Care Co-ordinator

**Care Coordinator - PCN**

We are looking to recruit to a care coordinator, to work within our Goldstone Primary Care Network team. Goldstone Primary Care Network is a network of 3 practices - Charter Medical Centre, Trinity Medical Centre and WellBN Wellbeing - with a combined list size of over 78,000 patients.

The post will be split over 3 sites - Charter Medical practice, Trinity Medical Practice and WellBN practice, all in Hove.

They will work closely with practice teams including clinical teams, social prescribing workers and health and wellbeing coaches making sure appropriate support is made available to people.

The postholder will work with a diverse range of people from different cultural and social backgrounds. The ability to work confidently and effectively in a varied, and sometimes challenging environment is essential.

Salary start £11 per hour

**Job Description - Care Coordinator**

**Purpose of the role**

Care coordinators play an important role within a PCN to proactively identify and work with people, to provide coordination and navigation of care and support across health and care services.

They will work closely with practice teams including clinical teams, social prescribing workers and health and wellbeing coaches making sure appropriate support is made available to people.

The postholder will work with a diverse range of people from different cultural and social backgrounds. The ability to work confidently and effectively in a varied, and sometimes challenging environment is essential.

Care coordinators could potentially provide time, capacity and expertise to support people in preparing for or following-up clinical conversations they have with primary care professionals to enable them to be actively involved in managing their care and supported to make choices that are right for them. Their aim is to help people improve their quality of life.

attitude, keen to work and learn as part of a team and committed to providing people, their families and carers with high quality support.

This role is intended to become an integral part of the PCN’s multidisciplinary team, working alongside social prescribing link workers and health and wellbeing coaches to provide an all-encompassing approach to personalised care and promoting and embedding the personalised care approach across the PCN.

There may be a need to work remotely depending on the requirements of the role. Please note that the role of a care coordinator is not a clinical role.

**Key responsibilities**
- Help people to manage their needs through answering queries, making and managing appointments, and ensuring that people have good quality written or verbal information to help them make choices about their care.
- Provide coordination and navigation for people and their carers across health and care services, working closely with social prescribing link workers, health and wellbeing coaches, and other primary care professionals; helping to ensure patients receive a joined-up service and the most appropriate support.
- Work collaboratively with GPs and other primary care professionals within the PCN to proactively identify and manage a caseload, which may include patients with long-term health conditions, and where appropriate, refer back to other health professionals within the PCN.
- Support the coordination and delivery of multidisciplinary teams with the PCN.
- Raise awareness of how to identify patients who may benefit from shared decision making and support PCN staff and patients to be more prepared to have shared decision-making conversations.
- Work with people, their families, carers and healthcare team members to encourage effective help-seeking behaviours;
- Support PCNs in developing communication channels between GPs, people and their families and carers and other agencies;
- Identify unpaid carers and help them access services to support them;
- Conduct follow-ups on communications from out of hospital and in-patient services;
- Maintain records of referrals and interventions to enable monitoring and evaluation of the service;
- Support practices to keep care records up-to-date by identifying and updating missing or out-of-date information about the person’s circumstances;
- Contribute to risk and impact assessments, monitoring and evaluations of the service;
- Work with commissioners, integrated locality teams and other agencies to support and further develop the role.
- Work with the wider PCN, MDTs, and the social prescribing service to look at how carers can support people - this could include the initial identification of carers onto the carer register

Work towards increasing patients’ understanding of how to manage and develop health and wellbeing through offering advice and guidance

**Coordinate and integrate care**

a. Making and managing appointments for patients, related to primary, secondary, community, local authority, statutory, and voluntary organisations

b. Help people transition seam