Frailty Service Coordinator

An exciting opportunity has become available for a FrailtyService Coordinator to work in a new integrated community-based servicesupporting the frail housebound population across Easington and Sedgefield.This is a chance to play a key role in shaping and delivering proactive care topatients in partnership with local stakeholders.The proactive service has launched and is already showing early benefits, it is designedto bring joined-up, multidisciplinary care to patients. The post holder will bea vital link in the coordination and delivery of holistic care.Main duties of the jobAs the Frailty Service Coordinator, you will be instrumental in the smooth running of the service. Your key responsibilities will include:Managing clinician diaries and coordinating appointmentsContacting patients and completing pre-assessment formsProcessing referrals and maintaining patient recordsSupporting remote consultations and ensuring follow-up careCarrying out home visits to take baseline observationsAssisting with digital tools to enable remote examinationsLiaising with GP practices, patients, and families/carersEnsuring the effective use of digital technologies to enhance care deliver.Support team in issuing and fitting functional equipmentand observing for signs of damage and wear and tear to feedback into the MDTdiscussion.This role combines administrative coordination with hands-on patient care and engagement.About usSouth Durham Health CiC is the managing agent for the 5primary care networks (PCNs) in the Sedgefield and Easington localities. Wealso hold a number of NHS contracts providing additional services to ourpatient populations.We serve a combined patient population of 204,554 across 21practices.We are early adopters of the Integrated Neighbourhood Teamstrategy and have already developed 2 Integrated Neighbourhood Teams (INTs)aligned to our future work against NHS key strategies.Job responsibilitiesJOB PURPOSE:The Frailty Service Coordinator will be pivotal in helpingto launch and run a new service aimed at the housebound, frail population ofEasington and Sedgefield. They willassist a multi-disciplinary team in delivering patient care within thecommunity. Your role will involve managing clinicians diaries, contactingpatients and booking appointments, completing pre-assessment forms, andcoordinating patient flow. You will liaise with GP practices, processreferrals, and support remote consultations and follow-up care.Home visits are an integral part of the role, where you willtake baseline observations, facilitate remote examinations using digital tools,issue functional equipment and provide support to patients and their families.You will also maintain digital technologies to ensure smooth service deliveryand effective communication, helping ensure high-quality care for patients inthe local community.MAIN DUTIES AND RESPONSIBILITIESOrganise and manage clinicians schedules efficiently,ensuring that appointments are correctly documented in ledgers to maintainsmooth workflow.Schedule appointments for patients, ensuring effectivecommunication with patients and their families/carers to confirm bookings andaddress any concerns.Oversee the completion and accurate documentation ofpre-assessment forms, ensuring they are entered into patient records in atimely manner.Ensure efficient patient flow within the community frailtyservice, coordinating between the team members to minimise delays and ensuretimely delivery of care.Identify and generate referrals for patients who requirefurther services or specialist interventions, ensuring that they are referredin a timely and appropriate manner.Prepare and send necessary documentation regarding patientrecommendations to general practices, ensuring all required information isincluded and communicated effectively.Maintain ongoing communication with local GP practices,providing updates and receiving necessary information regarding patient careand coordination.Responsible for organising the daily MDT meetings, ensuringthat all relevant stakeholders are present, and support the team in discussingpatient care.Arrange follow-up appointments and ensure that appropriatecare and support are provided to patients in a timely manner.Utilise SystmOne to extract relevant patient data, ensuringthat information is accurately gathered and available for clinical review.Set up and maintain the necessary technology for remoteconsultations, including configuring Teams links and ensuring clinicians haveall relevant patient information beforehand.Oversee the management and upkeep of all digitaltechnologies used within the service, ensuring they are functioning correctlyand supporting patient care.Visit patients in their homes when required, facilitatingremote consultations between patients and clinicians by setting up necessarydigital devices.Support therapist in issuing and fitting functional equipmentand observing for signs of damage and wear and tear to feedback into the MDTdiscussion.Conduct initial assessments by taking baseline vital signs,including blood pressure (lying and standing), pulse, oxygen saturation,respiratory rate, temperature, height, and weight.Support remote examinations through the use of a digitalstethoscope and other technology to ensure comprehensive patient assessments.Provide support to patients and their families as needed,offering reassurance and assistance with understanding care plans or addressingconcerns.Ensure recoding of full and chronological documentation accordingto information governance guidelines.Ensuring infection control guidelines are followed correctly when delivering safe and appropriate care.ManagerialCarry out surveys and audits as appropriateto your area of workSupport colleagues to access the mostappropriate service by problem solving and directing referrals to the mostappropriate level of care.Maintain and provide accurate and timelystatistics and information within the required timescalesParticipate in team meetings.Manage time and caseload pressure in arapidly changing environment, using appropriate prioritisation.Undertake any other professional duty asrequired within the service, in accordance with training, and experiencefollowing consultation with the trained member of the team.Plan own caseload, asking for support whenrequiredCommunicationEstablish and maintain effective, collaborative working withcolleagues in Primary/Secondary Care, Social Services, Voluntary andIndependent Sectors in all aspects of patient care.Participate in multi-disciplinary team meetings and liaisewith other disciplines to achieve comprehensive, effective and holistic ongoingcare management planning for the patient.Demonstrate the ability to communicate information,sometimes of a complex and sensitive matter and respond appropriately topatients, carers and staff.Maintain accurate and contemporaneous record keeping to ahigh standard utilising specific templates on SystmOne.Demonstrate the ability to communicate information,sometimes of a complex and sensitive matter and respond appropriately topatients, carers and staff.Ensure timely and effective communication with the qualifiedstaff on all team matters.TrainingActively participate in your own personal development planwith your supervisor in order to develop the skills and knowledge required tocarry out the responsibilities set out in the job descriptionEnsure that personal support and development is gainedthrough performance review, regular supervision and that training needs areidentified with subsequent training as appropriate, in line with employers' policy.Person SpecificationExperienceAbility to work effectively as a team player under appropriate supervision, and as part of a multi-disciplinary team.Experience of SystmOne.Previous experience in a Primary Care setting.Previous Health Care experienceTherapy Assistant CompetenciesProfessional approach to workResponsive and positive role model.Can recognise personal limitations and refer to more appropriate colleagues when necessary.Commitment to continued Professional Development through further study.QualificationsGCSEs Grade A-C in Maths and English or key skills level 2 in Maths and English (to be evidenced by a test if relevant qualifications not available)Care certificateSkills and AbilitiesExcellent interpersonal skills.Effective written, verbal, and non-verbal communication with patients, carers, and all members of the multidisciplinary teams.Ability to work with patients from a diverse range of religious, cultural, and social backgrounds to meet their needs.Flexible and adaptable to change.Strong team player as well as working on own initiative when required.Clear and concise record keepingDemonstrate an understanding of the data protection act and patient confidentiality, clinical and information governance and Caldicott requirementsPromote health and prevent ill health.Provide and monitor CareAbility to prioritise workloadClinical observation skillsDisclosure and Barring Service CheckThis post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions. #J-18808-Ljbffr