Pcn Care Coordinator

Pendle West PCN is looking for a Care Co-ordinator to join our growing team.

This is an exciting opportunity to help deliver integrated care based around the needs of our patient population.Working very closely with the practice and multidisciplinary team (MDT) within the PCN these roles are pivotal in ensuring all patients receive the best possible care and service.The role will suit individuals with a strong administrative, HCA, OT or similar background.

We have several posts available working with specific cohorts of patients or projects e.g. care homes, cancer, diabetes, health and wellbeing.Hours are negotiable between 30-37.5 per week.

Applicants need to be flexible to work across our geographical area of Nelson and Brierfield.

General practice experience is desirable but not essential.Main duties of the jobOur aim is to ensure our patients feel supported and have access to the services that are right for them, helping them to manage their own needs where possible, promote and encourage patient awareness, skills and confidence and to help patients maintain and make decisions about their own health and wellbeing.

There will be a focus on those patients who are harder to reach or may have access or unmet needs.About usPendle West PCN is made up of seven GP practices within Nelson and Brierfield and covers a local population of circa 52,000.

The PCN has a strong commitment to leading and developing change in the local healthcare community.

We have a vision for healthcare that is sustainable, high quality and offers excellent patient and staff experience.

Our services are designed to reflect the needs of the population they serve, and promote lifestyle health and wellbeing.

We offer development and training supported by a full complement of experienced clinical support staff, non-clinical support staff and management.Primary care networks build on the core of current primary care services and enable greater provision of proactive, personalised, coordinated and more integrated health and social care.

We are committed to working together to improve the health and wellbeing of local people.Job responsibilitiesPendle West PCNPCN Care Co-ordinator - Job DescriptionResponsible to -Clinical DirectorAccountable to -Pendle West PCN BoardHours of work -30+Salary -Equivalent to Band 4 Agenda for ChangeJob SummaryTo provide co-ordination and navigation for people and their carers across health and care services, working closely with Social Prescribing Link Workers, Health and Wellbeing Coaches and a range of primary care professionals within Pendle West Primary Care Network (PCN).

The Care Co-ordinator will be a member of the PCN Multidisciplinary Team (MDT) and will be responsible for co-ordinating and facilitating elements of care for people registered with our 7 local GP Practices to improve the quality of care and support they receive.

The Care Co-ordinator will support the co-ordination and delivery of MDT meetings within the PCN.A key part of the role is also to provide organisational and administrative support to the neighbourhood team.As this is a new role the duties of this post will be subject to review regularly.Primary Duties and Areas of ResponsibilityTo work closely and in partnership with the GP practices and health and wellbeing team within the PCN.To utilise local population health information to proactively identify and work with a cohort of patients to deliver personalised care.To support patients to utilise decision aids in preparation for a shared decision-making conversation.To holistically bring together all of a persons identified care and support needs, and explore the options to meet these, within a single personalised care and support plan (PCSP), in line with best practice and based on what matters to the person.To 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.To support people to take up training and employment, and to access appropriate benefits where eligible.To support people to understand their level of knowledge, skills and confidence (their Activation level) when engaging with their personal health and wellbeing, including through the use of the Patient Activation Measure or another suitable assessment tool.To assist people to access self-management education courses, peer support or interventions that support them in their health and wellbeing and increase their activation level.To provide co-ordination 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, and support the co-ordination and delivery of MDTs within the PCN.To work with the GPs and other primary care professionals within the PCN to identify and manage a caseload of patients, and where required and as appropriate, refer people back to other health professionals within the PCN.To raise awareness within the PCN of shared-decision making and decision support tools; and how to identify patients who may benefit from shared decision making and support PCN staff and patients to be more prepared to have shared decision-making conversations.To be able to plan and respond to workload according to operational priorities.More specifically, in relation to arranging the MDT meetings, the postholder will be required : To schedule the monthly MDT meetings, manage the meeting agenda items; ensuring that all new referrals are identified, and information circulated to team members in advance of the meeting.To co-ordinate and manage the administrative functions of MDT meetings.To liaise with all clinical and non-clinical members in the MDT to ensure effective MDT function.Take minutes of MDT meetings and disseminate; chase progress against actions identified in these meetings and ensure follow up where necessary.Follow through actions identified by the MDT including arranging tests, referrals, signposting, etc.Manage reporting required and associated within the Network DES specifications for required services.Communicate effectively and sensitively and use language appropriate to a patient and carer / relatives condition and level of understanding.Effectively use all methods of communication and be aware of and manage barriers to communication.Effectively recognise and manage challenging behaviours, carers and or relatives.Provide information to patients, their carers and / or relatives on behalf of the team.Health and Safety / Risk ManagementThe post holder must comply at all times with the organisation and PCN Practices Health and Safety policies, in particular by following agreed safe working procedures and reporting incidents using the organisations Incident Reporting System.The post holder will comply with the Data Protection Act (1984), The General Data Protection Regulations (2018) and the Access to Health Records Act (1990).

