Care Co-ordinator
1 month ago
1. Utilise population health intelligence to proactively identify and work with a cohort of patients (for example the elderly, disabled or at risk) to deliver personalised care e.g. patients with learning disabilities. 2.
Support patients to utilise decision aids in preparation for a shared decision making conversation. 3. Holistically bring together all of a person’s identified care and support needs and explore their options to meet these into a single personalised care and support plan, in line with best practice. 4.
Help patients 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 choices about there are. 5. Support people to take up training and employment, and to access appropriate benefits where eligible. 6.
Support people to understand their level of knowledge, skills and confidence when engaging with their health and wellbeing. 7. Assist people to access self-management education courses, peer support or interventions that support them in their health and wellbeing and increase their activation level. 8.
Explore and assist people to access personal health budgets where appropriate. 9. Provide coordination and navigation for people and their carers across health and care services, working closely with the care co-ordinator (safeguarding), social prescribing link workers, clinical administrators, and other primary care professionals. 10.
Where appropriate refer people back to other health professionals. 11. Support the coordination and delivery of MDTs 12. To work collaboratively with the general practice team to meet the needs of patients supporting the delivery of policy and procedures whilst managing own workload to deliver the practice priorities.
13. Raise awareness within the Network of shared-decision making and decision support tools. 14. Raise awareness of how to identify patients who may benefit from shared decision making.
15. Ensure that all activities are recorded, monitored and evaluated. 16. Attend all meetings as required 17.
Work in accordance with policies, ensuring that all work and procedures and undertaken in accordance with issued guidance. 18. Attend any training courses and supervision sessions as required. 19.
Promote the professional image and services offered by the practices. 20. Any other duties that may be required and agreed by the management team.
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