Job summary Face to face interviews will be held on the 26th March 2025 at Gibson Lane Practice, 276 Gibson Lane Kippax LS25 7JN. Main duties of the job Assessment Work as part of the multidisciplinary team in clinics and making home visit across a population of patients who are mostly frail Take a holistic approach to supporting the assessment of the health and well-being needs of the individual patient which includes undertaking basic clinical observations to accurately assess and monitor a patients blood pressure, pulse, respiratory rate, temperature, oxygen saturations and take blood samples Carry out a holistic, person-centred assessment which looks at the health and social needs of the person, conducted in partnership with the individual person, their family and carers. The assessment will be conducted, in the persons own home or in clinic to take account of environmental factors and to fully understand the persons functional ability in a familiar setting. Carry out agreed specific assessments including a basic falls risk assessment, mental health and dementia assessments training can be provided Develop and agree care plans and if necessary, reviews for ongoing needs. Support with information gathering; undertaking CCSP Part 1 as part of long-term condition management. Manage and prioritise your own caseload under supervision and in accordance with the care needs, priorities and any urgent support required by individual patient About us Our Primary Care Network is a fantastic collaboration between 7 practices across our area. Each practice is unique and individual, but share the same common goal of working together for the greater good of our patients and community. Our vision is to enable greater provision of proactive, personalised and more integrated health and social care. We aim to do that by bringing in a range of healthcare workers including social prescribers, health and wellbeing coaches, pharmacists, pharmacy technicians, occupational therapists and paramedics. We take pride in providing the best health care that we can, working with individual practices, community health care services and local community groups to offer a wide range of services that can really make a difference to our population. Since the formation of PCN in 2019, we have gone from a small team of existing practice staff to a large team of over 20, and this continues to grow. Our staff in all our practices and our PCN take pride in serving the community, and I would like to thank them for all their hard work and commitment. Date posted 27 February 2025 Pay scheme Other Salary £24,000 to £26,600 a year Depending on experience Contract Permanent Working pattern Full-time, Flexible working Reference number U0053-25-0010 Job locations Hosted employer's address 1st Floor Park Edge Practice Leeds West Yorkshire LS14 1HX Job description Job responsibilities Intervention Refer and liaise with a range of statutory and voluntary sector support agencies, ensuring the person has access to a wide range of support : Social prescribing is a large part of the role utilising the resources available to signpost to the right person that can offer help support. Facilitate an awareness of the different resources available other than the health care sector that can help individuals holistically. Building relationships with the wider teams such as the volunteer sector and local councils. Where necessary identify urgent needs taking relevant action or liaison and familiarise with individual practice protocols. Refer for relevant equipment including telecare to increase the persons independence. Offer review and support to implement coping strategies to help manage mental health and dementia needs by referrals and signposting, Provide guidance and support to increase the use of self-care methods. Take a holistic approach to supporting the assessment of the health and wellbeing needs of the patient which includes undertaking basic clinical observations to accurately assess and monitor a patients blood pressure, pulse respiratory rate, temperature, oxygen saturations, and take blood samples, and has an awareness of escalation procedures at each individual practice including emergency procedures and when to ring 999. Carry out low level falls assessment screening and provide advice and information on falls prevention, including referral for equipment where necessary. Monitor and review care plans and agreed outcomes in partnership with the person. Promotion of the benefits of social prescribing and work of local groups and communities including responsibilities to educate other members of the PCN team on what services and support are available in the wider community Act as an advocate for the person and report to senior staff when required As this is a developing role there may be a requirement to carry out other tasks dependent on level of training, service need and staffing Communication To provide, and receive, information with empathy and understanding, and to adapt communication when barriers to understanding arise seeking senior guidance when necessary. Take an active role in MDT processes providing input around the persons history, family circumstances etc. To develop and maintain effective working relationships with other members of the primary care ICC team. Administration Keep timely, accurate and complete electronic patient records and activity data, all of which will be maintained and stored in accordance with professional and organisational standards. To have responsibility for appropriate documentation related to patients in their care to be disseminated to all relevant professionals in a timely