Health Coach Patient Navigator PCN Lead Manager Dependant on Experience WORKING HOURS 30 hours Summary Exeter City PCN (ECPCN) has developed a same day service to support our patients and GPs in providing care for med- low risk patients who present to the practice for on the day support and advice. The team has been so successful in supporting patients we are looking to expand services under a pilot for the next 6 months. This role will support patients who currently use alternative services and pathways for care to consider using the same day service team, community services and secondary care services appropriately. The post holder will work as part of a multi-disciplinary team and within their own competencies to provide expertise in using their skills to support patients by text, over the telephone to consider alternative services to support their care needs. This role is pivotal to improving the quality of continuity of care for patients. You will also be able to support and signpost or refer patients to other appropriate services or colleagues within the well-established same day service team. The team comprises of a physio, pharmacists, pharmacy technicians, 2 Health Coaches, a Social Prescriber, Assessment and Brief Intervention Worker (ABI), Mental Health Nurses. Part of the role will involve reviewing data and providing lists to practices about patient behaviour and attendance patterns. The post holder role is temporary for 6 months as part of DEVON ICB and Exeter City PCN joint pilot to evaluate the role of non-GP interventions in increasing capacity in general practice. The post holder will be asked to contribute to data collections and support review of the service. Scope and Purpose of the role Supporting patients to make best use of alternative services such as community based voluntary services as well as formal NHS support pathways. Our offer to patients is to ensure they are helped to access timely care and able to navigate primary care, secondary care and voluntary services effectively. This role will be integral in understanding the number of patients choosing to use inappropriate services outside and support them to access services more local to them, which better meet their needs. KEY RESPONSIBILITIES: Daily review of ED attendances and 111 contacts to gather a list of patients accessing these services Developing patient messaging and education to support navigation to other services such as primary care and the voluntary sector. Identifying trends and frequent attenders and suggesting interventions to support patients making appropriate decisions. Proactively manage patients who frequently attend services, suggesting care plans and check ins to change behaviour. Work with Devon ICB to understand shared data and provide suggestions, delivering campaigns to guide patients to access appropriate services across primary and secondary care as well as voluntary services. Managerial: Support the Clinical Lead in ensuring the effective provision of care, service developments of the Same Day Service Team Managing own workload and ensure interventions happen in a timely, flexible and responsive manner. Participate in team meetings, initiating and discussing new methods and contribute to the Devon ICB and Exeter City PCN joint pilot. Participate in the multi-disciplinary and multi-agency decision-making process through team meetings and team building when required. Undertake duties as assigned by senior staff to ensure that all agreed patient quality, safety and operational performance outcomes are delivered within the area of responsibility. Provide specialist advice, support, and consultation to staff within the team, outside teams and other agencies on managing patient behaviours. The post holder will support the introduction of outcome measures, to measure patient experience and behaviour. Contribute towards team education and development providing opportunities for exchange of ideas, experience, techniques and interventions. A holistic approach to care is required that encompasses physical health, mental health and social care. Take part in service development and review. Responsibility for Patient/Client Care: Develop and maintain effective individualised care by ensuring the following areas are proactively undertaken at all times: Review relevant data and consider mental, physical and social care needs of patients frequently accessing services. Planning, implementation, and evaluation of interventions Clear, accurate and concise documentation of individualised patient care and recording both qualitative and quantitative measures, as agreed with PCN director and PCN lead. Signposting patients and promoting self-care as appropriate. Supervision and Training An Induction programme will be provided. Monthly meetings with the PCN Lead Manager will be provided for more formal supervision. Quality: The post-holder will: Alert other team members to issues of quality and risk, reporting Significant Events as they arise and participating in the review and learning of incidents. Assess own performance and take accountability for own actions, either directly or under supervision. Contribute to the effectiveness of the team by reflecting on own and team activities and making suggestions on ways to improve and enhance the teams performance. Work effectively with individuals in other agencies to meet patients needs. Effectively manage own time, workload and resources. Participate in audit, where appropriate