Health Coach Frailty

4 weeks ago

Stockport, United Kingdom Heaton Moor Medical Group Full time

**Job Purpose;**

Health and Wellbeing Coaches are new to Primary Care and we have a number of these roles across the borough of Stockport.

The Health Coach - (Frailty) will support the Heatons PCN (Primary Care Network) to ensure all patients identified as frail have access to support from health & social provisions as required. The Health Coach will be integral in overseeing the interdisciplinary care and will be responsible for co-ordinating a package of care and support from a variety of specialists who may be working with the patient.

The Health and Wellbeing Coach will support with key activity across the PCN; supporting practices by co-ordinating activity and providing efficient, well organised administrative and operational support to the clinicians and managers in the network to ensure effective timely delivery of the PCN objectives.

**Main Roles & Responsibilities**:

- The aim of the role is to support individuals to manage their health and wellbeing and continue to live independently in their own homes for as long as possible.
- The post holder will provide an innovative, integrated service to anyone who has been identified as frail or at risk of frailty.
- The role requires a caring, dedicated, reliable and patient focused individual who enjoys meeting new people.
- Frailty Health Coach will undertake frailty assessments/Comprehensive Geriatric Assessments & falls assessments using Rockwood criteria, and review dementia care plans and be required to record coding accurately
- Proactively identify cohorts of patient who require assessment for the development of their personal management plan and any decision making tools for their care
- Identify support needs and options for treatment pathways
- Ensure all long-term conditions are managed, and symptoms are escalated appropriately and relevant patient information, including historical information, compliance issues are recorded
- Work with MDT members to organise direct referral to their services where beneficial to the patient
- Co-ordinating SIPS team/medicines optimisation within the community where necessary including arranging annual medication reviews
- To work alongside digital services providers to enable electronic care planning when developed/implemented
- To support clinical teams with advanced care planning/end of life care planning as appropriate
- To assist with validation of and communication with people registered under a lasting power of attorney
- To support with the GSF register and meetings/minutes
- To work closely with social prescribing link workers, health and wellbeing coaches and other primary care roles.
- Share ideas with colleagues to improve care and suggest areas for innovation
- Participate in audit activities being undertaken across the PCN
- Contribute to the improvement of service by reflecting on own practice and supporting that of others
- Adhere to legislation, policies, procedures and guidelines both local and national
- Regularly attend workplace and staff engagement meetings and contribute positively to discussions about the improvement of care

**Person Specification**

**Health Coach - Frailty**

**Criteria - Essential/Desirable/ Assessment Qualifications**

Achieved grade C or above, in English and Maths GCSE or equivalent E A/I

NVQ Level III (Health and Social Care) or equivalent or equivalent experience E A/I

Coaching Qualification(s)/mentoring L3 - D A/I

Formal training in working with long term conditions - D A/I

**Knowledge and Experience**

Previous experience working within healthcare or the voluntary/community sector, supporting vulnerable groups. - E A/I

Experience of working autonomously and part of a team - E A/I

Ability to recognise and respond appropriately to risk and safeguarding concerns - E A/I

Knowledge around importance of confidentiality and data protection - E A/I

Knowledge of local resources and services and how to access them. - E A/I

Experience of working within frailty supporting patients carers/family - D A/I

Experience of working in Primary Care - D A/I

Experience of working with Older Adults/Dementia/Learning Disabilities/Safeguarding - D A/I

Experience of working with individuals with long term conditions. - D A/I

Evidence of working within a multidisciplinary team. - D A/I

An understanding of the Mental Capacity Act/Safeguarding - D A/I

Experience of care plans and end of life care plans - D A/I

**Skills**

Good communication and interpersonal skills, including an ability to build rapport and establish good one to one relationships - E A/I

Ability to deal with challenging behaviour and difficult conversations - E A/I

Be able to offer support in a person centered and non-judgmental way - E A/I

Ability to effectively manage a variable workload - E A/I

Ability to maintain accurate and concise records - E A/I

Ability to provide information effectively - E A/I

Experience of working without direct supervision - D A/I

**Other**

Good IT skills and profic

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