Care Coordinator

York Road Group Practice; Ellesmere Port; On-site; GBP 25,000 - 32,000; Full time

Job summary

York Road Group Practice is seeking a caring, proactive Care Coordinator on a maternity cover basis to support frail and elderly patients and those with long-term conditions. You will work with the PCN team to coordinate care, chair MDTs and promote preventative services.

The role involves helping patients access services, coordinating vaccination programmes, and participating in PPG activities while upholding safeguarding and data protection standards.

Qualifications

• Excellent communication and listening skills for patient navigation.
• Strong organisational skills and ability to manage multiple tasks.
• Empathy and ability to work with diverse patient groups.
• Ability to work independently within a multidisciplinary team.

Responsibilities

• Identify and support frail, elderly, long-term condition and vulnerable patients, coordinating care across health, social care and voluntary services.
• Help patients navigate services, prepare for appointments and manage their health and wellbeing.
• Coordinate and chair MDT meetings, identifying patients, facilitating discussions and following up agreed actions.
• Support screening programmes, encouraging attendance and addressing barriers to access.
• Support flu, COVID-19 and RSV vaccination programmes, including patient engagement and appointment coordination.
• Support and coordinate the Patient Participation Group (PPG) and patient engagement activities.
• Work collaboratively with GPs, nurses, pharmacists, social prescribers and wider health and care professionals.
• Maintain accurate records and contribute to monitoring, reporting and service improvement.
• Communicate with patients and carers in a compassionate, person-centred manner.
• Signpost and refer patients to appropriate services and follow up where required.
• Maintain confidentiality and comply with information governance, safeguarding and data protection requirements.
• Contribute to practice and PCN meetings, training and service development.

Skills

Communication

Organisational skills

Interpersonal skills

Compassionate approach

Tools

EMIS

MS Office

Job description

We are looking for a caring, organised and proactive Practice Care Coordinator to join our practice team on a maternity cover basis, working closely with the wider PCN Care Coordinator Team. The post holder will support patients to access coordinated, personalised & preventative care, with a focus on frail and elderly patients, people living with long-term conditions & other vulnerable groups. You will work across the practice, PCN & wider health & care services to help patients navigate services, prepare for & follow up clinical conversations, and become more actively involved in managing their health & wellbeing. Key responsibilities include coordinating and chairing MDT meetings, ensuring appropriate patients are discussed & actions followed up; supporting national and local screening programmes by encouraging eligible patients to attend and addressing barriers to access; and contributing to PCN services, including seasonal vaccination programmes such as flu, COVID-19 and RSV. You will also support Patient Participation Group (PPG) activities and work closely with practice and PCN colleagues to improve patient experience, access and outcomes. We are looking for an excellent communicator with strong organisational and interpersonal skills who is compassionate, approachable and able to work independently and as part of a multidisciplinary team. This is an opportunity for someone passionate about person-centred care, preventative healthcare and reducing health inequalities.

Main duties of the job

• Identify and support frail, elderly, long-term condition and vulnerable patients, coordinating care across health, social care and voluntary services.
• Help patients navigate services, prepare for appointments and manage their health and wellbeing.
• Coordinate and chair MDT meetings, identifying patients, facilitating discussions and following up agreed actions.
• Support screening programmes, encouraging attendance and addressing barriers to access.
• Support flu, COVID-19 and RSV vaccination programmes, including patient engagement and appointment coordination.
• Support and coordinate the Patient Participation Group (PPG) and patient engagement activities.
• Work collaboratively with GPs, nurses, pharmacists, social prescribers and wider health and care professionals.
• Maintain accurate records and contribute to monitoring, reporting and service improvement.
• Communicate with patients and carers in a compassionate, person-centred manner.
• Signpost and refer patients to appropriate services and follow up where required.
• Maintain confidentiality and comply with information governance, safeguarding and data protection requirements.
• Contribute to practice and PCN meetings, training and service development.

About us

York Road Group Practice is a friendly, forward-thinking GP practice in the centre of Ellesmere Port, serving approximately 12,000 patients. We have a diverse and experienced multidisciplinary team committed to providing high-quality, patient-centred care. Our clinical team includes 4 GP Partners, 6 Salaried GPs, an ANP, Clinical Pharmacist, Pharmacy Technician, Practice Nurses, HCAs and GPAs, supported by a highly skilled administrative team including a Practice Manager, Practice Secretary, Personal Assistant, Administration Team Leader and Team Coordinator.

