Job summary
We are looking for a Social Prescribing Link Worker to join our team. Park and Orchard PCN in Horsham is anew PCN with a population of 31,000 patients. We have a higher than averagepopulation of elderly patients, many of whom live in their own homes andrequire a lot of social support. There are challenges for the whole populationin terms of the cost of living, social isolation and loneliness, housing,employment and mental health issues. We also have higher than average numbersof young people struggling with mental health issues and we have a good workingrelationship with the iRock cafe in Horsham.
During the last 5 years as part ofHorsham Central PCN we have had a strong focus on personalised care, buildingour team of social prescribers, health coaches and care coordinators alongsideour mental health support workers. We led on developing our Horsham DistrictBefriends community service and obtained funding in order to address socialisolation after the Covid pandemic. We are also working in partnership withHorsham Wellbeing hub and other local community organisations to offer supportto those struggling with the peri/menopause. We run a partnership MenopauseCafe and Menopause Information Sessions. We also have a strong focus ondementia, young peoples mental health and cost of living and are keen todevelop these further.
Our new PCN will be developing amultidisciplinary Frailty Team which will include our social prescriber.
Main duties of the job
Socialprescribing empowers people to take control of their health and wellbeingthrough referral to non-medical linkworkers whogive time, focus on whatreally matters to me andtake a holistic approach, connecting people to community groups and statutoryservices for practical and emotional support. Link workers support existinggroups to be accessible and sustainable and work collaboratively with all localpartners.
Socialprescribing can help to strengthen community resilience and personal resilienceand reduces health inequalities by addressing the wider detriments of health,such as debt, poor housing and physical inactivity, by increasing peoples active involvement withtheir local communities. It particularly works for people with long termconditions (including support for mental health), for people who are lonely orisolated, or have complex social needs which affect their wellbeing.
About us
Alliance for BetterCare CIC is a GP Federation that unites 47 NHS GP practices across 12 PrimaryCare Networks in Sussex and Surrey. We support our Primary Care colleagues aswell as their patients, to transform how healthcare is managed within the community.
As a membership organisation, our focus is to work in partnership with ourmembers and help them to improve the provision of General Practices in thelocal area.
We work with and listen to our GP Practices, PCNs, Hospitals, CommunityOrganisations and the Third Sector. These vital partnerships ensure that,together, we deliver a truly integrated approach that offers the support andexpertise needed to effectively serve our communities.
More about ourorganisation:
Job description
Job responsibilities
Primaryduties and areas of responsibility
Work withthe GP practices within Park and Orchard PCN to provide personalised support toindividuals, their families, and carers to take control of their wellbeing,live independently and improve their health outcomes. This will involve workingwith GPs and PCN practice staff and referrals from and to a wide range ofagencies, including multi disciplinary teams, hospital discharge teams,allied health professionals, fire service, police, job centres, social careservices, housing associations, and voluntary, community and social enterprise(VCSE) organisations (list not exhaustive).
Developtrusting relationships giving people time to focus on what matters to me. Take a holistic approach, based on the persons priorities andthe wider determinants of health. Co-produce a personalised support plan andimprove health and wellbeing, introducing or reconnecting people to communitygroups and statutory services. The role will require managing and prioritisingyour own caseload, in accordance with the needs, priorities and any urgentsupport required by individuals on the caseload. It is vital that you have astrong awareness and understanding of when it is appropriate or necessary torefer people back to other health professionals/ agencies, when what the personneeds is beyond the scope of the link worker role, when there is a mentalhealth need requiring a qualified practitioner.
Drawon and increase the strengths and capacities of local communities, enablinglocal VCSE organisations and community groups to receive social prescribingreferrals. Ensure they are supported and can provide opportunities for theperson to develop friendships and a sense of belonging, and build knowledge,skills and confidence.
Keytasks
1. Build relationships with key staff in GP practices within thePrimary Care Network (PCN), attending relevant meetings, becoming part of thewider network team, educating, giving information and feedback on socialprescribing.
2. Promoting social prescribing with patients, staff and otheragencies, its role in self-management, and the wider determinants of health.
3. Be proactive in developing strong links with local agenciesto ensure PCN staff are confident in the service to make appropriate referrals.
4. Work in partnership with local agencies to raise awareness ofsocial prescribing and how partnership working can improve health outcomes andenable a holistic approach to care.
5. Seek regular feedback about the quality of service and impactof social prescribing on referral agencies.
6. Be proactive in encouraging self-referrals and connectingwith local communities, particularly those communities that statutory agenciesmay find hard to reach.
7. Use the social prescribing platform to store information anddata about referrals and patient feedback for the purposes of furtherdeveloping the service.
Providepersonalised support
8. Meet people on a one-to-one basis, making home visits whereappropriate. Give people time to tell their stories and focus on what mattersto me. Build trust with the person, providing non-judgemental support,respecting diversity, and lifestyle choices. Work from a strength-basedapproached focusing on a persons assets.
