Care Coordinator

5 months ago

Bristol, United Kingdom 4PCN Full time

**4PCN (Primary Care Network)**

**Hanham Health, Kingswood Health Centre, Cadbury Heath Health Centre and Close Farm**

**Care Coordinator - Patients with Enhanced Needs**

**MATERNITY COVER FOR 9 MONTHS**

**Reporting to**: PCN Operations Manager/PCN Manager

**Hours**: 22.5 hours per week

**Salary**:£12.18 - £12.86 depending on skills and experience

**Base**: Based at Kingswood Health Centre, but travel within the PCN area is required

**Job Overview**

Care Coordinators provide extra time, capacity, and expertise to enable patients with enhanced needs to access the services and support they require to improve their health and wellbeing, thus helping to improve their quality of life and reducing health care inequalities.

They will ensure these patients and their carers have access to good quality information to help them make informed choices about their care and wellbeing.

They will proactively identify and liaise with an identified cohort of patients to support their personalised care requirements, making sure that appropriate support is made available to them and their carers, and ensuring that their changing needs are addressed.

Care Coordinators work with groups of patients identified by the PCN. At present the current focus for this role is patients who are housebound, experiencing difficulty in attending their surgery, frail/elderly and/or suffering with Dementia or memory impairment.

You will proactively organise and carry out general wellbeing and health check home visits for appropriate patients, providing them with tools and information to support them to remain well in their own home through the development of a personalised care and support plan.

You will help patients and their carers by being a point of contact/advocate. With your support, it is hoped patients will be signposted effectively for their health needs and ensure they have excellent

good quality information. This may take the form of being the link between their registered GP practice, the multi-disciplinary team or the wider healthcare community, or signposting towards services such as Social Prescribing, Alzheimer’s Society etc.

You would be expected to complete appropriate training, such as the Health Education England Care Certificate (or equivalent). You will be given training to take blood and carry out basic physical checks where necessary, so the patient does not need to travel to the GP surgery for these to be done. You will also be expected to actively take part in reviewing and developing the role, responsibilities, and the service provision.

**Supporting Frail & Housebound People**
- You will run searches to identify patients proactively through each practice’s EMIS clinical system.
- Once identified, you will book visits as appropriate, providing information to ensure the patients understand how you can help them.
- You will undertake the visits and take any appropriate follow up actions. This could be liaising with other healthcare professionals, social services, or a wide range of other organisations. You may also need to follow up with the patients or carer through further visits or telephone support.
- You will proactively engage with these patients, their carers and the practices to ensure maximum uptake of these reviews and follow up any patients who do not respond to initial invitations.
- You will monitor the recording of these checks to ensure the coding and recording has been done appropriately, and in line with national guidance.
- You will act as a link between Support Workers, the GP and any PCN, primary, community or secondary care colleagues, supporting any onward referrals, care planning or administrative patient needs as appropriate.
- You will take part in any multidisciplinary team meetings (MDT’s), practice/PCN meetings or system-wide meetings as appropriate to support the service in achieving its aims.

**General Duties**
- You will ensure safeguarding issues or patient related concerns are raised appropriately to a suitable individual
- You will help administratively with any auditing or searching of GP clinical systems
- You will assist the PCN and the practice achieve contractual targets where appropriate

This job description is only a brief summary of what the Care Coordinators job entails, and the role will expand and change over time as the needs of the PCN changes, the requirement of the Network

DES expands and the priorities of the population evolve. Any changes will be discussed with the postholder in advance.

**Supervision Received**

The postholder will be operationally lined managed by the PCN Operations Manager, with feedback and support received from the PCN Manager, Clinical Director, and other members of the PCN board.

**Supervision Exercised**

The postholder will not have any operational line management responsibility.

**Disclosure and Barring Service Check**

**Person Specification**

**Essential**
- GCSE Maths and English.
- A commitment to continuing p

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