manner and in accordance with operating standards. Clinical duties Clinical duties which may be expected in house and at home visits include: Phlebotomy Undertaking CCSP1 and dementia reviews NHS Health Checks Blood pressure recording Height Weight recording Performing ECGs Urinalysis Chaperoning duties Accurate, legible labelling of all samples to confirm patient identity Checking patient identification against GP/nurse request and confirming with patient Recording collection of blood sample in patient record in accordance with practice procedure Ensuring that samples are dispatched to the appropriate laboratories in a timely fashion Ensuring that anomalies are reported to a senior member of staff Notifying the GP nurse of any significant patient issues Liaising with and assisting members of the administrative team Perform health promotion or health education work Signpost and refer to appropriate services Other To participate in discussions about the direction of service developments and improvements. To participate in service audits and changes. To participate in discussion for the implementation of policies and procedures To contribute to the health and safety of others and the environment To participate in appraisal processes and participate in CPD personal development plan. To pro-actively participate in mandatory training and in-service training. To participate in mentoring and sharing best practice with colleagues and students Responsibilities and Confidentiality The post holder is expected to: Adhere to practice PCN policies and procedures and relevant legislation. Attend complete mandatory training as identified by the practice PCN The post holder must maintain the confidentiality of information about patients, staff and practice business in accordance with the General Data Protection Regulation, Caldicott principles and Practice Information Governance policies and procedures. Safeguarding All employees have a duty for safeguarding and promoting the welfare of children and adults at risk. Staff must be familiar with the practice PCNs Safeguarding Policy and the process for raising concerns about the welfare of anyone with whom they have contact. Staff must also ensure they receive the appropriate level of safeguarding children and adult training. Staff are expected to access supervision and support from their line managers and or the locality based safeguarding team when managing complex cases. Job Description Agreement This job description is intended to provide an outline of the key tasks and responsibilities only. There may be other duties required of the post holder commensurate with this position as requested by LS25 26 PCN. This description will be open to regular review and may be amended to consider the development of the PCN. All members of staff should be prepared to take on additional duties or relinquish existing duties in order to maintain the efficient running of the PCN practices. Job description Job responsibilities Intervention Refer and liaise with a range of statutory and voluntary sector support agencies, ensuring the person has access to a wide range of support : Social prescribing is a large part of the role utilising the resources available to signpost to the right person that can offer help support. Facilitate an awareness of the different resources available other than the health care sector that can help individuals holistically. Building relationships with the wider teams such as the volunteer sector and local councils. Where necessary identify urgent needs taking relevant action or liaison and familiarise with individual practice protocols. Refer for relevant equipment including telecare to increase the persons independence. Offer review and support to implement coping strategies to help manage mental health and dementia needs by referrals and signposting, Provide guidance and support to increase the use of self-care methods. Take a holistic approach to supporting the assessment of the health and wellbeing needs of the patient which includes undertaking basic clinical observations to accurately assess and monitor a patients blood pressure, pulse respiratory rate, temperature, oxygen saturations, and take blood samples, and has an awareness of escalation procedures at each individual practice including emergency procedures and when to ring 999. Carry out low level falls assessment screening and provide advice and information on falls prevention, including referral for equipment where necessary. Monitor and review care plans and agreed outcomes in partnership with the person. Promotion of the benefits of social prescribing and work of local groups and communities including responsibilities to educate other members of the PCN team on what services and support are available in the wider community Act as an advocate for the person and report to senior staff when required As this is a developing role there may be a requirement to carry out other tasks dependent on level of training, service need and staffing Communication To provide, and receive, information with empathy and understanding, and to adapt communication when barriers to understanding arise seeking senior guidance when necessary. Take an active role in MDT processes providing input around the persons history, family circumstances etc. To develop and maintain effective working relationships with other members of the primary care ICC team. Administration Keep timely, accurate and complete electronic patient records and activity data, all of which will be maintained and stored in accordance with professional and organisational standards. To have responsibility for appropriate