Gp Health Care Assistant

**Job Overview**
The GP Health Care Assistant will play a key role working with our Frailty Specialist Clinical Practitioner (FSP) and the wider multi-disciplinary team, delivering excellent, patient-facing care. You will visit frail, housebound patients in their own homes, returning to a GP practice for debriefing, team-working and administrative purposes. You may also spend some time undertaking work within the Hitchin & Whitwell practices, providing services for their diabetic patients and general patient cohort.

Frailty is a condition affecting older people in which their body’s ability to cope with events, such as infection, medication or environmental changes, is impaired and they are vulnerable to falls, disability and admission to hospital. Patients with frailty may also have other long term medical conditions. Housebound frail patients in particular can struggle to access pro-active health care. Personalised care planning is aimed at improving their health and wellbeing and preventing adverse outcomes.

This post is part of the Additional Roles Reimbursement Scheme (ARRS) for Primary Care Networks (PCNs).

With support from the patient’s registered GP and other colleagues, you will work with the FSP to undertake holistic reviews, including taking and recording clinical observations, the completion of local care planning documents, appropriate elements of long term condition reviews, evidenced based intervention, practical advice and emotional support to the frail patient and, where appropriate, their carer. You will be aware of local support services and be able to signpost into these as appropriate. You will work collaboratively with the health and social care team to meet the needs of the patients, supporting the delivery of appropriate care. You may be expected to undertake similar work within Hitchin and Whitwell practices for a more general patient cohort.

**Primary Responsibilities**
- Work clinical sessions providing face to face appointments in the patient’s home and surgery and telephone follow up where appropriate
- Be able to undertake and record clinical observations such as blood pressure, pulse and temperature accurately
- Be able to undertake other clinical assessments, including but not limited to: diabetic foot checks, Rockwood scoring, FRAT assessment
- Be aware of the importance of continence issue and pressure areas including a basic assessment of these
- Meet the multiple and often complex needs of frail people through assessment of health and wellbeing, helping to develop a personalised advanced care plan using shared decision making
- Utilise a range of effective evidence based interventions to promote health, wellbeing and self-management
- Provide appropriate preventative health care and advice
- Understand the needs of frail patients and be aware of local services which are available to support them
- Manage a cross-practice consolidated caseload of frail housebound patients, including helping to prioritise their reviews and plan the visiting schedule
- Act on alerts (e.g. QOF, local enhanced services etc.) and reminders during a consultation
- Be able to undertake phlebotomy
- Give immunisations as required under a PSD
- Liaise with other clinical colleagues regarding onward investigation, treatment and referral where appropriate
- Be confident and compassionate in raising awareness of advanced care planning
- Have excellent consultation skills to enable shared patient and practitioner decision-making
- Participate in multi-disciplinary team meetings
- Recognise your limitations and seek senior support where appropriate
- Record clear and contemporaneous IT based consultation notes to agreed standards
- Collect data for audit purposes

**Secondary Responsibilities**

In addition to the primary responsibilities, the Health Care Support Worker may be requested to:

- Participate in practice audits as requested by the audit lead
- Participate in local initiatives to enhance service delivery and patient care
- structured approach i.e. root cause analysis (RCA)

This list is not exhaustive and there may be on occasion, a requirement to carry out other tasks; this will be dependent upon factors such as workload, staffing levels and the needs of the business.

**Generic Responsibilities**

**Confidentiality**
- All staff are required to respect the confidentiality of all H&W Health, HWPCN and Practice business and the business of the staff, residents, patients and general public which they may learn in the execution of their duties.

**Data Protection**
- All staff are expected to adhere to the current laws regarding data protection.

**Health and Safety**

All staff are expected:

- To carry out the duties placed on employees by the Health and Safety at Work Act 1974,, Environmental Protection Act 1990, Environment Act 1995, Fire Precautions (workplace) Regulations 1999 and other statutory legislation.
- To take reasonable care for the Health and Safety of themselves and of o