Hertford Pcn Care Co-ordinator

4 weeks ago


Hertford, United Kingdom Generating Healthcare Ltd Full time

Hertford and Rurals Primary Care Network comprises four GP Practices covering a population of approximately 56,000 patients. We strive to provide a wide range of excellent services to our patients, delivered by a happy and confident multi-disciplinary team.

Care co-ordinators provide extra time, capacity and expertise to support patients in preparing for or in following-up clinical conversations they have with primary care professionals. They will work closely with the GPs and other primary care professionals within the PCN to identify and manage a caseload of identified patients, making sure that appropriate support is made available to them and their carers, and ensuring that their changing needs are addressed. They focus on delivery of the comprehensive model to reflect local priorities, health inequalities or population health management risk stratification. Care co-ordinators will have a base Practice, but may be expected to engage with patients from both Practices within the PCN, seeing patients either in the Practice, care homes or at the patient’s home where this is appropriate.

**Key role requirements**

Care co-ordinators will:

- Support the co-ordination and delivery of MDTs within the PCN
- Co-ordinate Care Home Ward Rounds and Care Home MDTs, liaising with staff at all relevant organisations
- Proactively identify and work with a cohort of people, including those with Long Term Conditions, to support their personalised care requirements, using the available decision support aids. This includes use of scoring systems and templates
- Proactively identify and invite appropriate patients for Structured Medication Reviews
- Proactively identify patients who are eligible for NHS cancer screening programmes such as cervical, bowel, breast cancer and create and maintain a robust system to facilitate non-attenders to engage
- Offer face-to-face appointments to complete appropriate elements of QoF and performance indicators related to individual needs; this may be at a Practice or in a patient’s home
- Bring together all of a person’s identified care and support needs and explore their options to meet these into a single personalised care and support plan
- Raise awareness of shared decision making and decision support tools, and assist people to be more prepared to have a shared decision-making conversation
- Ensure that people have good quality 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 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
- Explore and assist people to access personal health budgets where appropriate
- Provide co-ordination and navigation for people and their carers across health and care services, alongside working closely with social prescribing link workers, health and wellbeing coaches and other primary care roles
- Be actively involved in development and delivery of local flu and COVID vaccine campaigns
- Ensure that their learning is kept up to date, attending local education meetings and keeping appraised of current Quality and Outcome Framework requirements as well as local requirements
- Provide administrate support to the PCN Clinical Director and PCN Clinical Leads
- Support the E-consult system across the PCN.


**Person specification**:
Care co-ordinators will:

- Have experience of working with the general public
- Be confident in the use of computer systems, creating searches and completing templates
- Ideally have experience of working in a healthcare setting
- Ideally have a health care qualification such as BTEC or NVQ
- Have excellent organisational skills
- Be an empathetic communicator with good listening skills and be able to explain and simplify concepts to patients
- Have experience of working in teams
- Have a clear understanding of national cancer screening programmes
- Be an enthusiastic proponent of health promotion and prevention programmes

**Salary**: £11.00-£13.50 per hour

**Benefits**:

- Company pension

Schedule:

- Monday to Friday

**Education**:

- GCSE or equivalent (preferred)

**Experience**:

- Primary Care: 1 year (required)

Licence/Certification:

- Divers Licence (required)

Work Location: One location

Reference ID: HPCNCCO



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