Care Co-ordinator

3 months ago

Watford, United Kingdom Primary Care Careers Full time

**About the Role**:
Bridgewater Surgeries in Watford has an opportunity for a care co-ordinator to join our team and assist in re-shaping primary care across our communities.

The role involves working very closely with the practices and the multidisciplinary team (MDT) within the PCN, and is pivotal in ensuring that all patients receive the best possible care and service.

The main duties of the role include:

- Undertaking work in line with PCN directed priorities.
- Proactively identifying and working with a cohort of people to support their personalised care requirements. This would include patients with a learning disability, serious mental health illness, frailty, living in care home or supported living, those with long-term conditions, this list is not exhaustive.
- Working closely with purple star team to ensure we are making reasonable adjustments for patients with learning disabilities.
- Supporting national screening programmes.
- Routine and urgent domiciliary phlebotomy referrals
- including doing blood forms.
- Supporting immunisation programmes.
- Dealing with actions from out patient letters - e.g.. arranging bloods/ECGs and sending results to specialists, extract information, coding it in clinical system and arranging appointments, tests or referrals as required.
- Supporting the care of housebound patients. Ensuring they have their LTC reviews, and any immunisations are offered an organised. Help support arranging transport to enable hospital appointments.
- Ensuring regular and consistent communication with the referrer regarding patient progress and any complications or guidance.
- Raising awareness of health promotion and NHS health checks in practices.
- Liaising with pharmacy team and community pharmacies around medication issues/practical issues around delivery/dosette, including liaising with patients and carers.
- Creating and monitoring referrals to ensure tasks are completed and care delivered by keeping in regular telephone contact.
- Managing newly diagnosed pre-diabetics in line with practice protocol.
- Directing liaison with multi agencies to coordinate care for patients.
- Referring to PCN social prescribing link workers where a patient is identified as potentially benefitting from this service. This would include a project for high attending patients who could reduce their reliance on appointments with the doctor.
- Supporting carers by offering flexible appointments, flu and health checks, promoting carers in Herts referrals.
- Supporting Quality and Outcome Frameworks, PCN Network Des and other DES/LES specifications.
- Acting as the first port of call for patients, in their caseload in relation to their care.
- Raising awareness of shared decision-making and decision support tools, and assist people to be more prepared to have a shared decision-making conversation and ensure that people have good quality information to help them make choices about their care.
- Assisting people to access self-management education courses, peer support or interventions that support them in their health and wellbeing - including weight management, diabetes prevention program, active Watford etc.
- Following patients who don’t need clinical assessment - e.g. elderly who can’t reply to Accurx about OPA/other appointments.
- Working closely with the care homes we are responsible for. Arrange home visits, ward rounds, weekly MDT meetings, long term condition reviews and immunisations. Act as link between GPs and care home staff by chasing referrals, providing test results, assist with administrative queries etc.
- Preparing patients prior to going to see GP, taking brief history, recording basic readings in readiness for GP appointments, i.e., frailty reviews.
- Supporting some clinical work by doing vaccinations, taking blood pressures and urine samples once training completed.

Please see full job description attached.

If you are a skilled care co-ordinator, with excellent person-centred planning experience and strong local knowledge for accessing key support, then we would love to hear from you.

The ideal applicant will have the following skills, experience and qualifications:

- Ideally you will have a NVQ Level 2 in Business Administration, or an equivalent qualification.
- Strong listening and communication skills.
- Familiar with local resources and services, including how to access them.
- Motivated by helping people, with care and empathy.
- Able to deliver person-centred support in a non-judgmental way.
- Able to communicate effectively, both verbally and in writing, with people, their families, carers, partner agencies and stakeholders.
- Demonstrates personal accountability, emotional resilience and works well under pressure.

**About Us**:
We are a large teaching GP practice, with over 31,000 patients and a team of enthusiastic, multi-disciplinary and friendly staff.

**Disclosure and Barring Service Check

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