documentation related to patients in their care to be disseminated to all relevant professionals in a timely manner and in accordance with operating standards. Clinical duties Clinical duties which may be expected in house and at home visits include: Phlebotomy Undertaking CCSP1 and dementia reviews NHS Health Checks Blood pressure recording Height Weight recording Performing ECGs Urinalysis Chaperoning duties Accurate, legible labelling of all samples to confirm patient identity Checking patient identification against GP/nurse request and confirming with patient Recording collection of blood sample in patient record in accordance with practice procedure Ensuring that samples are dispatched to the appropriate laboratories in a timely fashion Ensuring that anomalies are reported to a senior member of staff Notifying the GP nurse of any significant patient issues Liaising with and assisting members of the administrative team Perform health promotion or health education work Signpost and refer to appropriate services Other To participate in discussions about the direction of service developments and improvements. To participate in service audits and changes. To participate in discussion for the implementation of policies and procedures To contribute to the health and safety of others and the environment To participate in appraisal processes and participate in CPD personal development plan. To pro-actively participate in mandatory training and in-service training. To participate in mentoring and sharing best practice with colleagues and students Responsibilities and Confidentiality The post holder is expected to: Adhere to practice PCN policies and procedures and relevant legislation. Attend complete mandatory training as identified by the practice PCN The post holder must maintain the confidentiality of information about patients, staff and practice business in accordance with the General Data Protection Regulation, Caldicott principles and Practice Information Governance policies and procedures. Safeguarding All employees have a duty for safeguarding and promoting the welfare of children and adults at risk. Staff must be familiar with the practice PCNs Safeguarding Policy and the process for raising concerns about the welfare of anyone with whom they have contact. Staff must also ensure they receive the appropriate level of safeguarding children and adult training. Staff are expected to access supervision and support from their line managers and or the locality based safeguarding team when managing complex cases. Job Description Agreement This job description is intended to provide an outline of the key tasks and responsibilities only. There may be other duties required of the post holder commensurate with this position as requested by LS25 26 PCN. This description will be open to regular review and may be amended to consider the development of the PCN. All members of staff should be prepared to take on additional duties or relinquish existing duties in order to maintain the efficient running of the PCN practices. Person Specification Qualifications Essential English and Maths to GCSE Grade C or above or equivalent. Desirable NVQ level 3 or working towards Other requirements Essential Current driving licence and access to own vehicle Highly motivated and proactive. Flexibility of working hours Experience Essential Previous experience working with the general public. Evidence of good practice Working autonomously and as part of a team Desirable Previous experience working with frail, older people. Skills, Knowledge and Aptitudes Essential Excellent interpersonal, verbal and written communication skills Be able to provide high quality care. Ability to recognise risk and refer appropriately and safely Time management and ability to prioritise workload Able to work independently and effectively within a team Flexible and motivated Excellent computer skills Able to recognise and work within own limitations Understanding of equal opportunity and diversity issues Desirable Ability to adapt to change within working situations Reflective working Awareness of frailty and chronic conditions Knowledge of the PCN and community working. Understanding of role of patient advocate. Person Specification Qualifications Essential English and Maths to GCSE Grade C or above or equivalent. Desirable NVQ level 3 or working towards Other requirements Essential Current driving licence and access to own vehicle Highly motivated and proactive. Flexibility of working hours Experience Essential Previous experience working with the general public. Evidence of good practice Working autonomously and as part of a team Desirable Previous experience working with frail, older people. Skills, Knowledge and Aptitudes Essential Excellent interpersonal, verbal and written communication skills Be able to provide high quality care. Ability to recognise risk and refer appropriately and safely Time management and ability to prioritise workload Able to work independently and effectively within a team Flexible and motivated Excellent computer skills Able to recognise and work within own limitations Understanding of equal opportunity and diversity issues Desirable Ability to adapt to change within working situations Reflective working Awareness of frailty and chronic conditions Knowledge of the PCN and community working. Understanding of role of patient advocate. 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 South and East Leeds GP Group Address Hosted employer's address 1st Floor Park Edge Practice Leeds West Yorkshire LS14 1HX Employer's website https://www.seleedsgpgroup.nhs.uk/ (Opens in a new tab)