We work closely with our wider PCN team, including First Contact Physiotherapists, Social Prescribers and a Dementia Practitioner, enabling patients to access a broad range of support. We are a training practice, supporting GP Registrars, medical students and administrative apprentices, and are committed to learning, development and continuous improvement. We value teamwork, compassionate care, innovation and professional development, with our clinical, administrative and PCN teams working together to improve patient experience and outcomes.

This is a maternity cover position providing continuity within our Care Coordinator service while our permanent Care Coordinator is on leave. The successful candidate will receive an initial handover and induction and work alongside our practice and PCN teams to maintain and develop care coordination services throughout the cover period.

Job responsibilities

• Beproactive in identifying patients through admissions and discharge data andorganise appointments/follow ups as needed and appropriate
• Aproven record of excellent written and verbal communication skills andinterpersonal skills
• Becreative and tenacious in finding solutions to difficult problems
• TheCare Coordinators role will support the PCN leadership team and GPs incoordinating all key activity including improving access to services, providingadvice and information in addition to ensuring health and care planning istimely, efficient, and patient-centered
• Workwith GPs and other clinicians, supported by data to identify cohorts ofpatients who will benefit from personalised care
• Supportpatients to engage in training and employment, accessing education and otherservices to improve their well being
• Workacross the PCN team as directed
• Manageresources effectively in line with local PCN guidance
• Assistwhen appropriate to design and implement organisational Policies and Procedures
• Usesignificant event analysis to alert appropriate staff to risk areas
• Engagewith all necessary mandatory training
• Keepup to date with latest guidelines
• Undertakeadditional training as maybe necessary
• Youwill work in partnership with your clinical and non-clinical colleagues,management support and the widePCN to ensure the role delivers the bestpossible outcomes for our patients.
• Fullyintegrate and support the coordination and delivery of MDTs within the Practice
• Bea first point of contact for all non-English speaking patients who apply toregister/seek medical care at the practice and guide them through the process,utilise language line for booking appointments with clinician appropriately andnavigate and signpost them to appropriate non-clinical services
• Supportthe delivery and running of the practices Patient Participation Group
• Otherduties as required in line with the Care Co-Ordinator framework

Other

• Meets a Disclosure and Barring Service (DBS) reference standards and criminal record checks
• Willingness to work flexible hours when required to meet work demands, especially during the seasonal Vaccination Programme
• Access to own transport
• Ability to travel across the locality on a regular basis

Skills & Knowledge

• Understanding of personalised care and the comprehensive model of personalised care
• Understanding of the wider determinants of health, including social, economic and environmental factors and their impact on communities, individuals, their families and carers
• Understanding of, and commitment to, equality, diversity and inclusion
• Strong organisational skills, including planning, prioritising, time management and record keeping
• Knowledge of how the NHS works, including primary care and PCNs
• Understanding of the needs of older people / adults with disabilities / long term conditions particularly in relation to promoting their independence
• Basic knowledge of long -term conditions and the complexities involved: medical, physical, emotional and social
• Ability to recognise and work within limits of competence and seek advice when needed

Personal Qualities

• Ability to actively listen, empathise with people and provide personalised support in a non-judgemental way.
• Ability to provide a culturally sensitive service supporting people from all backgrounds and communities, respecting lifestyles and diversity
• Commitment to reducing health inequalities and proactively working to reach people from diverse communities.
• Ability to support people in a way that inspires trust and confidence, motivating others to reach their potential
• Ability to communicate effectively, both verbally and in writing, with people, their families, carers, partner agencies and stakeholders
• Ability to identify risk and assess / manage risk when working with individuals
• 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 care coordinator role e.g. when there is a mental health need requiring a qualified practitioner
• Ability to maintain effective working relationships and to promote collaborative practice with all colleagues
• Ability to demonstrate personal accountability, emotional resilience and work well under pressure
• Ability to organise, plan and prioritise on own initiative, including when under pressure and meeting deadlines
• Ability to work flexibly and enthusiastically within a team or on own initiative
• Knowledge of, and ability to work to policies and procedures, including confidentiality, safeguarding, lone working, information governance, and health and safety
• Demonstrable commitment to professional and personal development
• Experience using EMIS
• Proficient in MS Office and web -based services
• Ability to provide motivational coaching to support peoples behaviour change

Experience

• Experience of working in health, social care and other support roles in direct contact with people, families or carers (in a paid or voluntary capacity)
• Experience of working within multi - professional team environments
• Experience of supporting people, their families and carers in a related role
• Experience of data collection and using tools to measure the impact of services
• Experience of working directly in a care co-ordinator role, adult health and social care, learning support or public health / health improvement
• Experience or training in personalised care and support planning
• Experience of working with elderly or vulnerable people, complying with best practice and relevant legislation

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.