Care Coordinator
| Posting date: | 23 April 2024 |
|---|---|
| Salary: | £25,147.00 per year |
| Additional salary information: | £25147.00 a year |
| Hours: | Full time |
| Closing date: | 10 May 2024 |
| Location: | York, YO62 5HD |
| Company: | NHS Jobs |
| Job type: | Contract |
| Job reference: | A2024-24-0003 |
Summary
Dementia Care Coordinator - Principal Responsibilities Whilst not exhaustive, the following will provide an overview of what is expected of this role: Data gathering and organization To include: 1) Developing an understanding of our coding of dementia and cognitive impairment using clinical templates 2) Identifying missed dementia due to coding errors 3) Developing and maintaining a register of patients with dementia 4) Creating a RAG (red, amber, green) dashboard of risk/need, with red being the patients we most need to consider for advanced care planning and green being low level concern 5) Monitoring systems that inform GPs about secondary care episodes, outpatient/inpatient and Emergency Department attendances, as well as OOH activity. Developing and reviewing care plans To include: 6) Being involved in the introduction of and changes to care plans 7) Ensuring care plans and advanced care plans are up to date and shared with the multidisciplinary team via the Teamnet portal 8) Ensuring that all patients are discussed, and outcomes are recorded and reviewed 9) Working with staff teams to ensure any planned or recommended treatment occurs in a reliable and timely manner acting as a single point of contact 10) Informing the lead clinician of any delays in assessment or delivery of care needs. Identify where plans or recommendations are not achieved and undertake process mapping to identify any bottlenecks. Developing communications and reports To include: 11) Negotiating with all involved in care issues to establish and promote good working relationships and improve the coordination of the patient journey 12) Establishing effective communication networks with clinicians and other team members and ensuring the continuation of good communication 13) In particular, develop close working relationships with the existing Frailty and Cancer Care Coordinator and the Parkinsons Disease Nurse to recognize cognitive impairment 14) Recognising people's needs for alternative methods of communication and respond accordingly 15) Keeping a diary of all team meetings and minuting those meetings 16) Producing reports of care plans as advised by lead clinicians 17) Preparing reports on behalf of Clinical Leads for peer review activities 18) Updating and maintaining a Directory of Services in real time 19) Providing a local point of contact for bereaved relatives, sign posting towards appropriate support at any stage following the loss of a relative or close friend to dementia 20) Ability to discuss blood test results and care pathways with a degree of knowledge. General Care Coordinator - Responsibilities 1) Utilize population health intelligence to proactively identify and work with a cohort of patients to deliver personalized care 2) Support patients to utilize decision aids in preparation for a shared decision-making conversation 3) Holistically bring together all of a person's identified care and support needs and explore options to meet these within a single personalized care and support plan (PCSP), in line with PCSP best practice, based on what matters to the person 4) Help people to 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, using tools to understand people's level of knowledge, confidence in skills in managing their own health 5) Support people to take up training and employment, and to access appropriate benefits where eligible for example, through referral to social prescribing link workers 6) Assist people to access self-management education courses, peer support or interventions that support them to take more control of their health and wellbeing 7) Explore and assist people to access personal health budgets where appropriate. Provide coordination and navigation for people and their carers across health and care services, working closely with social prescribing link workers, health and wellbeing coaches, and other primary care professionals 8) Support the coordination and delivery of MDTs within the PCN. GENERIC INFORMATION The post holder will maintain the security of sensitive personal and other confidential information and will apply all relevant Information Governance policies reliably to working practice. Additionally, they will be expected to follow secure operating procedures for handling information in all formats, including verbal, written and that held electronically. The post holder is responsible and accountable for their own practice in line with Infection Prevention and Control that reflect evidence, best practice and legislative requirements. The post holder will have the appropriate level of child protection and adult safeguarding knowledge, skills and practice required for the post and be aware of and comply with child protection and adult safeguarding policies and procedures. In addition to observing the PCNs rules and procedures, which all staff are required to observe and follow, the post holder is also required to follow general policies and procedures that apply to the employment relationship. It is the duty of the post holder to accept personal responsibility for the practical application of these policies, procedure and standards. Confidentiality In the course of seeking treatment, patients entrust us with, or allow us to gather, sensitive information in relation to their health and other matters. They do so in confidence and have the right to expect that staff will respect their privacy and act appropriately In the performance of the duties outlined in this Job Description, the post-holder may have access to confidential information relating to patients and their carers, PCN staff and other healthcare workers. They may also have access to information relating to the PCN as a business organisation. All such information from any source is to be regarded as strictly confidential Information relating to patients, carers, colleagues, other healthcare workers or the business of the PCN may only be divulged to authorised persons in accordance with the PCN policies and procedures relating to confidentiality and the protection of personal and sensitive data. Health and Safety Under the Health and Safety at Work etc. Act 1974, it is the responsibility of individual employees at every level to take care of their own health and safety at work, and that of others who may be affected by their acts at work. This includes co-operating with management in complying with health and safety obligations, particularly by reporting promptly any defects, risks or potential hazards. The post-holder will assist in promoting and maintaining their own and others health, safety and security as defined in the PCN Health & Safety Policy, to include: Using personal security systems within the workplace according to PCN guidelines Identifying the risks involved in work activities and undertaking such activities in a way that manages those risks Making effective use of training to update knowledge and skills Using appropriate infection control procedures, maintaining work areas in a tidy and safe way and free from hazards Reporting potential risks identified Working Time Regulations: The post holder must ensure that they do not work more than an average of 48 hours per week based on a 17-week period regardless of whether this is for the Trust as a secondary contract, as overtime, bank/casual, agency work or with another employer. Equality and Diversity The post-holder will support the equality, diversity and rights of patients, carers and colleagues, to include: Acting in a way that recognizes the importance of peoples rights, interpreting them in a way that is consistent with PCN procedures and policies, and current legislation Respecting the privacy, dignity, needs and beliefs of patients, carers and colleagues Behaving in a manner which is welcoming to and of the individual, is non-judgmental and respects their circumstances, feelings priorities and rights. Personal/Professional Development The post-holder will participate in any training programme implemented by the PCN as part of this employment, such training to include: Participation in an annual individual performance review, including taking responsibility for maintaining a record of own personal and/or professional development Taking responsibility for own development, learning and performance and demonstrating skills and activities to others who are undertaking similar work. Quality The post-holder will strive to maintain quality within the PCN, and will: Alert other team members to issues of quality and risk Assess own performance and take accountability for own actions, either directly or under supervision Contribute to the effectiveness of the team by reflecting on own and team activities and making suggestions on ways to improve and enhance the teams performance Work effectively with individuals in other agencies to meet patients needs Effectively manage own time, workload and resources. Contribution to the Implementation of Services The post-holder will: Apply PCN policies, standards and guidance Discuss with other members of the team how the policies, standards and guidelines will affect own work Participate in audit where appropriate.