The Care Coordinator will work as part of our multi-disciplinary team. This role will give you the opportunity to develop both the service and the role. You will be working with patients to help them better understand their conditions and what support is available locally to keep them happy and independent. This might involve working with clinicians looking after local Care Homes, participating in multi-disciplinary team meetings for both clinical and non-clinical staff, or working with a specific cohort of patients yourself.
We are looking for a positive team player who is willing to go the extra mile to help patients and others who come into contact with the organisation. We need someone who can build strong relationships with team members, is hard-working, and able to meet deadlines.
The role requires high standards and great attention to detail, to provide an excellent service to patients and colleagues. The ideal candidate will be an individual who is self-motivated, organised, reliable, and committed to improving patients' wellbeing as part of a team.
Main duties of the job
1. Work collaboratively with our existing Care Coordinator to provide support to specific patient groups.
2. Support the delivery of effective, coordinated care to our aligned care homes.
3. Liaise with other clinical and non-clinical professionals within the team and other partners involved in patient care.
4. Help people to manage their needs through answering queries, making and managing appointments, and ensuring that people have good quality written or verbal information to help them make choices about their care.
5. Provide coordination and navigation for people and their carers across health and care services, working closely with social prescribing link workers, health and wellbeing coaches, and other professionals.
6. Help identify where reasonable adjustments are required to support the delivery of equitable care.
About us
Our existing clinical team provides us with a diverse skill set consisting of four GP Partners, Salaried GP, Paramedic Practitioner, Nurse Practitioners, Practice Nurses, Healthcare Assistants, and Phlebotomists. As a member of Recdar Costal PCN, we benefit from having access to various ARRS practitioners and have good working relationships with the other member practices.
The Green House Surgery currently has a registered patient list of approximately 10,000 patients residing in Redcar and surrounding areas. We work from modern, purpose-built premises and benefit from ease of access to hospital-based diagnostics and other services. We have excellent public transport links (Redcar train stations are within walking distance) and also have free on-site parking for both patients and staff.
We are a friendly & supportive team.
Job responsibilities
PRIMARY DUTIES AND AREAS OF RESPONSIBILITY
Service Delivery
1. Work with practice teams to coordinate care for patients with greater needs to improve the patient pathway and expedite care as appropriate.
2. Proactively identify patients who require care coordination, using agreed criteria and population health tools as appropriate.
3. Support the delivery of the practice GSF and frailty programmes.
4. Support the achievement of practice quality standards including QOF IIF DES and LIS.
5. Work closely and in partnership with the Social Prescribing Link Workers, to address wider determinants of health, such as poor housing, debt, stress, and loneliness and identify and prioritise a person's care/support needs in a single personalised care and support plan, based on what matters to the person in a shared decision-making process.
6. Help patients manage their needs through answering queries, making and managing appointments, and ensuring that people have access to good quality information about their care.
7. Assist people to access personal health budgets where appropriate.
8. Coordinate appointments and encourage uptake of vaccinations in eligible populations.
9. Encouraging uptake of QOF LTC Annual and Structured Medication Reviews.
10. Encouraging the delivery of good quality annual health checks for patients with learning disabilities and SMI.
11. Supporting the practice in delivering its IIF priorities.
12. Supporting cancer screening, including FIT tests/bowel screening, cervical screening, and breast screening. Refer smokers to smoking cessation.
13. Coordinating and following up on referrals and appointments.
Person Specification
Qualifications
* GCSE Maths & English grade A to C
* Qualification in Health & Social Care or allied professional
* Understanding of health & social care processes
Knowledge & Skills
* Be self-motivated and use initiative
* Able to work under pressure
* Excellent organisational skills and ability to prioritise tasks effectively
* IT skills including accurate written/electronic records and documents
* Empathy with the patient's needs and conditions
* Discretion in the handling of sensitive and confidential information
* Excellent oral and written communication skills; able to engage effectively with a wide range of audiences
Experience
* Minimum of 2 years' experience of working with Health Care or Social care professionals and or previous experience in the NHS primary or social care or relevant.
* Experience of providing and receiving complex, sensitive and confidential information.
* Able to deliver successful outcomes within determined timeframes.
* Experience of working with GP clinical systems, such as SystmOne/EMIS.
* Positive attitude to work, colleagues, and patients.
* Non-judgemental attitude to patients.
Additional Requirements
* Commitment to continuing professional development of self and others
* Able to maintain the consistent delivery of high-quality services
* Satisfactory completion of an enhanced check through the disclosure and barring service
* Legal right to work in the UK
* A commitment to anti-discriminatory practices in employment, training, and service delivery
* An understanding of Health and Safety responsibilities
* Flexibility in working hours
* Excellent Attendance Record
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.
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