Care Coordinator

Job summary

Anopportunity has arisen for our forward thinking, enthusiastic and supportivePCN to employ a Care Co-ordinator within our Frailty Team. The post is 30 hours per week. You will be required to support patient needsas required by the 5 practices within our PCN. You will work within the FrailtyTeam and others clinicians within the practices to help provide high levels of care to ourpatients. In addition you will work with care homes and other stakeholders suchas Sirona Healthcare to provide support to patients. This roles requires the ability to travel to visit patients in their homes and for this reason the ability to drive independantly and have access to a car for work purposes is exxential.

Main duties of the job

There may be, on occasion, arequirement to carry out other tasks. This will be dependent upon factors suchas workload and staffing levels. The main duties will involve:

Working with patients and their families or carers, to identifytheir needs and wishes to assess their needs for care and support

Working closely with GP practices and PCN healthcare staff toidentify and work with a cohort of people to support their requirements

Working with Care Home staff to develop personalised care plansfor residents.

To assist in the co-ordination of health professionals in amulti-disciplinary team to identify patients in most need and liaise withproviders to meet these needs

Assisting patients to be better prepared to have conversationson shared decision making and to improve awareness of shared decision makingand related support tools

Providing patients with high quality, easy to understand informationto assist them in making choices about their care

To provide coordination and navigation of patients, and whereappropriate their carers, across health and social care services, includingsignposting them to assistance with finances and benefits and other wellbeingservices

To attend and participate in the delivery of multi-disciplinaryteams (MDT) within PCNs.

About us

Yate & Frampton Primary Care Network is a collection of 5 GP Practices within the Yate and Frampton area working together to provide better health care to local residents. We provide a supportive and collaborative working environment and welcome forward thinking and flexible individuals to our team. Working at Yate & Frampton PCN is an exciting opportunity to become involved with patients and bring forward new ideas for patient care and support. The PCN supports Health and wellbeing activities both within the PCN and externally and have a professional but relaxed working environment.

Job description

Job responsibilities

Job SummaryA patient care co-ordinator (PCC)will support patients to receive and access appropriate health care andwellbeing support. The PCC will liaise between patients and their families,Clinicians, GP surgeries, Community services and other health care andvoluntary sector services to work towards the specified aims of each patient.Working closely with the patientand their clinician or other healthcare professional, the PCC co-ordinatespatients healthcare and directs them to the appropriate service to ensure thatthey get the most suitable care from whatever health or social care provider is PCCs role requires them tobe able to work with, and understand the roles of, a variety of differentpeople working in the practice and across the PCN including doctors, nurses,healthcare assistants, social prescribing link workers, physiotherapists,physician associates, paramedics, health and wellbeing coaches, podiatrists,occupational therapists, pharmacy technicians and will need to be a car driverand have access to a car as this role involves travelling to differentpractices and patients across the Yate and Frampton Cotterell practice areas. PrimaryDuties & Areas of ResponsibilityThere may be, on occasion, arequirement to carry out other tasks. This will be dependent upon factors suchas workload and staffing levels. The main duties will involve:

Working with patients and their families or carers, to identifytheir needs and wishes to assess their needs for care and support

Working closely with GP practices and PCN healthcare staff toidentify and work with a cohort of people to support their requirements

Working with Care Home staff to develop personalised care plansfor residents.

To assist in the co-ordination of health professionals in amulti-disciplinary team to identify patients in most need and liaise withproviders to meet these needs

Assisting patients to be better prepared to have conversationson shared decision making and to improve awareness of shared decision makingand related support tools

Providing patients with high quality, easy to understand informationto assist them in making choices about their care

Liaising with other PCCs in other practices within the PCN andshare best practice

To provide coordination and navigation of patients, and whereappropriate their carers, across health and social care services, includingsignposting them to assistance with finances and benefits and other wellbeingservices

To support in the delivery of Quality and Outcomes Framework,enhanced services and other service requirements on behalf of the GP Practices

To attend and participate in the delivery of multi-disciplinaryteams (MDT) within PCNs.

To undertake all mandatory training and induction programmes

To contribute to and embrace the spectrum of clinical governance

To develop yourself and the role through participation intraining and service redesign activities

To contribute to public health campaigns ( flu clinics)through advice or direct care

In addition to the primaryresponsibilities, the PCC may be requested to:

Support delivery ofQOF, incentive schemes, QIPP and other quality or cost effectivenessinitiativesUndertake any tasksconsistent with the level of the post and the scope of the role, ensuring thatwork is delivered in a timely and effective mannerDuties may varyfrom time to time without changing the general character of the post or thelevel of responsibilityIn addition to the primaryresponsibilities, the PCC may be requested to:Confidentiality:

In the course ofseeking treatment, patients entrust us with, or allow us to gather, sensitiveinformation in relation to their health and other matters. They do so in confidence and have the rightto expect that staff will respect their privacy and act appropriately.

In the performance ofthe duties outlined in this job description, the post-holder may have access toconfidential information relating to patients and their carers, practice staffand other healthcare workers. They mayalso have access to information relating to the practice as a business organisation.All such information from any source is to be regarded as strictly confidential.