The post holder will comply with all necessary training requirements relevant to the role as identified by the PCN.Equality and DiversityThe post holder must co-operate with all policies and procedures designed to ensure equality of employment.

Co-workers, patients and visitors must be treated equally irrespective of gender, ethnic origin, age, disability, sexual orientation, religion, etc.Respect for Patient ConfidentialityThe post holder should always respect patient confidentiality and not divulge patient information unless sanctioned by the requirements of the role.Personal / Professional DevelopmentThe postholder will participate in any training programme implemented by the PCN as part of this employment, such as training to include : o All statutory and mandatory training requirements.o Participation in an annual performance review, including taking responsibility for maintaining a record of own personal and / or professional development.o Taking responsibility for own development, learning and performance and demonstrating skills and activities to others who are undertaking similar work.CommunicationThe postholder should recognise the importance of effective communication within the team and will strive to : o Communicate effectively with other team members.o Communicate effectively with patients and their carers.SafeguardingThe postholder is required to undertake regular safeguarding training and to report any concerns wither to the PCN Clinical Director or to the respective Practice Safeguarding Leads.Special Working ConditionsThe post holder is required to travel independently between local sites when necessary.Job Description AgreementThis job description is intended as a basic guide to the scope and responsibilities of the post and is not exhaustive.

It will be subject to regular review and amendment as necessary in consultation with the post holder.Person SpecificationAptitude and Personal QualitiesProfessional attitude and assertive approachCommitted to developmentConscientious, hardworking and self-motivated to work with minimal supervisionCreative and tenacious in finding solutions to difficult problemsAbility to meet deadlines and work under pressureAbility to engage and sustain relationships with all professionals, other organisations and service-usersApproachable and flexibleHonest and reliableSensitive to patients needsDemonstrate commitment to combatting disadvantage and inequality in health provisionCommitment to person centred careDemonstrate a willingness to participate in sharing the future of the PCN by taking on responsibilities and projects in addition to core workloadForward thinkerAble to work in a changing environmentValues, Drivers and MotivatorsWillingness to undergo further training and developmentRequires a flexible approach and a need to be highly motivatedThe role may need to be reviewed and developed in the future in line with changing prioritiesOtherFlexibility to work outside of core office hours if requiredCar user (to travel between more than one GP practice and other sites within the PCN geographical footprint)Car insured for business useQualificationsEducated to GCSE or equivalentEvidence of further study / trainingGSCE Grade C (or equivalent) in Maths and EnglishSkills and AttributesExcellent written and verbal communication skillsExcellent interpersonal skillsExcellent knowledge of Microsoft OfficeAble to deal with service users sensitivelyAble to work as part of a teamAbility to work independently and prioritise own workload working on complex cases in a busy environmentAbility to work as a member of a multidisciplinary teamExcellent motivational and influencing skillsStrong analytical and judgement skillsAbility to analyse and interpret information and present results in a clear and concise mannerExcellent organisational and administration skillsEnsures completion of tasks on time and able to effectively influence others to complete agreed actionsExperience of providing advice / signposting to usersExperienceAble to demonstrate a clear understanding of working with confidential information and an understanding of service user confidentialityUnderstanding of social determinants of health and how these can be addressed in regard to patient careSound understanding of disease prevention (primary, secondary and tertiary) and how patients can build prevention into their lifestyleMinimum of 2 years experience of working with healthcare professionals and / or previous experience in the NHS or social care or relevant fieldExperience of electronic patients recordsExperience of working in a patient facing roleExperience of setting up meetings through Microsoft Teams or ZoomExperience of data collection and providing monitoring informationExperience of working in a multidisciplinary setting where influence and negotiation is requiredExperience of coordinating and liaising with multiple stakeholders or individuals to meet specified outcomesExperience of undertaking quality improvement activityAwareness of local services and resources for individuals, carers and familiesKnowledge / familiarity of medical terminologyDisclosure and Barring Service CheckThis 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.Full-time,Part-time,Job share,Flexible working

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