Care Co-ordinator

4 weeks ago


Wakefield, United Kingdom Conexus Healthcare Ltd Full time

**Closing Date - 28th May 2023**

**Job summary**

A Care Coordinator exists to make a difference to the lives of our patients. Building relationships with our patients is key to our success. Every day is different and at times the work is fast paced. We like to make sure that our teams have opportunities to develop and contribute to the growth of our forward-thinking PCN. We can offer the NHS Pension Scheme and associated benefits. Our team work flexibly to meet the needs of our patients but also allowing them some flexibility to suit their needs. There is potential for some home working, although much of our work involves face to face contact with patients in their own homes and in practices.

**Main duties of the job**

The role of the Care Co-ordinator is to proactively:
Identify patients and support practices with non-medical interventions and referrals to external partners.

Key patient cohorts include (this list is not exhaustive):

- Patients with high use of the GP surgery who may need non-medical support.
- Patients living in care homes or supported living.
- Patients living with Dementia
- Patients on the Learning Disability Register
- Patients diagnosed with Cancer
- Patients who are informal carers
- Patients at risk of Health Inequalities
- Housebound patients.

For these patients the Care Co-ordinator helps in multiple ways;
- Take basic clinical observations (e.g. Blood Pressure, Height, Weight. Full training provided)
- Support patients to retain their independence.
- Act as a link between external agencies and General Practice.
- Support in improving health outcomes for those patients.
- Support the PCN with the delivery of projects that aim to reduce the impact and occurrence of health Inequality.

**About us**

Trinity Health Group is a Primary Care Network made up of four practices on the west of the district (Trinity Medical Centre, Maybush Medical Centre, Crofton & Sharlston Medical Practice and Warrengate Medical Centre). Our vision is that all our patients should have the same chance at a happy, healthy life. We believe that a sustainable, resilient Primary Care Service working collaboratively with volunteer and community services and social enterprise organisations supports this vision. Our Mission is to add years to the lives of our patients, whilst adding life to those years.

Conexus Healthcare CIC is the Confederation for general practice in Wakefield, we have four areas of work.

1. _Delivery of high-quality public facing Health and Wellbeing services across the Wakefield District_

2. _Delivery of Training, Development and Consultancy support across the United Kingdom_
- 3. Supporting Our Practices and Primary Care Networks (PCNs)_

4. _Providing a voice and influence for General Practice in the Health and Care System_

Built within primary care, for primary care, Conexus Healthcare Limited works with local GPs and their practices to champion investment in and deliver effective primary care at scale. By connecting in this way, we are stronger, more resilient and can care effectively for over 370,000 local people together.

**Job description**

**Job responsibilities**

The post will evolve as we develop our services but the postholder will be required to undertake the following duties (Full training will be provided):

- Proactively identify and work with a cohort of patients to support their personalised care requirements.
- Consult with patients and family members to bring together their identified care needs into a single personalised care and support plan.
- Educate patients about their condition, medication, and give them specific instructions on how to manage their needs.
- Ensure that patients have good quality information to help them make informed choices about their care.
- Assist patients to access self-management education courses, peer support or interventions that support them in their health and well-being.
- Answering patient queries and support them to make appointments with appropriate services and professionals.
- Navigate and signpost patients and their carers appropriately, working alongside social prescribing link workers, health and wellbeing coaches and other primary care roles.
- Carry out home visits as necessary to ensure housebound patients are fully supported and monitored, carrying out basic clinical observations.
- Develop and maintain effective and productive relationships with practice staff and other teams, referring and liaising with them in the best interest of the patients care.
- Support patients to take up training and employment and assist with benefit claims working collaboratively with DWP Work Coaches.
- Check-in on the patients regularly and evaluate and document their progress.
- Referring patients and securing funding for medical care as required
- Attend and support the co-ordination and delivery of MDT meetings particularly in relation to care homes.
- Use practice IT systems to accurately record patient care and manage their he



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