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Care Coordinator
3 months ago
The post available is 34 hours per week, working patterns to be discussed at interview.
The rate of pay is £ £13.31 per hour, depending on experience with the option of an NHS or NEST pension.
Interviews will be taking place week commencing 24th June 2024.Main duties of the job
The post holder will contribute to tackling inequalities in health and social care particularly regarding individuals with long-term conditions. An ethos of promotion of independence and partnership-working is integral to this post.
A key part of the role of a care coordinator role is in the Care Homes Multi Disciplinary Team (MDT): improving the continuity of care by acting as a point of contact for residents, families and professionals who visit care homes, such as MDT members and in-reach specialists.
This will involve coordinating the work of healthcare professionals and non clinical staff including volunteers and third sector agencies invloved in the care of registered patients.
They will support the MDT with the weekly virtual home round through identification of people in need of review, or collation of information on people requiring an MDT review in addition to providing coordination, secretarial and administrative support to the MDTs within a single or multiple PCNs.
As a patient facing role the post holder will also be responsible for a caseload of patients identified through the MDT meetings.
Support provided directly with patients and their carers would include co-producing personalised plans, utilising decision aids, providing information and training opportunities, making appointments, coordination and navigation for people and their carers across health and care services.
About usSymphony Healthcare Services Ltd.
is a growing primary care organisation based in Somerset which aims to improve and develop the best patient-centred care and services in the country, and we are embracing change within general practice by implementing new and innovative models of care.
If you are passionate about delivering outstanding healthcare and share our values, join us to support the achievement of our goals.
Job descriptionJob responsibilitiesPrimary Duties and Areas of Responsibility
Multi-Disciplinary Teams
Overall responsibility for arranging the weekly PCN led MDT meetings (including the weekly virtual Care Home(s) MDT) and the smooth running of integrated care within the team setting.
A key role of the Care Coordinator will be to schedule the weekly 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.
Take minutes of MDT meetings and disseminate; chase progress against actions identified in these meetings and ensure follow up where necessary.
Patient IdentificationUtilise population health intelligence to proactively identify and work with a cohort of patients to deliver personalised care.
Receive and collate information from transfers of care (including hospital admissions and discharges) plus out of hours calls and present this information to the MDT as required.
Liaise with service providers and clinicians to identify frequent flyers, and new service users utilising risk stratification tools provided and present this information to the weekly MDT meetings.
Support the completion of new referrals by checking criteria, and where criteria have been met, direct referral to the MDT.
Direct patient facing work
Manage a caseload of patients identified through the MDT
Support patients to utilise decision aids in preparation for a shared decision-making conversation.
Holistically bring together all of a persons identified care and support needs, and explore options to meet these within a single personalised care and support plan (PCSP), in line with PCSP best practice, based on what matters to the person.
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.
Support people to understand their level of knowledge, skills and confidence (their Activation level) when engaging with their health and wellbeing, including through the use of the Patient Activation Measure.
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.
**Communication an
