Primary Care

5 months ago

Sale, United Kingdom Bodmin Road Health Centre Full time

The post holder will undertake work in line withBRHC directed priorities, proactively identifying and working with a cohort of people to support their personalised care requirements. This could include: the development of digital solutions across the health centre supporting access needs ofpatients; care navigation of patients contacting the practice to better meet their access needs; supporting the co ordination of personalised annual recall invites for patients with longterm conditions; Engaging with and developing processes in support of localised, agreed, access processes. Facilitating enhanced processes to support the care coordination of patient group consultations supporting effective and efficient care delivered by clinical team members Proactively supporting and assisting with the development of patient access activity coordinating patient access into and external of the health centre in a timely and safe manner. Resolving any queries in relation to these workstreams and ensuring allparties are kept informed of progress towards resolution.

Supporting Quality and Outcome Frameworks and other DES specifications. 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 choicesabout their care Facilitating and supporting the development oflocalised clinical group consultations. Bringing together patients identified care and support needs and exploring their options to meet theseinto a single personalised care and support plan (PCSP), in line with PCSP best practice. Assisting people to access self management education courses, peer support or interventions that support them in their health and wellbeing.

Providing coordination and navigation for patients/carers across health and care services, alongsideworking closely with social prescribing link workers and other primary care roles. Supporting residents in care homes/LD homes ensuring personalised care is delivered through collaborative working between health, social care, voluntary, community and social enterprise sector andcare home partners. At times you will be required to support adult patients and assist them through the healthcare system by acting as a patient advocate and navigator, empowering them, and educating them to promote andsupport their independence Be proactive in developing strong link with local agencies, and in encouraging equality and inclusion. Partnership working and communication Develop strong working relationships with GPs, practice teams and other health care colleagues to optimise the timely and good quality delivery of services to patients and tosupport the working lives of colleagues.

Work collaboratively with neighbourhood colleagues to share best practises. Ensure that all relevant professionals are kept up to date so that any issues or concernscan be appropriately addressed and supported. Keep accurate up to date, contemporaneous and appropriately Snomed coded on records of patient contacts, appropriately using EMIS software and other record, referral and messaging systems relevant to the role, adhering to information governanceand data protection legislation. Maintain records of interventions to enable monitoring and evaluation of the service.

Provide regular feedback to relevant stakeholders about service progress.

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