PCN Care Coordinator

NHS; City Of London; On-site; GBP 25,000 - 35,000; Full time

Job summary

A prominent health organization in London is seeking a PCN Care Coordinator to assist patients in managing their care with a focus on communication and administrative support. The candidate will work collaboratively with GPs and other clinicians, engage patients in care planning, and ensure needs are met effectively. This is a permanent position requiring excellent organizational skills and previous experience in healthcare.

Qualifications

• Excellent communication skills, both verbal and written.
• Ability to motivate others and inspire trust.
• Experience in supporting patients and their families.

Responsibilities

• Assist patients in managing their care.
• Coordinate clinics and manage patient calls.
• Document and monitor care coordination and delivery.

Skills

Communication

Administrative skills

Time management

Empathy

Problem solving

Education

ECDL or equivalent

Training in motivational coaching and interviewing

Tools

Word

Excel

PowerPoint

EMIS ERS

Job description

Overview

We are looking for 1 WTE PCN Care Coordinators with excellent communication and administrative skills to work with the GPs and other clinicians within the Waterloo Health Centre.

You will be working with GPs and other clinicians, to assist patients in the management of their care.

One of successful care coordinators will concentrate on providing Administration support across practices as well as Care Coordination.

You will be none judgmental, empathetic as the first point of contact for patients, clinicians and community carers. Identifying personalised care plans, engaging them in training and employment to improve their wellbeing.

Having excellent time management skills will be important to manage your workloads and deliver role objectives within the timescales

*Previous applicants need not apply*

Main duties of the job

1. North Lambeth Primary Care Network are excited to advertise a new rolein our network
2. As a Care coordinator you will play a crucial role in supportingpatients in preparing for or in following-up clinical conversations they havewith primary care professionals.
3. You will work closely with the GPs and other primary care professionalswithin the PCN to identify and manage a caseload of identified patients, makingsure that appropriate support is made available to them and their carers, andensuring that their changing needs are addressed.
4. You will focus delivery of the comprehensive model to reflect localpriorities, health inequalities or population health management riskstratification.
5. 1x PCN Care Coordinators wanted at North Lambeth Primary Care Network
6. Role Title
7. Hours
8. 37.5hours per week.
9. Duration
10. Permanent
11. Reporting to
12. PCN Network Manager
13. Location
14. NorthLambeth member practices for the Primary Care Network
15. Key responsibilities
16. 1.Undertakework in line with PCN directed priorities.
17. 2.Proactively identify and work with a cohort of people to supporttheir personalised care requirements, using the available decision support aids
18. 3.Ensureregular and consistent communication with the referrer regarding patientprogress and any complications or guidance
19. 4.Raise awareness of health promotion and NHS health checks inpractices
20. 5.Work with Member Practices to facilitate the .
21. 6.Evaluate treatment programmes that promote health andwell-being
22. 7.Co-ordinate clinics, liaising with the schedulers andcontacting the identified patients with appointments.
23. 8.Manage patient initiated calls for help/signposting etc,booking into named GP urgent care slots/tel slots if necessary.
24. 9.Document and monitor aspects of patient co-ordination andservice delivery, supporting data collection and audit using the patientadministration system
25. 10.Demonstrate the ability to recognise and respondappropriately when faced with a sudden deterioration or emergency situation,alerting the team or enabling a rapid response.
26. 11.Dependant on work plans, there may be a requirement to workacross different tumour groups and teams.
27. 12.Organise and prioritise own workload the postholder shouldbe comfortable working independently and as a committed member of themulti-disciplinary team.
28. 13.Support national screening programmes
29. 15.Monitor referralsto ensure tasks are completed and care delivered by keeping in regulartelephone contact
30. 16.Direct liaisonwith multi agencies to coordinate care for patients
31. 17.Refer to PCNsocial prescribing link workers were a patient is identified as potentiallybenefitting from this service
32. 18.To supportpatient/carer contact roles, and collate patient and carer feedback on theirexperiences
33. 19.Support Qualityand Outcome Frameworks and other DES/LES specifications
34. 20.Maintain anddevelop engagement with all practice staff and encourage best practice
35. 21.Act as the first port of call for patients, in their caseloadin relation to their care.
36. 22.Bring together all of a persons identified careand support needs, and explore their options to meet these into a singlepersonalised care and support plan (PCSP), in line with PCSP best practice
37. 23.Help people to manage their needs, answeringtheir queries and supporting them to make appointments
38. 24.Support people to take up training, employmentand access appropriate benefits where eligible
39. 25.Raise awareness of shared decision-making and decisionsupport tools, and assist people to be more prepared to have a shareddecision-making conversation
40. 26.Ensure that people have good quality informationto help them make choices about their care
41. 27.Support people to understand their level of knowledge,skills and confidence their Activation level when engaging with theirhealth and wellbeing, including using the Patient Activation Measure
42. 28.Assist people to access self-management educationcourses, peer support or interventions that support them in their healthandwellbeing
43. 29.Explore and assist people to access personalhealth budgets where appropriate
44. 30.Provide coordination and navigation for people andtheir carers across health and care services, alongside working closely withsocial prescribing link workers and other primary care roles
45. 31.Support the coordination and delivery of MDTswithin PCNs. - ManageMDT meetings for this patients and identifying issues to be addressed, liaisingwith other agencies if necessary as well as GPs, Pharmacists and Nursing team.
46. 32.Liaise directly withCare Homes and other key providers, to identify patients for discussion at MDT,and compile and circulate relevant information to attendees
47. 33.Other duties asdefined by the PCN as necessary

