Pcn Care Co-ordinator

Care Co-ordinator

**Job Title**

Care Co-ordinator - Care and Support Team (CaST)

**Salary**

TSP Grade 3/4 - depending on experience

**Hours**

Part-time

**Responsible to**

Clinical Support Team Lead

**Accountable to**

The Partnership

**This Job Description is correct as of (Date)**

Author(s) - JA/EC

**Job Summary**

The Care and Support Team Care Co-ordinator role will help co-ordinate services for patients experiencing issues with social isolation, aspects of daily living and care needs alongside their physical and mental health who need additional support in accessing NHS services and voluntary services.

As a member of the Care and Support Team (CaST), you will be required to have a large degree of patient contact and liaison with carers and other agencies. In addition, it involves some information analysis and data management. The team offers patients a holistic assessment, to help with a wide range of physical, social and mental health issues.

The aim of CaST is to support these patients to remain as independent as possible in their own home by accessing care, benefits, mobility aids, advice, and many other areas that they may need help. The team also seeks to combat loneliness and isolation by supporting the work of the volunteer Telephone Befrienders and signposting patients to appropriate social opportunities.

**Mandatory Requirements**
- 5 passes or more at GCSE (C grade or above) English; mathematics; and one other
- Has able to drive

**Desirable**
- Clinical qualification
- Health and Social Care or equivalent qualification

**Principal Responsibilities**
- Act as a patient advocate and care navigator
- To be a familiar point of contact for vulnerable patients and their families/carers
- Help navigate health and social care pathways for patients with complex needs
- To liaise with other members of the Multidisciplinary Team (MDT)
- To attend surgery meetings and feedback information regarding patients
- To ensure colleagues are made aware of any service changes, offering guidance and help as required
- Ensure electronic record keeping is maintained for each patient contact

**Key Areas of Responsibility and Duties**

To help patients remain at home and supported holistically
- To coordinate additional care from other agencies as and when required
- To arrange and attend the clinical meetings, safeguarding meetings and support meetings
- To keep accurate and up to date computerised clinical records
- To work with patients/families/carers on care planning including end-of-life care
- To ensure patients in specific cohorts have regular health checks
- To proactively engage with patients following hospital discharge or A&E admissions to prevent re-occurrence
- To manage a caseload of patients which are referred in from patients themselves, families, and other services
- To work towards undertaking overarching health and social care patient assessments as deemed appropriate
- To make referrals or signpost to statutory and voluntary services
- To complete all mandatory training and attend other training as required

**General responsibilities for all staff**

The post holder is expected to;
- Adhere to practice policies and procedures and relevant legislation including the requirements of any professional bodies.
- Attend mandatory training as identified by the practice
- Highlight potential development areas.

**Confidentiality**:
The post holder must maintain the confidentiality of information about patients’ staff and practice business in accordance with the Data Protection Act 2018 and Caldicott principles.
- 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**:
Employees must be aware of the responsibilities placed upon them under the Health Safety at work Act (1974), to ensure that the agreed safety procedures are carried out to maintain a safe environment for employees and visitors.

All staff have a responsibility to report all clinical and non-clinical accidents, incidents or near-misses promptly and when requested to co-operate with any investigations under-taken.
- Using personal