Job summary
Harbourside Family Practice is a large well established 11,000 patient practice in Portishead.
We are looking for an enthusiastic and reliable care coordinator to join our team on a part time basis. The hours and days of work of this post are negotiable (ideally around 22.5hours).
Care co-ordinators play a key role in proactively identifying and working with people, including the frail / elderly and those with long term conditions, to provide co-ordination and navigation of care and support across health and care services. This includes making sure that individuals have access to the reviews and appointments they need to support them to manage their conditions effectively.
You will also work closely with our social prescribers, mental health practitioners and our health and wellbeing coach.
Main duties of the job
You
will be part of a developing multi-disciplinary team (MDT).
You
will work closely with the MDT providing an efficient, professional, and
flexible service to our patients.
You
will take a holistic approach to bringing together a patients care and support
needs and draw up personalised care and support plans (PCSP).
You
will support the surgery in coordinating all key activity including access to
services, advice and information, ensuring health and care planning is timely,
efficient and patient-centred.
The
role includes supporting digital initiatives while co-ordinating and navigating
the patients journey through primary care including liaising with secondary
care hospitals. A key part of the role will be working with vulnerable and
complex patients.
The
candidate will need to be an excellent communicator and be able to establish
efficient monitoring and quality assurance systems. Training and support will
be provided to successful applicants.
About us
We are a 4 Partner high achieving PMS Practice situated in Portishead, a beautiful coastal town in North Somerset overlooking the Severn Estuary, just five miles from the city of Bristol.
We are a forward thinking practice with a strong emphasis on teamwork and patient centred care. We work from a new purpose-built health centre with bright, modern facilities that enable us to offer high quality clinical services to our local population of 11,000 patients. We are also a training practice.
We have had consistently high QoF results and were delighted that we were assessed as Good in our latest CQC inspection. We are also a 4.5 star rated practice on NHS Choices and 4.2 star rated on Google Reviews.
Job description
Job responsibilities
Main Responsibilities:
To work with the GPs and other primary care
professionals within the surgery to identify and proactively recall a selected
cohort of patients to deliver personal care. For example, patients with
Dementia, Cancer or Learning Disabilities who may need annual reviews of their
health or medications.
To work closely and in partnership with the Social
Prescribing Link Workers (SPLWs) and the wider Community Services including
Sirona, to explore care options for patients based on what matters to the
person.
To support patients to utilise decision aids in
preparation for a shared decisions-making conversation and to help create
single personalised care and support plans, in line with best practice.
To help people manage their needs through answering
queries, making and managing appointments, and ensuring that people have good
quality written or verbal information to help them make choices about their
care e.g annual flu or covid vaccinations. This may include supporting people
to take up vaccinations, training and employment, self-management education
courses and access appropriate benefits where eligible.
Also to support in
the delivery of contract specifications. This may include administrative tasks
such as: -
Inputting data around screening tests /
vaccinations
Running searches to identify populations who may
need intervention e.g. children who require calling in for immunisations.
Support and feed into the development of the MDT
approach to working with our patients
Becoming a contact point for patients who are: -
o
Complex and or frail
o
Frequent visitors to the GP
o
Recently discharged from hospital or about to be
discharged
o
Recently attended A and E and would benefit from
follow up
o
New patients to our list with follow up
requirements
Requiring active
signposting to self-care services as part of on the day and minor illness
approach
Job description
Job responsibilities
Main Responsibilities:
To work with the GPs and other primary care
professionals within the surgery to identify and proactively recall a selected
cohort of patients to deliver personal care. For example, patients with
Dementia, Cancer or Learning Disabilities who may need annual reviews of their
health or medications.
To work closely and in partnership with the Social
Prescribing Link Workers (SPLWs) and the wider Community Services including
Sirona, to explore care options for patients based on what matters to the
person.
To support patients to utilise decision aids in
preparation for a shared decisions-making conversation and to help create
single personalised care and support plans, in line with best practice.