Information relating topatients, carers, colleagues, other healthcare workers or the business of thepractice may only be divulged to authorised persons in accordance with the practicepolicies and procedures relating to confidentiality and the protection ofpersonal and sensitive data

Health& safety:

The post-holder will implement and lead on a fullrange of promotion and management of their own and others health and safety andinfection control as defined in the practice health & safety policy, thepractice health & safety manual, and the practice infection control policyand published procedures. This will include (but will not be limited to):

Using personal securitysystems both within and external to the workplace according to practiceguidelines.

Awareness of nationalstandards of infection control and cleanliness and regulatory / contractual /professional requirements, and good practice guidelines.

Responsible for thecorrect and safe management of the specimens process, including collection,labelling, handling, use of correct and clean containers, storage and transportarrangements.

Management andmaintenance of Personal Protective Equipment (PPE) for the practice, includingprovision, ordering, availability and ongoing correct usage by staff.

Responsible for handhygiene across the practice.

Ownership of infectioncontrol and clinically based patient care protocols and implementation of thoseprotocols across the practice.

Active observation ofcurrent working practices across the practice in relation to infection control,cleanliness and related activities, ensuring that procedures are followed andweaknesses / training needs are identified, escalating issues as appropriate.

Identifying the risksinvolved in work activities and undertaking such activities in a way thatmanages those risks across clinical and patient process.

Making effective use oftraining to update knowledge and skills, and initiate and manage the trainingof others across the full range of infection control and patient processes.

Monitoring practicefacilities and equipment in relation to infection control, ensuring thatprovision of hand-cleansing facilities, wipes etc. are sufficient to ensure agood clinical working environment. Lack of facilities to be escalated asappropriate.

Safe management ofsharps procedures, including training, use, storage and disposal.

Using appropriateinfection control procedures, maintaining work areas in a tidy, clean andsterile way, safe and free from hazards. Initiation of remedial/correctiveaction where needed or escalation to responsible management.

Actively identifying,reporting, and correction of health and safety hazards and infection hazardsimmediately when recognised.

Keeping own work areasand general/patient areas generally clean, sterile, identifying issues andhazards/risks in relation to other work areas within the business, and assumingresponsibility in the maintenance of general standards of cleanliness acrossthe business in consultation (where appropriate) with other sector managers.

Undertaking periodicinfection control training (minimum twice annually).

Routine management ofown team/team areas, and maintenance of work space standards.

Waste management,including collection, handling, segregation, container management, storage andcollection.

Spillage controlprocedures, management and training.

Decontamination controlprocedures, management and training, and equipment maintenance.

Maintenance of sterile environments.

Demonstrate due regard for safeguarding andpromoting the welfare of children.

Equality and diversity:

The post-holder willsupport the equality, diversity and rights of patients, carers and colleagues,to include:

Acting in a way thatrecognises the importance of peoples rights, interpreting them in a way thatis consistent with practice procedures and policies, and current legislation.

Respecting the privacy,dignity, needs and beliefs of patients, carers and colleagues.

Behaving in a mannerthat is welcoming to and of the individual, is non-judgmental and respectstheir circumstances, feelings priorities and rights.

Quality:

The post-holder willstrive to maintain quality within the practice, and will:

Alert other teammembers to issues of quality and risk.

Assess own performanceand take accountability for own actions, either directly or under supervision.

Contribute to theeffectiveness of the team by reflecting on own and team. Activities and makingsuggestions on ways to improve and enhance the teams performance.

Work effectively withindividuals in other agencies to meet patients needs.

Effectively manage owntime, workload and resources.

Contribution to the implementation of services:

The post-holder will:

Apply practice policies, standards and guidance.

Participate in auditwhere appropriate.

To carry out any other duties as maybe required by the practice either temporarily or permanently. This job description isintended to provide an outline of the key tasks and responsibilities. There maybe other duties required of the post-holder commensurate with the position.

Person Specification

Qualifications

Essential

Educated to GCSE level or equivalent Experience of working with healthcare professionals and/or previous experience in the NHS or social care or relevant field

Desirable

NVQ Level 3 Business Administration (or relevant experience) Qualification in health or social care allied profession Long term conditions training

Experience

Essential

Experience of working in a people centred environment Understanding of working with confidential information and an understanding of service user confidentiality Understanding of basic health and social care terminology Working in a multi-disciplinary setting Experience providing signposting and how and when to signpost An understanding of safeguarding and an awareness of the Mental Capacity Act Ability to communicate confidently with staff of all seniority levels Developing relationships with a wide variety of people Ability deliver successful outcomes within determined timeframes Skills and abilities: Excellent verbal communication skills with the ability to communicate effectively at all levels including with patients, carers, specialist services, GPs and colleagues. Good technical literacy with Word, Excel experience using a clinical system such as EMIS Able to work independently and manage own workload Able to build strong professional relationships Demonstratable experience of effective planning and organisation skills to deliver targets to deadlines Good communication and negotiation skills Ability to problem solve and be an analytical thinker Creative, flexible approach to working with people with diverse support needs Ability to work for multiple stakeholders Be a car driver and be able to travel and work across 5 sites as well as all the care homes in the area. You will be required to have a clean driving licence and access to personal transportation for work purposes.

Desirable

Care Co-ordinator role in primary care Experience coordinating with multiple stakeholder or individuals to meet specified outcomes The needs of vulnerable adults, safeguarding and the associated legislative framework Working with the elderly Awareness of relevant Health and Social care legislation and a developed knowledge of crisis intervention

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