN Service Specifications e.g., Early Cancer Diagnosis, Cardiovascular Disease Prevention and Diagnosis and Enhanced Health in Care Homes. Assist patients to access self-management education courses, peer support or interventions that support them to take more control of their health and wellbeing in relation to the PCN Service Specifications. Provide coordination and navigation for patients and their carers across health and care services, working closely with social prescribing link workers, health and wellbeing coaches, and other primary care where relevant. Work with the GPs and other primary care professionals within the PCN to identify and manage a caseload of patients, and where required and as appropriate, refer people back to other health professionals within the PCN. Support the coordination and delivery of MDTs within the PCN. Use the GP Practice clinical system to identify patients requiring Flu and Covid-19 Vaccinations Support patients to manage their vaccinations through answering queries, making, and managing appointments, and ensuring that they have good quality written or verbal information To work with the PCN Leadership Team to ensure the smooth and efficient operation of the PCN Vaccination Programmes, including administration of patient tickets, staff and volunteer rota management, set-up and preparation of the vaccination site and data inputting. To support their GP Practice to meet PCN targets, including areas identified by their Practice Manager such as Impact and Investment Fund and Quality Outcomes Framework (QoF) projects. Gather information and undertake enquires for the PCN and the wider group as and when necessary. Be a proactive team player, be able to manage their own time and workload and work under own initiative. The above is not an exhaustive list. The successful candidate may be asked to complete tasks in line with the overall objectives of the organisation and PCN agenda. These duties will be reviewed regularly with the job holder with an aim of developing the scope of the role. Practice Related Objectives Be the first port of contact for all non-English speaking patients who apply to register at the practice and guide them through the process, utilise language line for booking appointments with clinician appropriately and navigate and signpost them to appropriate non-clinical services. Support the coordination and delivery of Practice Patient Participation Group within the Practice Provide coordination and navigation for patients and their carers across health and care services, working closely with social prescribing link workers, health and wellbeing coaches, and other primary care services/roles where relevant. Ensure all screening and public health campaign days are acknowledged and visual displays are updated within the practice and on-social media platforms that the practice subscribes to Use significant event analysis to alert appropriate staff to risk areas. Engage with all necessary mandatory training. Keep up to date with latest guidelines. Undertake additional training as maybe necessary. Proactively identity patients and work with a cohort of people to support their personalised care requirements To work in collaboration with other employed care co-ordinator/admin team to ensure continuity of NHS screening campaigns including cytology screening, breast screening, bowel screening, aortic amorism, retinopathy and child imms. Review the annual re-call system for HPV screening, Bowel screening, aortic aneurysm, Retinopathy & Child Immunisations To liaise with the GP QOF, Lead to discuss any changes and ways to move forward With PM and clinicians, devise new processes and systems to maximise uptake of screening campaigns Be a recognised admin expert on codes and reports. Produce coded reports, registers, and lists as requested Undertake a process of continuous improvement within the practice and to liaise with other Practices to learn and share best practice. Other duties as required in line with the Care-coordinator framework Professional Development All employees will be expected to complete all mandatory training as instructed by the organisation and complete additional training as and when required. The post holder must have the ability to reflect on practice, identify learning needs and take responsibility for continued professional development (with line management support). Confidentiality Working within the PCN employees may gain knowledge of confidential matters which may include personal and medical information about patients and staff. All information, either written or electronic, must be treated as strictly confidential at all times, and must not be divulged to any other person unless it is appropriate to do so. Health & Safety All employees are required by section 7 of Health and Safety at work act 1974 to take reasonable care on their own health and safety and that of others who may be affected by their acts or omissions. Equality & Diversity It is the responsibility of every person to act in ways that support equality and diversity and work within the spirit and detail of equality legislation including, but not limited to the Equality Act 2010 and the Human Rights Act 1998 Act in ways that support equality and diversity and recognises the importance of peoples rights in accordance with legislation, policies, procedures and good practice. Valuing people as individuals and treating everyone with dignity and respect, consideration and without prejudice, respecting diversity and recognising peoples expressed beliefs, preferences and choices in working with others and delivering appropriate services. Recognise and report behaviour that undermines equality Be consciously aware of own behaviour and encourage the same levels of behaviour in colleagues. Acknowledge others different perspectives and recognise the diverse needs and experiences of everyone they come into contact with. The PCN and its recognised providers are Equal Opportunities Employers and aim to challenge discrimination, promote equality and respect human rights.