Learning Disability Care Coordinator Administrator

2 weeks ago

Elmbridge, United Kingdom WHAM PCN Full time

**JOB TITLE: Learning Disability Care Coordinator**

**REPORTS TO: WHAM PCN Clinical Director/WHAM PCN Health Inequalities Lead**

**HOURS**:_**18.75 per week - 0.5 FTE Part Time Fixed Term Contract (1 Year)**_

**Salary: Band 4**
- (please note this role is not on Agenda for Change)_
- Weybridge and Hersham (WHAM) Primary Care Network (PCN) have an exciting opportunity for a Learning Disability (LD) Care Coordinator to join our PCN, and work with our population of patients with LD who are: overweight; hypertensive; smokers; diabetic or pre-diabetic. The LD Care Coordinator will engage with this cohort in order to understand barriers to accessing weight reduction, healthy eating, exercise, and smoking cessation interventions, and work with them with the aim of overcoming these barriers. They will be supported by, and work in conjunction with, the multi-disciplinary team across the health and social care system, in order to improve access to services and outcomes for this cohort._
- WHAM PCN operates from 4 surgeries: Hersham Surgery; The Fort House Surgery; Church Street Practice; and Rowan Tree Practice, with our population living in Weybridge, Hersham and Walton on Thames in Surrey. We are a growing and forward thinking PCN, with a team including our Operations Manager; Clinical Pharmacists; Community Paramedics; Social Prescribers and Care Coordinators._

**Key responsibilities**

1. Work with the cohort of patients within WHAM PCN who have been identified as having Learning Disability **and **any of the following conditions: BMI 25 or above; Pre-diabetes; Type 2 Diabetes Mellitus or Hypertension. This role is part of a one year pilot project with the aim of improving access and outcomes for this cohort.

2. Support these patients to utilise decision aids in preparation for a shared decision making conversation on the topics of: weight reduction; healthy eating; exercise; and where appropriate smoking cessation.

3. Taking into account a person’s identified care and support needs, explore options for them to access local interventions and services aimed at facilitating: weight reduction; healthy eating; exercise and where appropriate smoking cessation. This will include identifying, and working to overcome, individual barriers to accessing these interventions and services.

4. Help this cohort to manage their needs through answering queries, making and managing appointments, and ensuring that they have good quality written or verbal information to help them make choices about their care, using tools to understand their level of knowledge, confidence, and skills in managing their own health.

5. Provide coordination and navigation for this cohort and their carers across the range of services available for: weight reduction; healthy eating; exercise and where appropriate smoking cessation. This will include working closely with the wider Learning Disability team (including the Primary Care Liaison Nurse and Health Facilitators), and Social Prescribing Link Workers.

6. Monitor the outcomes of referrals to services, and identify any barriers affecting completion of intervention programmes or continued service utilisation. This will include keeping in regular contact with the cohort.

7. Raise awareness within the PCN of shared decision making and decision support tools that are particularly effective for this cohort.

8. Engage with the evaluation of this PCN pilot project aimed at improving outcomes for this cohort

**Key Wider Responsibilities**:
1. Work with the GPs and other primary care professionals within the PCN in order to manage this caseload, and where required and as appropriate, refer people back to other health professionals within the PCN. Support the co-ordination and delivery of MDTs for this cohort within the PCN

2. Attend appropriate meetings

3. Organise and prioritise own workload. The postholder should be comfortable working both independently and as a committed member of the MDT.

4. Support national screening and immunisation programmes

5. Maintain and develop engagement with all PCN staff and encourage ‘best practice.’

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, their carers, practice or staff information. All such information from any source is to be regarded as strictly confidential.
- Information relating to patients, carers, colleagues, or the members practices may only be divulged to authorised persons in accordance with PGPA policies and procedures relating to confidentiality and the protection of personal and sensitive data, or under the guidance of your manager.

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