Transfer of Care Co-ordinator

1 month ago


Harlow, United Kingdom The Princess Alexandra Hospital NHS Trust Full time

You will act as the focal point for the multidisciplinary team and have responsibility for patient flow, planning and implementing safe and timely discharges, working as part of the integrated discharge team.

Be responsible for the management of the patient journey and collection of data required to monitor relevant access targets and Delayed Transfers of Care (DTOC) and Red 2 Green.

You will escalate blocks to patient flow allowing the trust efficient use of the trust capacity. You will be skilled in taking a collateral history for patients; and ensuring that this information is accurately reflected in any complex discharge planning referrals. Demonstrate initiative when dealing with enquiries from stakeholders, able to work unsupervised; have excellent communication skills and competent in handling the expectations of Patients and Senior Clinical staff under pressure. You will be required to be flexible and be able to adapt to the challenging and changing priorities.
- To liaise with multidisciplinary teams across the health economy, interpret, monitor and convey information accurately and concisely.
- To accurately assess patient collateral history and discharge risk assessment score; enabling accurate completion of discharge planning referrals and identification of appropriate discharge pathway.
- To provide advice and support to service users and carers
- To prepare detailed care and discharge plans and circulate to all service users.
- To manage a caseload of service users and be aware of and work with the safeguarding vulnerable adult policies.
- To maintain up to date knowledge of targets such as Red2Green and processes relating to patient pathways and be a point of reference for other members of the MDT.
- To work in developing, implementing and monitoring changes to the patient pathway process and facilitating change.
- To maintain case records and general administration related to caseload as per departmental procedures.
- To utilise negotiation skills effectively regarding, diagnostic testing and any other relevant procedures regarding the patient’s effective pathways, or if necessary escalate to the Transfer of Care Team.
- To participate in the Department’s staff development and training programmes.
- To adhere to the Trust’s General Principles and Guidelines on Patient Access and discharge
- To carry out such duties as are required and as are commensurate with the grade of the post.

This is an exciting time for PAHT. Over the next five years we are on a digital transformation journey, leading us to our brand new hospital. You’ll be being part of the team leading and supporting our organisation in a diverse and challenging role; a role which can make a significant difference to our patients and staff.

Our people demonstrate energy and commitment towards improving the care and experiences provided to our patients and the drive to be an ‘outstanding’ organisation.

It’s never been a better time to join us.
- To work with the Ward and the Transfer of Care Team to provide key performance data and to deliver against key performance indicators as part of the reducing length of stay
- To work alongside the Ward Managers to ensure Discharge activities are synchronised and arranged effectively to manage patient journeys towards their Planned dates of discharge (PDD)
- To support ward teams in the management of patient requiring community services on discharge.
- To provide support to the Discharge Facilitators in managing complex cases



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