In your role as a Health & Wellbeing Coach, you will work as part of an Integrated Personalised Care Team, alongside SPLWs supporting seven practices within the Primary Care Networks of North Gosforth and Jesmond and Lower Gosforth.
The Health & Wellbeing Coach will be responsible for delivering sessions on healthy eating, physical activity and health and well-being to meet with personalised care plans. The coach will play a critical role in engaging patients and use health coaching techniques to support them to take an active role in their health.
You will work in a variety of venues in general practice and the community. You will work collaboratively as part of our friendly personalised care team and also with our individual practices and with professional links. Teamwork, flexibility, enthusiasm, and the ability to prioritise tasks effectively are essential skills.
Main duties of the job
This is a new role and as such the coach will be able to help shape and develop the role. Your role and skills will support and encourage the prevention of developing further illness, or the deterioration of existing long-term conditions.
Providing support to a cohort of patients who will benefit from proactive health management and care.
Playing a health and wellbeing coaching role; teaching and supporting patients/carers to understand and manage their own conditions and maintain an independent lifestyle through health coaching techniques.
Supporting the development of personalised patient care plans, liaising with the practice team, patient/carer and the complex care team as appropriate.
Proactively outreaching to patients on a regular and agreed basis.
Map and connect community activities/ resources at a locality level.
Support the delivery of community based public health initiatives such as physical activity, healthy eating and social connectedness.
Build and maintain strong links with the voluntary sector.
Support delivery of systematic self-care support plans for those with COPD, Diabetes, Pre-Diabetes, CVD and multiple long-term conditions.
Interest in weight management, diabetes and group consultations desirable.
Understand when it is appropriate or necessary to refer people to other health professionals/agencies.
About us
Gosforth Jesmond Health is a company set up by the Primary Care Networks (PCN) of North Gosforth and Jesmond and Lower Gosforth to manage and deliver PCN contracts and services. We are innovative in our approach and our working environment is dynamic and complex, as we endeavour to support the seven GP practices of our two networks deliver high quality primary care services in challenging times.
Job responsibilities
Primary Responsibilities
Coach and motivate patients through multiple sessions to identify their needs, set goals, and support them to implement their personalised health and care plan.
Provide personalised support to individuals, their families and carers to ensure that they are active participants in their own healthcare; empowering them to take more control in managing their own health and wellbeing, to live independently and improve their health outcomes through:
* Providing interventions.
* Supporting people to establish and attain goals set by the person based on what is important to them.
* Working with the social prescribing service to connect them to community-based activities.
* Working with the Long-Term Conditions (LTC) team to deliver specific health advice, where appropriate.
* Working to increase the prevalence of treatable LTCs by undertaking health checks.
* Inputting data including appropriate disease and referral coding.
* Provide support to local community groups and work with other health, social care and voluntary sector providers to support the patients; health and well-being holistically.
* Help to establish and co-ordinate patient groups to aid self-management, peer support, and the creation of patient communities.
* Support colleagues to improve their skills and understanding of personalised care, behavioural approaches.
* Undertake all the necessary training and induction for the role.
* Raise awareness within the PCN of shared decision making and decision support tools and supporting people in shared decision-making conversations.
* Explore and support access to a personal health budget, where appropriate, for their care and support.
* Utilise existing IT and MDT channels to screen patients, with an aim to identify those that would benefit from health coaching.
* Work with the PCN and practices towards a number of different outcome and quality improvement measures including QOF, QIPP and IIF.
Main Tasks
* Manage and prioritise a caseload, in accordance with the health and wellbeing needs of their population. Supporting practices teams in identifying patients who will benefit from the support and encouragement.
* Provide personalised support to individuals, their families, and carers to support them to be active participants in their own healthcare; empowering them to manage their own health and wellbeing and live independently. Helping them understand what is important to them and working with them to get there.
* Coaching, supporting, encouraging and motivating patients through multiple sessions to identify their needs, set goals, and support them in achieving their personalised health goals.
* Introducing patient support such as self-management education and peer support like group consultations.
* Supporting personal choice and positive risk taking while ensuring that patients understand the accountability of their own actions and decisions, thus encouraging the proactive prevention of further illnesses.
* Working in with the Social Prescribing Link Workers, Care Coordinators, Pharmacists clinical and non-clinical teams with in the PCN to connect patients to community-based activities which support them and help them to take control of their health and wellbeing.
* Explore and support patient access to a personal health budget, where appropriate, for their care and support.
* Support delivery of systematic self-care support plans for those with COPD, Diabetes, Pre-Diabetes, CVD and multiple long-term conditions.
* Interest in weight management, diabetes and group consultations desirable.
* Understand when it is appropriate or necessary to refer people to other health professionals/agencies.
Person Specification
Experience
* Minimum of 2 years' experience at delivering primary care level (level 2) weight management services including to diabetic patients. MDT working with diverse service providers in a community setting
* Experience of General Practice
Qualifications
* Good standard of general education. GCSE grade C/Level 5 or above in English Language and Mathematics or equivalent. Full UK driving license.
* Training and or qualification in motivational coaching and interviewing, strength based questioning or equivalent
Skills
* Able to communicate effectively and engage with individuals from the PCN, other agencies, including patients and the public. Able to work across 2 networks and support the development of our primary care health and lifestyle coach service.
Knowledge
* Knowledge of personalised care approach and evidence based social prescribing interventions and activities Knowledge of local community and VCSE service providers and associated referral criteria Knowledge of HR practices and processes
* Knowledge of General Practice
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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