Care Co-ordinator

NHS; London; On-site; GBP 1,000; Full time

Job summary

A leading healthcare provider is seeking a Care Coordinator to manage patient care and service coordination in London. The successful candidate will develop personalized care plans, facilitate communication across care teams, and ensure continuity of care for patients with various health needs. This role is integral in promoting self-management and supporting vulnerable populations within the community, operating within a compassionate and busy environment.

Benefits

20 days leave pro rata in the first year

Qualifications

• Key skills include strong communication and interpersonal abilities, empathy, and good organizational skills.
• Knowledge of local health services and understanding of confidentiality required.

Responsibilities

• Conduct assessments and develop personalized care plans with patient involvement.
• Coordinate services for patients and ensure effective communication among care teams.
• Review care plans regularly to adjust support based on patient needs.

Skills

Strong communication

Interpersonal skills

Empathy

Organisational abilities

Confidentiality understanding

Knowledge of local services

Job description

Ensure accurate coding and records are kept, reviewed and monitored, coordinate care planning, and ensure effective communication among different care teams. Organise and managed huddles and MDT meetings, follow up on actions, and ensure continuity of care. Be part of the recall and referrlas team.

Main duties of the job

Assessment and Planning

Conduct or contribute to assessments of patients' health and social care needs.

Develop personalised care plans with input from the patient, family, and other professionals.

Coordinating Services

Act as the main point of contact for the patient, helping them access various services (e.g., GPs, social services, mental health teams).

Ensure communication between different parts of the health and care system.

Monitoring and Reviewing Care

Regularly review care plans to ensure they remain relevant.

Adjust support as the patient's condition or circumstances change.

Advocacy and Support

Help patients understand their care options and make informed decisions.

Ensure the patient's voice is heard in planning and decision-making.

Multidisciplinary Collaboration

Work closely with doctors, nurses, social workers, therapists, and others.

Attend multidisciplinary team (MDT) meetings to discuss cases and ensure coordinated care.

Documentation and Reporting

Keep accurate records of assessments, care plans, and interactions.

Report concerns or changes in patient condition promptly.

Support patients in managing their own care where appropriate.

Encourage self-care and access to community support.

Assessment and Planning

• Conduct or contribute to assessments of patients' health and social care needs.

• Develop personalised care plans with input from the patient, family, and other professionals.

Coordinating Services

• Act as the main point of contact for the patient, helping them access various services (e.g., GPs, social services, mental health teams).

• Ensure communication between different parts of the health and care system.

Monitoring and Reviewing Care

• Regularly review care plans to ensure they remain relevant.

• Adjust support as the patient's condition or circumstances change.

Advocacy and Support

• Help patients understand their care options and make informed decisions.

• Ensure the patient's voice is heard in planning and decision-making.

Multidisciplinary Collaboration

• Work closely with doctors, nurses, social workers, therapists, and others.

• Attend multidisciplinary team (MDT) meetings to discuss cases and ensure coordinated care.

Documentation and Reporting

• Keep accurate records of assessments, care plans, and interactions.

• Report concerns or changes in patient condition promptly.

Promoting Independence

• Support patients in managing their own care where appropriate.

• Encourage self-care and access to community support.

Who They Typically Support:

People with long-term conditions

Those with mental health issues

Patients with multiple health needs

Older adults or individuals needing social care coordination

About us

We are a large very friendly team consisting of 8 partners, 4 salaried GP's, 3 nurse practitioners, 5 nurses, 1 HCA along and 10 admin/reception members. This is an extremely busy practice with approx. 16,000 patients. We are all mindful of each other and will always help out where and when needed. The successful person will receive 20 days leave pro rata in the first year and the salary is £14.65 per hour.

Job responsibilities

Identify patients who would benefit from care coordination (e.g. elderly, frail, frequent attenders, or with multiple conditions).

Serve as the main contact point for patients and their carers regarding their care journey.

Build trusted relationships with patients, encouraging self-management where possible.

Job description

Job responsibilities

. Patient Support & Coordination

• Identify patients who would benefit from care coordination (e.g. elderly, frail, frequent attenders, or with multiple conditions).

• Serve as the main contact point for patients and their carers regarding their care journey.

• Build trusted relationships with patients, encouraging self-management where possible.

2. Personalised Care Planning

• Work with patients to co-create personalised care plans tailored to their health needs and life goals.

• Ensure plans reflect patient preferences, involving family or carers when appropriate.

• Schedule and coordinate regular reviews of care plans.

3. Navigation & Signposting

• Help patients access appropriate servicesboth NHS (e.g., clinics, community nurses) and non-NHS (e.g., social prescribing, voluntary sector).

• Signpost patients to relevant community resources or support groups.

4. Multidisciplinary Team (MDT) Working

• Collaborate closely with GPs, nurses, pharmacists, social prescribers, health coaches, and other practice or Primary Care Network (PCN) staff.

• Attend regular MDT meetings to discuss complex patients and ensure joined-up care.

5. Proactive Population Health Management

• Use data and digital tools (e.g., patient registries, risk stratification software) to identify groups who need targeted interventions.

• Support proactive care, not just reactive appointments.

6. Administration & Record-Keeping

• Keep detailed and accurate records of all patient interactions, updates to care plans, and referrals.

• Update clinical systems (like EMIS or SystmOne) with care coordination notes and plans.

7. Health Promotion & Preventative Care

• Encourage and support patients in attending health checks, screenings, and vaccinations.

• Promote healthier lifestyles in line with NHS guidance.

Person Specification

Qualifications

• Key Skills for a Care Coordinator in General Practice:
• Strong communication and interpersonal skills
• Empathy and patience
• Good organisational and record-keeping abilities
• Understanding of confidentiality and safeguarding
• Knowledge of local services and health systems

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.