Confidentiality

In the course of seeking treatment,patients entrust us with, or allow us to gather, sensitive information inrelation to their health and other matters. They do so in confidence and havethe right to expect that staff will respect their privacy and actappropriately.

In the performance of the dutiesoutlined in this job description, the post-holder may have access toconfidential information relating to patients, their carers, practice or staffinformation. All such information from any source is to be regarded as strictlyconfidential.

Information relating to patients,carers, colleagues, or the members practices may only be divulged to authorisedpersons in accordance with PGPA policies and procedures relating toconfidentiality and the protection of personal and sensitive data, or under theguidance of your manager.

This role profile is not exhaustive, and you may be directed tocomplete other tasks according to the skills and requirements for individualroles. These duties will always be reasonable and deemed within theexpectations of your position.

Person Specification

Personal Qualities & Attributes

• Ability to organise, plan and prioritise on own initiative, including when under pressure and meeting deadlines.
• Able to work as part of a team
• Able 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 maintain effective working relationships and to promote collaborative practice with all colleagues in PCN and the various Practice teams
• Demonstrates personal accountability, emotional resilience and works well under pressure

Skills and knowledge

• Knowledge of the personalised care approach
• Advanced experience of using word, excel and PowerPoint including ability to use word processing skills, emails and the internet to create simple plans and reports
• Creative problem solver and willing to search for hard-to-find information
• Knowledge of general practice clinical systems, such as, EMIS ERS, Footfall
• Ability to read large amounts of information and extract the salient points, to analyse data and report on findings

Other

• Meets DBS reference standards and has a clear criminal record, in line with the law on spent convictions
• Access to own transport and ability to travel across the locality on a regular basis
• Continued commitment to improve skills and ability in new areas of work

Experience

• Experience of working with healthcare professionals and or previous experience in the NHS or social care or relevant field (including unpaid work)
• Experience of data collection and providing monitoring information to assess the impact of services
• Experience of partnership/collaborative working and of building relationships across a variety of organisations
• Experience of working with or in general practice
• Working in a multi-disciplinary setting where influence and negotiation is required
• Knowledge/familiarity with medical terminology
• Experience of supporting people, their families and carers in a related role (including unpaid work)
• Experience in use of databases
• Vulnerable adults awareness
• Experience of care of the elderly

Qualifications

• ECDL or equivalent
• Demonstrable commitment to professional and personal
• development
• Training in motivational coaching and interviewing or equivalent

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.