Health Care Coordinator

Durham Dales Health Federation; Bishop Auckland; On-site; GBP 26,000; Full time

Job description

Job Summary

You will be responsible for coordinating, integrating and delivering support to elderly, learning difficulty, end of life frail patients. You will liaise with a broad range of medical, social and third sector services to provide effective and synchronised care to these patients.

You will work with frail and vulnerable adults, to improve their health and wellbeing by navigating them to appropriate services. You will assist them to access these services and any appropriate funding. The service will be targeted at specific patient groups, identified by GP practices. These patients will include but are not limited to adults with complex long term health needs, depression, organic mental illness, learning difficulties and those who are at risk of social isolation. You will be required to perform minor clinical observations such as basic monitoring and recording of vital signs, blood pressure monitoring on behalf of the DDHF and GP practices. These skills will be carried out in the community. Appropriate training and support will be provided as required.

You will be working at a variety of venues in the community, including patients homes and utilising premises in agreement with stakeholders and clients. You will work collaboratively with the general practice teams to meet the needs of patients, supporting the delivery of DDHF policies and procedures, and support leadership as required.

Main duties of the job

Service Delivery

• Build & develop strong working relationships with health and social sectors, in the Durham Dales area, including GP practices
• Prepare proactive care plans for vulnerable patients
• Build relationships with patients with home visits, telephone consultations and reviews within the community setting

Communication

• Attend practice level MDT meetings
• Utilise & demonstrate sensitive communication styles, to ensure patients are fully informed
• Communicate with and support patients
• Communicate effectively with patients, recognising the need for alternative methods of communication to overcome different levels of understanding, cultural background and preferred ways of communicating
• Anticipate barriers to communication and take action to improve communication
• Maintain effective communication

Delivering a quality service

• Produce accurate, contemporaneous and complete records of patient contact, consistent with legislation, policies and procedures
• Prioritise, organise and manage own workload in a manner that maintains and promotes quality
• Assess effectiveness of care delivery through self and peer review, benchmarking & formal evaluation
• Participate in the maintenance of quality governance systems and processes across the organisation and its activities
• In partnership with other clinical teams, collaborate on improving the quality of health care responding to local and national policies and initiatives as appropriate
• Support and participate in shared learning across the wider organisation.

About us

A group of 12 GP practices across Durham Dales got together, looking for a solution to help them provide the care patients needed, share resources and ideas, and be prepared for the challenges the NHS would face in the future. The answer they came up with was a formal collaboration between the dozen practices: the Durham Dales Health Federation. DDHF's founding principal is to work together to provide high-quality, cost-effective primary healthcare services. That means providing a range of services that all GP practices in the area can use to help look after patients. We employ a range of clinical staff pharmacists, nurses, emergency care practitioners and social prescribing link workers as well as non-clinical, administration support staff.

DDHF are able to offer an NHS pension and length of service holidays. Other benefits are available on our website.

Date posted

10 April 2025

Pay scheme
Other
Salary
£25,728 a year

Contract
Permanent

Working pattern
Full-time

Reference number
U0041-25-0004

Job locations
Unit 51 Innovation Hse, Longfield Rd
South Church Enterprise Park
Bishop Auckland
Durham
DL14 6XB

Job Description
Job responsibilities
Summary Of Role
You will be responsible for coordinating, integrating and delivering support to

• elderly
• learning difficulty
• end of life
• frail patients

You will liaise with a broad range of medical social and third sector services to provide effective and synchronised care to these patients.

You will work with frail and vulnerable adults to improve their health and wellbeing by navigating them to appropriate services. You will assist them to access these services and any appropriate funding. The service will be targeted at specific patient groups identified by GP practices.

These patients will include but are not limited to adults with

• Complex long term health needs
• Depression
• Organic mental illness
• Learning difficulties

You will be required to perform minor clinical observations such as basic monitoring and recording of vital signs, blood pressure monitoring on behalf of the DDHF and GP practices. These skills will be carried out in the community. Appropriate training and support will be provided as required.

You will be working at a variety of venues in the community, including patients homes and utilising premises in agreement with stakeholders and clients. You will work collaboratively with the general practice teams to meet the needs of patients, supporting the delivery of DDHF policies and procedures, and support leadership as required.

Primary Responsibilities
Service Delivery
Build and develop a robust knowledge of health & social sector provision in the Durham Dales area

Build and develop strong working relationships with health, social, and third sector providers in the Durham Dales area, including GP practices

Work closely with professionals from a variety of health specialties.

