Neighbourhood Support Care Coordinator

Job summary

We are looking for an enthusiastic team player to support the PCN in delivering an effective patient focused service which promotes proactive care and effective working relationships. This is a key role in supporting frail and vulnerable patients to remain safe, well and independent at home.

The role will be supporting both proactive and reactive patients, identified through referral and risk stratification and will include basic observations and a supportive approach to person centre self-management.

The post holder should work within their scope of practice, under agreed protocols, with escalation to registered clinicians as required. The role will act as a bridge between GP Practices, MDT and other INT services.

Main duties of the job The post holder will work across all PCN practices and as part of the wider Intergrated Neighbourhood team to ensure efficient and effective patient contacts and assit in the reduction of A&E admissions.

About us

Folkestone, Hythe and Rural Primary Care Network is an innovative, friendly and forward thinking organisation.

We are proud and enthusiastic to be an inventive front runner in the development of Integrated Neighbourhood Team working, which is assisting in shaping the future of primary care, ensuring that patients receive positive and effective encounters enhancing their health and well being.

We are located in the historical South Kent Coast of the Garden of England (Kent). General Practice is changing at pace and we see this as a positive and opportunistic challenge. Our PCN includes 7 practices with a combined list size of approx 52,000 patients.

Job description

Job

responsibilities

Promote and support a proactive approach to patient care, working with the team to identify patients needing support Process and effectively signpost patients and their carers to the appropriate healthcare professional or health/social care, voluntary service depending on the presenting condition Detect early signs of patient deterioration through basic observations and holistic approved assessment Support the coordination, delivery and actions for MDTs within PCN Increase patient confidence and understanding in their own health Reduce crisis situations unplanned admissions and carer breakdowns Support patients that are not managing their long term conditions, signposting to relevant services and highlighting concerns to GP practice Liaise with PCN services, GP practices, community teams and voluntary services to support patients Take part in hospital discharge reviews to assist in communicating and coordinating patient care Action incoming emails and correspondence as necessary Accurately detail information on patients records within the clinical system Bridging the gap between GPs and realities patients face at home encompassing what really matters to them Promote the image of the organisation and services by ensuring that all information and communication is up to date and suitably presented Take responsibility for ensuring that internal and external communication systems are fit for purpose Respond to telephone, email and written queries on behalf of the service area including call handling where appropriate Demonstrate flexibility and adaptability to meet changing priorities within a dynamic operational environment Be proactive and contribute ideas for improvement in the way the service is delivered Support in providing telephone cover during annual leave, sickness or peak demand periods, including answering incoming calls, booking appointments, taking messages and signposting patients appropriately Ensure that all complaints, compliments, concerns, comments and suggestions are escalated appropriately Able to work on own initiative, prioritising work within defined policies and procedures to set timescales Manage specific projects as requested by the PCN Operational manager and provide updates on progress

Person Specification

Knowledge and Understanding Essential Understanding of Primary Care, GP practices or the wider NHS landscape Understanding of how multi-practice or multi-organisation working operates Knowledge of operational processes, administration workflows or service coordination Effective communicator Understanding of confidentiality, information governance and data handling principles Desirable Understanding of PCN governance, DES requirements or NHS programme delivery Experience Essential Experience of working within a multi-disciplinary team Strong administrative skills with excellent attention to detail Experience in using the Microsoft Office suite of applications, including Word, PowerPoint and Outlook Experience in completing patient observations Experience of working under pressure and managing varying workloads and changing demands Excellent communication skills with the ability to communicate orally and in written form in a confident, articulate manner Ability to build relationships with others to enable and support collaborative working Desirable - Experience of implementing or supporting service improvements - Experience of using IT systems such as EMIS Web, Docman or other clinical systems - Experience of working within primary care - Experience phlebotomist

Qualifications

Essential - GCSE grade A* to C (9-4) in English and Maths or equivalent - NVQ Level 3, Advanced level administrative qualification or equivalent - Completion of STEP / Care Certificate - Demonstrable commitment to professional and personal development Desirable - Willingness to work towards further educational qualifications required for the role.

Disclosure and Barring Service Check This 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.