Lead Social Prescribing Link Worker
5 months ago
KEY RESPONSIBILITIES Supervision of PCN personalised care team members. Acting as first point of call for team members with queries, questions or ideas. Being familiar with personalised and proactive care elements of the Network Contract DES and ensure compliance throughout the team. Develop appropriate induction and training plans for new members of the team; identify training requirements of existing team members.
Encourage development of the team, overseeing regular peer support sessions. Monitor personalised care team outputs. Attend local and national personalised care meetings to provide feedback on local roles and understand national initiatives. To work with patients in a variety of settings, in their own homes or in GP surgeries and other community settings to signpost them to local services/organisations which the patient themselves feels would be of benefit to reach their goals.
To work with partner organisations to support the development and delivery of an integrated care plan for the client so all their needs are met in a holistic way. To follow up with clients, update their records and support them on an ongoing basis. Be the patients Advocate to the health and social care system. Signpost patients to appropriate services and sources of funding and where appropriate assist in accessing such funding.
Through formal MDT and informal means educate clinical and non-clinical staff from the wider practice/PCN teams. Through verbal or written advice offer guidance and training on the availability of support services within the community and how/when patients can access these. To make and maintain contact with local health and wellbeing service providers and build a network and knowledge of referral routes to and from service providers. To ensure information about providers and voluntary groups is shared locally across neighbouring networks To undertake regular training to extend and update knowledge of health and wellbeing issues.
Ensure your own and the teams' caseloads are appropriate and regularly review to ensure timely discharges. DELIVERING A QUALITY SERVICE Ensure the team produces accurate, contemporaneous, and complete records of patient contact, consistent with legislation, policies and procedures. Prioritise, organise and manage the team and your own workload in a manner that maintains and promotes quality and efficiency. Assess effectiveness of care delivery through self and peer review, benchmarking and formal evaluation.
Support and participate in shared learning across the wider organisation. COLLABORATIVE WORKING RELATIONSHIPS Participate and engage with stakeholders across the PCN, providing input and guidance to local initiatives where appropriate. Liaise, communicate effectively, and collaborate with member practices within the PCN to ensure smooth running of personalised care teams and their outputs. Understand own role and scope, work within this scope of practice and identify how this may develop over time.
Work as an effective and responsible team member, supporting others and exploring the mechanisms to develop new ways of working. Delegate clearly and appropriately, adopting the principles of safe practice and assessment of competence. Create clear referral mechanisms to meet patient need. Actively works towards developing and maintaining effective working relationships across the PCN.
Prioritise team and own workload and ensure effective time-management strategies are embedded. Work effectively with others to clearly define values, direction and policies impacting upon care delivery. Discuss, highlight and work with the team to create opportunities to improve patient care. Liaises with other stakeholders as needed for the collective benefit of patients.
Recognise personal limitations and refer to more appropriate colleagues when necessary. Actively works towards developing and maintaining effecting working relationships across the PCN. Foster and maintain strong links with all services across locality. Explore all potentials for collaborative working and take opportunities to initiate and sustain such relationships.
EDUCATION, TRAINING & DEVELOPMENT Completed (or be working to complete) the NHS England and NHS improvement online learning programme. Be enrolled in, undertaking or qualified from appropriate training as set out by the Personalised Care Institute. Ongoing, the post holder must attend Peer Support Networks run by NHS England and NHS Improvement at ICS and/or STP level. Understand and demonstrate the characteristics of a role model to members in the team and/or service.
Disseminate learning and information gained to other team members in order to share good practice and inform others about current and future developments (e.g. courses and conferences). Assess own learning needs and undertake learning as appropriate. Assess the learning needs of the wider team, encouraging further learning.
Develop your learning through regular clinical supervision sess
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