Prepare proactive care plans for vulnerable patients

Build relationships with patients, patients families, and carers with home visits, telephone consultations and reviews within the community setting and at dedicated venues.

Act as an advocate for patients and service users to the health and social care system

Signpost patients towards appropriate services

Communication
Attend practice level MDT meetings to discuss patients and coordinate with health care professionals

Utilise and demonstrate sensitive communication styles, to ensure patients are fully informed

Communicate with and support patients who are receiving bad news

Communicate effectively with patients and carers, recognising the need for alternative methods of communication to overcome different levels of understanding, cultural background and preferred ways of communicating

Anticipate barriers to communication and take action to improve communication

Maintain effective communication within the practice environment and with external stakeholders

Delivering a quality service
Produce accurate, contemporaneous and complete records of patient contact, consistent with legislation, policies and procedures

Prioritise, organise and manage own workload in a manner that maintains and promotes quality

Assess effectiveness of care delivery through self and peer review, benchmarking and formal evaluation

Participate in the maintenance of quality governance systems and processes across the organisation and its activities

Utilise the audit cycle as a means of evaluating the quality of the work of self and the team, implementing improvements where required

In partnership with other clinical teams, collaborate on improving the quality of health care responding to local and national policies and initiatives as appropriate

Evaluate patients responses to health care provision and the effectiveness of care

Support and participate in shared learning across the wider organisation.

Assess the impact of policy implementation on care delivery

Understand and apply legal issues that support the identification of vulnerable and abused adults, and be aware of statutory vulnerable patients health procedures and local guidance

Specific Tasks/ Responsibilities
Team working
Understand own role and scope, work within this scope of practice and identify how this may develop over time

Work as an effective and responsible team member, supporting others and exploring the mechanisms to develop new ways of working

Delegate clearly and appropriately, adopting the principles of safe practice and assessment of competence

Create clear referral mechanisms to meet patient need

Prioritise own workload and ensure effective time-management strategies are embedded

Work effectively with others to clearly define values, direction and policies impacting upon care delivery

Discuss, highlight and work with the team to create opportunities to improve patient care

Managing information
Use technology and appropriate software as an aid to management in planning, implementation and monitoring of care, presenting and communicating information

Ensuring that patient data is kept confidential at all times and is shared on a need to know basis only.

Understand responsibility of self and others regarding the Freedom of Information Act

Collate, analyse and present data and information to the team

Learning and development
Disseminate learning and information gained to other team members in order to share good practice and inform others about current and future developments (eg courses and conferences)

Assess own learning needs and undertake learning as appropriate.

Equality and inclusion
Identify patterns of discrimination and take action to overcome this and promote diversity and equality of opportunity

Enable others to promote equality and diversity in a non-discriminatory culture

Support people who need assistance in exercising their rights

Adhere to local chaperoning policies

Act as a role model in the observance of equality and diversity good practice

Accept the rights of individuals to choose their care providers, participate in care and refuse care

General Responsibilities
Ensure strict confidentiality of correspondence, reports, meetings and verbal communications as appropriate.

Adapt to and support any changes that are implemented to improve the service.

At all times provide a caring service and to treat those with whom they come into contact in a courteous and respectful manner.

Demonstrate commitment by the efficient completion of all tasks allocated.

Carry out duties and responsibilities in compliance with health and safety policy and statutory regulations.

Adhere to equal opportunities policy throughout the course of employment.

Person Specification
Qualifications Essential

• GCSE Grade C or above in Maths and English, or equivalent qualification

Desirable

• Qualification in a health or social care allied profession
• Phlebotomy
• HCA qualification

Experience Essential

• Experience of working with or caring for elderly people, friends or relations

Desirable

• Experience of working in primary care
• Experience of working in social care or health
• Experience of working with frail and vulnerable patients
• Experience of working as part of an MDT

Skills Essential

• Communication skills, both written and verbal
• Empathy with the older persons needs and conditions
• Positive attitude to work, colleagues and patients
• Non-judgemental attitude to patients
• Tact and diplomacy
• Desire to help and put people first
• Ability to negotiate the best possible services for patients
• Advocacy skills
• Time management
• Team working
• Good record keeping
• Good IT keyboard skills

Desirable

• Knowledge of SystmOne
• Care planning knowledge

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.

Employer details
Employer name
Durham Dales Health Federation

Address
Unit 51 Innovation Hse, Longfield Rd
South Church Enterprise Park
Bishop Auckland
Durham
DL14 6XB

Employer's website
https://ddhf.co.uk/