Key Responsibilities Take referrals from the PCNs Core Network Practices and from a wide range of agencies, including wider multi-disciplinary teams, hospital discharge teams, allied health professionals, fire service, police, job centres, social care services, housing associations, and voluntary, community and social enterprise (VCSE) organisations (list not exhaustive) Provide personalised support to individuals, their families and carers to take control of their wellbeing, live independently and improve their health outcomes. Develop trusting relationships by giving people time and focusing on 'what matters to me' Take a holistic approach, based on the persons priorities and the wider determinants of health Co-produce a personalised support plan to improve health and wellbeing, introducing or reconnecting people to community groups and statutory services. The role will require managing and prioritising your own caseload, in accordance with the needs, priorities and any urgent support required by individuals on the caseload It is vital that you have a strong awareness and understanding of when it is appropriate or necessary to refer people back to other health professionals/agencies, when what the person needs is beyond the scope of the link worker role e.g. when there is a mental health need requiring a qualified practitioner Draw on and increase the strengths and capacities of local communities, enabling local VCSE organisations and community groups (including faith groups) to receive social prescribing referrals. Ensure they are supported, have basic safeguarding processes for vulnerable individuals and can provide opportunities for the person to develop friendships, a sense of belonging, and build knowledge, skills and confidence Work together with all local partners to collectively ensure that local VCSE organisations and community groups are sustainable and that community assets are nurtured, by making them aware of small grants, including providing support to set up new community groups and services, where gaps are identified in local provision Social prescribing link workers will have a role in educating non-clinical and clinical staff within their PCN multi-disciplinary teams on what other services are available within the community and how and when patients can access them. This may include verbal or written advice and guidance Referrals Promoting social prescribing, its role in self-management, and the wider determinants of health As part of the PCN multi-disciplinary team, build relationships with key staff in GP practices, attend relevant meetings, becoming part of the wider network team, giving information and feedback on social prescribing Be proactive in developing strong links with all local agencies to encourage referrals, recognising what they need to be confident in the service to make appropriate referrals Work in partnership with all local agencies to raise awareness of social prescribing and how partnership working can reduce pressure on statutory services, improve health outcomes and enable a holistic approach to care Be proactive in encouraging self-referrals and connecting with all local communities, particularly those communities that statutory agencies may find hard to reach Providing personalised support Meet people on a one-to-one basis, making home visits where appropriate within organisations policies and procedures. Give people time to tell their stories and focus on what matters to me. Build trust with the person, providing non-judgemental support, respecting diversity and lifestyle choices. Work from a strength-based approach focusing on a persons assets Be a friendly and engaging source of information about health, wellbeing and prevention approaches Help people identify the wider issues that impact on their health and wellbeing, such as debt, poor housing, being unemployed, loneliness and caring responsibilities Work with the person, their families and carers and consider how they can all be supported through social prescribing Help people maintain or regain independence through living skills, adaptations, enablement approaches and simple safeguards Work with individuals to co-produce a simple personalised support plan based on the persons priorities, interests, values, cultural and religious/faith needs, and motivations including what they can expect from the groups, activities and services they are being connected to and what the person can do for themselves to improve their health and wellbeing Where appropriate, physically introduce people to community groups, activities and statutory services, ensuring they are comfortable. Follow up to ensure they are happy, able to engage, included and receiving good support Seek advice and support from identified individual(s) to discuss patient-related concerns (e.g. abuse, domestic violence and support with mental health), referring the patient back to the GP or other suitable health professional if required Supporting community groups and VCSE organisations to receive referrals Forge strong links with local VCSE organisations, community and neighbourhood level groups, utilising their networks and building on whats already available to create a map or menu of community groups and assets. Use these opportunities to promote micro-commissioning or small grants if available Develop supportive relationships with local VCSE organisations, community groups and statutory services, to make timely, appropriate and supported referrals for the person being introduced Working collectively with all local partners to ensure community groups are strong and sustainable Work with commissioners and local partners to identify unmet needs within the community and gaps in community provision Support local partners and commissioners to develop new groups and services where needed, through small grants for community groups, micro-commissioning and development support Encourage people who have been connected to community support through social prescribing to volunteer and give their time freely to others, in order to build their skills and confidence, and strengthen community resilience Professional development Work with your PCN/Practice line manager and/or supervising GP to undertake continual personal and professional development, taking an active part in reviewing and developing the roles and responsibilities Adhere to organisational policies and procedures, including confidentiality, safeguarding, lone working, information governance, and health and safety Miscellaneous Work as part of the team to seek feedback, continually improve the service and contribute to business planning Undertake any tasks consistent with the level of the post and the scope of the role, ensuring that work is delivered in a timely and effective manner Duties may vary from time to time, without changing the general character of the post or the level of responsibility Quality - strive to maintain quality and be responsible for: Alerting the line manager of any issues with quality and risk Assessing own performance and taking accountability for own actions, either directly or under supervision Contributing to the effectiveness of the team by reflecting on own and the teams activities, and making suggestions on ways to improve and enhance the teams performance and service expansion Working effectively with individuals in other agencies to meet patients needs Effectively managing own time, workload and resources Other Responsibilities within the Organisation: Contributing to service development and implementation of the service contract Awareness of and compliance with all relevant policies / guidelines / procedures, e.g. safeguarding, confidentiality, data protection, health and safety A commitment to life-long learning Attending training events organised internally and other agencies, where appropriate Attending team meetings and other meetings as may be necessary Job Limitations: At no time should the post holder work at a level outside their level of competence. If the post holder has concerns regarding this, they must discuss immediately with their manager. All junior staff therefore have a responsibility to inform those supervising their duties, if they are not competent to perform a duty. For complete job description please see attachment.