Pcn Care Coordinator

2 weeks ago

Nuneaton, United Kingdom Nuneaton & Bedworth Primary Care Network Full time

Job Purpose/Summary As a PCN Care Coordinator you will be part of the Primary Care Multidisciplinary Team, offering a personalised approach to caring for the social and psychological needs of identified patients on your caseload, making sure that appropriate support is made available to them and their carers, and ensuring that their changing needs are addressed. You will work closely with the GPs and other members of the practice and PCN teams to ensure the coordination and management of identified patients at all points of their care journey. Key Responsibilities Create a positive working environment in which equality and diversity are professionally managed, dignity at work is upheld and staff can do their best; Work alongside the Senior Care Coordinator to effectively perform the role and develop throughout by attending supervision sessions, appraisal meetings and training / development days. Ensure that Standard Operating Procedures (SOPs) are adhered to supporting in the delivery of service and completing reviews and updates with the Senior Care Coordinator.

Utilise adequate level of knowledge around primary care to meet the required needs of the service. Support the Senior Care Coordinator to develop quality of work and keep detailed records of day-to-day tasks including managing caseloads. Encourage good teamwork throughout the partnership and with each of the GP surgeries. Care Coordinator As a PCN Care Coordinator, you will work closely with member practices and the PCN in offering a personalised approach to caring for social and psychological needs of identified patients on your caseload, making sure that appropriate support is made available to them and their carers, and ensuring that their changing needs are addressed.

You will also support the senior care co-ordinator by contributing toward projects on an ad hoc basis to support health improvements to patients registered with member practices. Your main duties will include: Receiving and actioning referrals from a wide range of agencies, working with GP practices within the Primary Care Network (PCN), pharmacies, multi-disciplinary teams, hospital discharge teams and allied health professionals (list not exhaustive); Utilise population health intelligence to proactively identify and work with a cohort of patients to deliver personalised care; Facilitate and ensure the effective delivery of patient-centred, personalised health and social care plans for patients, monitoring progress and reporting outcomes, contributing to patient reviews and care planning within appropriate time frames; Provide coordination and navigation for patients and their carers across the spectrum of services available; Support local Care Homes to manage patient needs, including completing/reviewing Care Home Care Plans and Dementia reviews as required; Complete Annual Learning Disability reviews on behalf of the practice; Undertake visits to see patients in their own homes, where applicable, for Blood Pressure checks, welfare checks and provide support; Work alongside other PCN Additional Roles staff and outside agencies to provide wrap-around support to patients; Make appropriate third-party referrals; and Complete and maintain accurate patient records.

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