To help people manage their needs through answering
queries, making and managing appointments, and ensuring that people have good
quality written or verbal information to help them make choices about their
care e.g annual flu or covid vaccinations. This may include supporting people
to take up vaccinations, training and employment, self-management education
courses and access appropriate benefits where eligible.
Also to support in
the delivery of contract specifications. This may include administrative tasks
such as: -
Inputting data around screening tests /
vaccinations
Running searches to identify populations who may
need intervention e.g. children who require calling in for immunisations.
Support and feed into the development of the MDT
approach to working with our patients
Becoming a contact point for patients who are: -
o
Complex and or frail
o
Frequent visitors to the GP
o
Recently discharged from hospital or about to be
discharged
o
Recently attended A and E and would benefit from
follow up
o
New patients to our list with follow up
requirements
Requiring active
signposting to self-care services as part of on the day and minor illness
approach
Person Specification
Skills, Ability and Knowledge
Essential
- Ability to organise and prioritise workload effectively
- Ability to exercise sound judgement when faced with conflicting pressures
- Excellent record keeping skills
- IT literate and proficient in the use of Microsoft Office
- Good verbal and listening skills
- Works well as an autonomous / independent practitioner and within a team
- Excellent communication skills including able to communicate effectively, both verbally and in writing, with a wide range of people and stakeholders
- Excellent administration skills including able to prioritise and to finish work tasks
Desirable
- Proficient in the use of web-based applications or programmes
- Awareness of local referral pathways
Experience
Essential
- Experience of supporting people, their families and carers in a related role
- Good experience of IT systems and packages including EMIS Web and Docman 10
- Experience of data collection and providing monitoring information
- Experience of working within a patient facing role
- Experience of Electronic Patient Records
- Knowledge of the purpose of departmental policies, procedures and care pathways
Desirable
- Experience of working directly in a community development context, adult health and social care, learning support or public health/health improvement (including unpaid work)
- Experience of supporting people with their mental health
- Experience of collaborative working and building relationships across varied organisations
Qualifications
Essential
- NVQ Level 3, Advanced level or equivalent qualifications
- Demonstrable commitment to professional and personal development
Desirable
- Training in motivational coaching and interviewing or equivalent experience
Other Requirements
Essential
- Patient focused and compassionate about delivery of safe and effect care.
- Ability to demonstrate commitment to the PCNs ethos and values
- Resilient and flexible to meet service needs.
- Ability to travel to meetings in the interests of the PCN as required
- Ability to attend meetings outside core hours as required
Person Specification
Skills, Ability and Knowledge
Essential
- Ability to organise and prioritise workload effectively
- Ability to exercise sound judgement when faced with conflicting pressures
- Excellent record keeping skills
- IT literate and proficient in the use of Microsoft Office
- Good verbal and listening skills
- Works well as an autonomous / independent practitioner and within a team
- Excellent communication skills including able to communicate effectively, both verbally and in writing, with a wide range of people and stakeholders
- Excellent administration skills including able to prioritise and to finish work tasks
Desirable
- Proficient in the use of web-based applications or programmes
- Awareness of local referral pathways
Experience
Essential
- Experience of supporting people, their families and carers in a related role
- Good experience of IT systems and packages including EMIS Web and Docman 10
- Experience of data collection and providing monitoring information
- Experience of working within a patient facing role
- Experience of Electronic Patient Records
- Knowledge of the purpose of departmental policies, procedures and care pathways
Desirable
- Experience of working directly in a community development context, adult health and social care, learning support or public health/health improvement (including unpaid work)
- Experience of supporting people with their mental health
- Experience of collaborative working and building relationships across varied organisations
Qualifications
Essential
- NVQ Level 3, Advanced level or equivalent qualifications
- Demonstrable commitment to professional and personal development
Desirable
- Training in motivational coaching and interviewing or equivalent experience
Other Requirements
Essential
- Patient focused and compassionate about delivery of safe and effect care.
- Ability to demonstrate commitment to the PCNs ethos and values
- Resilient and flexible to meet service needs.
- Ability to travel to meetings in the interests of the PCN as required
- Ability to attend meetings outside core hours as required
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.
