Long Term Conditions Care Co-ordinator

2 weeks ago

Carlisle, United Kingdom Eden Medical Group Full time

Deal with incoming queries directly from patients. Assist with signposting patients to appropriate community or local services, alongside social prescribers. Act on communications from hospitals or community providers. The role will involve taking baseline observations from patients i.e.

blood test, blood pressure, height weight, full training will be given. Book follow up appointments, tests or other reviews. Pro-actively ensure patients are booked in for chronic disease management appointments. Assist with and ensure patients participate in local or national screening programmes.

Promote health education to our patient population, such as through participation in self-care week. Pro-actively ensure patients take up vaccination opportunities such as flu, shingles or childhood immunisations. Refer patients to in the house social prescribers to assist with their care. Participate in practice MDT meetings and organise practice actions or follow ups.

Demonstrate the ability to recognise and respond appropriately when faced with a sudden deterioration or emergency situation, alerting the team or enabling a rapid response. Organise and prioritise own workload. Monitor tasks to ensure they are completed and care delivered through regular audit of the clinical system. Directly liaise with multi-agencies to coordinate care for patients.

Support patients and carers and collect feedback on their experiences. Work collaboratively with other care coordinators across the PCN to share best practice. Support the PCN practices to deliver on, QOF, KPIs and locally commissioned enhanced services. To update and maintain accurate patient medication records on the practice clinical computer system, including advice given and action taken.

Work collaboratively with the PCN team. Develop relationships and work closely with community, hospital and the wider health system. Participate in practice meetings, patient participation groups and other meetings to improve engagement with the role. Is enrolled in, undertaking or qualified from appropriate training as set out by the Personalised Care Institute.

COMMUNICATION Have the ability to communicate effectively with a wide range of people both verbally and written. To source, develop and manage a range of contact details and sources of information and services relevant to the local community and to make this accessible to other PCN staff. Be proactive within the PCN and with staff / patients. Work collaboratively with all local partners.

Communicate effectively to overcome communication barriers with patients. Ability to cope with challenging and stressful situations. Willing to accept supervision and advice. ADMIN To be administratively self-supporting.

Able to work on own initiative as well as part of the team. To attend events, meetings and forums to represent the PCN Team. Ability to provide patient centred care. Have a commitment to undertake relevant training related to the role.

Acting in a way that recognises the importance of peoples rights. Respecting the privacy and dignity of patients and their carers. HEALTH & SAFETY To take reasonable care for the health and safety of yourself and other people who may be affected by your actions or omissions. Identify risks involved in work activities and undertake activities in a way that manages any risk.

Be aware of site health and safety policies and how to report incidents.

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