Care Co-ordinator

7 months ago

BurtonOnTrent, United Kingdom Dove River Practice Full time

1. Utilise population health intelligence from EMIS and other dashboards to proactively identify and work with cohorts of patients to deliver personalised care, including those who are frail, housebound, or with diagnosis of Learning Disabilities or other health issues as required. 2. Support patients to utilise decision aids in preparation for a shareddecision-making conversation regarding their care.

3. Holistically bring together all of a persons identified care and supportneeds, and explore options to meet these within a single personalisedcare and support plan (PCSP), in line with PCSP best practice, based onwhat matters to the patient. 4. Help patients to manage their needs through answering queries, makingand managing appointments, and ensuring that people have good qualitywritten or verbal information to help them make choices about their care.

5. Maintain Denosumab and Prostap/Nebido/Zoladex registers. Ensure all patients are correctly recalled and meds ordered in line with Practice procedures, and shared care agreements are received and in place where required. 6.

Assist people to access self-management education courses, social prescribing, peer supportor interventions that support them in their health and wellbeing andincrease their activation level. 7. Explore and assist people to access personal health budgets whereappropriate. 8.

Provide coordination and navigation for people and their carers acrosshealth and care services, working closely with social prescribing linkworkers, health and wellbeing coaches, and other primary careprofessionals. 9. Provide scanning support to the Practice over two mornings a week as standard (more may be required for sickness/holiday cover) 10. Clinical coding of records/clinical letters into patient health records, and arranging follow up as required to streamline patient care.

11. Support the coordination and delivery of MDTs within the PCN. Key wider responsibilities You will work with the GPs and other primary care professionals within the Practice to identify and manage a caseload of patients, and where required and as appropriate, refer people back to other health professionals within the GP practice or associated teams. You will be responsible for raising awareness within the Practice of shared decision making and how to identify patients who may benefit from this.

You will assist patients in accessing Primary Care Services, including liaising with the IM&T Manager to ensure strategies are in place to ensure the Practice achieves National Targets set for the uptake of online services and ensure that all medical information gathered by the Practice is utilised effectively in the care of our patients. You will also have a knowledge of basic safe-guarding processes in place for vulnerable individuals; and provide opportunities for the patient to develop friendships and a sense of belonging, as well as build knowledge, skills and confidence. Full training from internal teams and external providers will be provided to enable you to achieve this. Confidentiality: All patient information that you come into contact with must be dealt with in the strictest of confidence.

**Any breach in confidence can lead to instant dismissal**: - In the course of seeking treatment, patients entrust us with, or allow us to gather, sensitive information in relation to their health and other matters. They do so in confidence and have the right to expect that staff will respect their privacy and act appropriately In the performance of the duties outlined in this Job Description, the post-holder may have access to confidential information relating to patients and their carers, Practice staff and other healthcare workers. They may also have access to information relating to the Practice as a business organisation. All such information from any source is to be regarded as strictly confidential Information relating to patients, carers, colleagues, other healthcare workers or the business of the Practice may only be divulged to authorised persons in accordance with the Practice policies and procedures relating to confidentiality and the protection of personal and sensitive data Health & Safety: The post-holder will assist in promoting and maintaining their own and others health, safety and security as defined in the Practice Health & Safety Policy, to include: Using personal security systems within the workplace according to Practice guidelines Identifying the risks involved in work activities and undertaking such activities in a way that manages those risks Making effective use of training to update knowledge and skill Safeguarding: All employees are required to act in such a way that at all times safeguards the health and wellbeing of children and vulnerable adults.

Familiarisation with and adherence to Safeguarding policies is an essential requirement of all employees as is participation in related mandatory/statutory training. We operate a No Smoking Policy.

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