PCN Care Coordinator
| Dyddiad hysbysebu: | 05 Rhagfyr 2025 |
|---|---|
| Cyflog: | £27,485.00 i £29,758.00 bob blwyddyn |
| Gwybodaeth ychwanegol am y cyflog: | £27485.00 - £29758.00 a year |
| Oriau: | Llawn Amser |
| Dyddiad cau: | 19 Rhagfyr 2025 |
| Lleoliad: | Stockport, SK8 5LL |
| Cwmni: | NHS Jobs |
| Math o swydd: | Parhaol |
| Cyfeirnod swydd: | A4536-25-0014 |
Crynodeb
You will coordinate and support the delivery and follow-up of all key health checks within the GP practice and PCN. This includes managing Serious Mental Illness (SMI) annual health checks by tracking completion of all core elements such as blood pressure, BMI, blood tests, lifestyle screening, medication reviews, and side-effect monitoring. You will liaise with mental health services to ensure follow-up actions, including ECGs and vaccinations, and promote engagement through reminders and reasonable adjustments. For Learning Disability (LD) annual health checks, you will organise invitations and follow-up for patients aged 14+, ensuring physical, mental health, medication, and lifestyle assessments are completed, while working closely with LD teams, carers, and advocates to support accessible communication. You will support the scheduling and coordination of long-term condition reviews, including diabetes, respiratory conditions, hypertension, heart failure, CHD, CKD, thyroid disorders, and other endocrine conditions. This also includes coordinating frailty assessments, falls reviews, medication checks, CGAs, and arranging home visits for housebound or care-home residents. You will assist with cancer care reviews, encourage participation in national screening programmes, support NHS Health Checks for adults aged 4074, and monitor patients with raised cardiovascular risk. You will also help coordinate womens and mens health reviews, including cervical screening, contraception, postnatal checks, menopause care, and prostate health, along with supporting routine and seasonal immunisation programmes. As part of supporting SMI Annual Health Checks, the post-holder will also undertake venipuncture (blood taking) once trained and deemed competent, ensuring timely completion of required blood tests. The role includes a commitment to completing any additional clinical training needed to support safe, effective patient care for example training related to physical health monitoring, ECG support, or other relevant skills in line with service needs. Ongoing development will be encouraged to enhance the quality of assessments carried out during SMI reviews and other health checks. The role involves providing care coordination and navigation for patients and carers, ensuring smooth transitions between hospital, community, and practice teams, managing post-discharge follow-up and medication reconciliation, and escalating concerns to clinical staff when required. You will work collaboratively within multidisciplinary team meetings, track agreed actions, and support proactive case-finding for high-risk or complex patients. Effective communication with patients, carers, and professionals is essential, including use of accessible formats and promoting self-management and shared decision-making. You will maintain accurate clinical records using EMIS, support QOF, DES, and IIF monitoring and reporting, and contribute to audits and service improvement work. Key working relationships include GP practice teams, PCN colleagues, community mental health and LD teams, secondary care services, and voluntary and community organisations.