9. Be a friendly source of information about well-being andprevention approaches.
10. Help people identify the wider issues that impact on theirhealth and well-being, such as debt, poor housing, being unemployed, lonelinessand caring responsibilities.
11. Work with the person, their families and carers and considerhow they can all be supported through social prescribing.
12. Help people maintain or regain independence through livingskills, adaptations, enablement approaches and simple safeguards.
13. Work with individuals to co-produce a simple personalisedsupport plan based on the persons priorities, interests, values andmotivations including what they can expect from the groups, activities andservices they are being connected to and what the person can do for themselvesto improve their health and wellbeing.
14. Where appropriate, physically introduce people to communitygroups, activities, and statutory services, ensuring they are comfortable.Follow up to ensure they are happy, able to engage, included and receiving goodsupport.
15. Where people may be eligible for a personal health budget,help them to explore this option as a way of providing funded, personalisedsupport to be independent, including helping people to gain skills formeaningful employment, where appropriate.
Supportcommunity groups and VCSE organisations to receive referrals
16. Forge strong links with local VCSE organisations, communityand neighbourhood level groups, utilising their networks and building on whatsalready available to create a map or menu of community groups and assets forthe PCN.
17. Develop supportive relationships with local VCSEorganisations, community groups and statutory services, to make timely,appropriate and supported referrals for the person being introduced.
18. Ensure that local community groups and VCSE organisationsbeing referred to have basic procedures in place for ensuring that vulnerableindividuals are safe and, where there are safeguarding concerns, work with allpartners to deal appropriately with issues.
19. Where policies and procedures are not in place, give help andsupport to groups to work towards this standard before referrals are made tothem.
20. Support local groups to act in accordance with informationgovernance policies and procedures, ensuring compliance with GDPR/DataProtection.
Workcollectively with all local partners to ensure community groups are strong andsustainable
21. Work with commissioners and local partners to identify unmetneeds within the community and gaps in community provision.
22. Support local partners and commissioners to develop newgroups and services where needed.
Please see full job description for further information.
Person Specification
Skills & Knowledge
Essential
23. Understanding of the wider determinants of health, including social, economic and environmental factors and their impact on communities
24. Knowledge of community development approaches
25. Knowledge of IT systems, including ability to use word processing skills, emails and the internet to create simple plans and reports
26. Knowledge of motivational coaching and interview skills
Desirable
27. Knowledge of the personalised care approach
28. Knowledge of VCSE and community services in the locality
Other requirements
Essential
29. Meets DBS reference standards and has a clear criminal record, in line with the law on spent convictions
30. Willingness to work flexible hours when required to meet work demands
31. Access to own transport and ability to travel across the locality on a regular basis, including to visit people in their own homes
Personal Qualities & Attributes
Essential
32. Ability to listen, empathise with people and provide person-centred support in a non-judgemental way
33. Able to get along with people from all backgrounds and communities, respecting lifestyles and diversity
34. Commitment to reducing health inequalities and proactively working to reach people from all communities
35. Able to support people in a way that inspires trust and confidence, motivating others to reach their potential
36. Ability to communicate effectively, both verbally and in writing, with people, their families, carers, community groups, partner agencies and stakeholders
37. Ability to identify risk and assess/manage risk when working with individuals
38. 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 when there is a mental health need requiring a qualified practitioner
39. Able to work from an asset-based approach, building on existing community and personal assets
40. Able to provide leadership and to finish work tasks
41. Ability to maintain effective working relationships and to promote collaborative practice with all colleagues
42. Commitment to collaborative working with all local agencies (including VCSE organisations and community groups). Able to work with others to reduce hierarchies and find creative solutions to community issues
43. Ability to organise, plan and prioritise on own initiative, including when under pressure and meeting deadlines
44. High level of written and oral communication skills
45. Ability to work flexibly and enthusiastically within a team or on own initiative
46. Understanding of the needs of small volunteer-led community groups and ability to support their development
47. Knowledge of and ability to work to policies and procedures, including confidentiality, safeguarding, lone working, information governance, and health and safety
Experience
Essential
48. Experience of working directly in a community development context, adult health and social care, learning support or public health/health improvement (including unpaid work)
49. Experience of supporting people, their families and carers in a related role (including unpaid work)
50. Experience of working with the VCSE sector (in a paid or unpaid capacity), including with volunteers and small community groups
51. Experience of partnership/collaborative working and of building relationships across a variety of organisations
Desirable
52. Experience of supporting people with their mental health, either in a paid, unpaid or informal capacity
53. Experience of data collection and providing monitoring information to assess the impact of services
Qualifications
Essential
54. NVQ Level 3 Health and Social Care, or equivalent qualifications or working towards
55. Demonstrable commitment to professional and personal development
Desirable
56. Training in motivational coaching and interviewing or equivalent experience