PCN Care Coordinator
NHS Jobs London
1x PCN Care Coordinators wanted at North Lambeth Primary Care Network Role Title PCN Care Coordinator Grade/Salary upto £28K Hours 37.5 hours per week. Duration Permanent Reporting to PCN Network Manager Location North Lambeth member practices for the Primary Care Network Key responsibilities 1.
Undertake work in line with PCN directed priorities. 2. Proactively identify and work with a cohort of people to support their personalised care requirements, using the available decision support aids 3. Ensure regular and consistent communication with the referrer regarding patient progress and any complications or guidance 4.
Raise awareness of health promotion and NHS health checks in practices 5. Work with Member Practices to facilitate the . 6. Evaluate treatment programmes that promote health and well-being 7. Co-ordinate clinics, liaising with the schedulers and contacting the identified patients with appointments.
8. Manage patient initiated calls for help/signposting etc, booking into named GP urgent care slots/tel slots if necessary. 9. Document and monitor aspects of patient co-ordination and service delivery, supporting data collection and audit using the patient administration system 10.
Demonstrate the ability to recognise and respond appropriately when faced with a sudden deterioration or emergency situation, alerting the team or enabling a rapid response. 11. Dependant on work plans, there may be a requirement to work across different tumour groups and teams.
12. Organise and prioritise own workload the postholder should be comfortable working independently and as a committed member of the multi-disciplinary team. 13. Support national screening programmes 14. Support immunization programmes 15. Monitor referrals to ensure tasks are completed and care delivered by keeping in regular telephone contact 16.
Direct liaison with multi agencies to coordinate care for patients 17. Refer to PCN social prescribing link workers were a patient is identified as potentially benefitting from this service 18. To support patient/carer contact roles, and collate patient and carer feedback on their experiences 19.
Support Quality and Outcome Frameworks and other DES/LES specifications 20. Maintain and develop engagement with all practice staff and encourage best practice 21. Act as the first port of call for patients, in their caseload in relation to their care.
22. Bring together all of a persons identified care and support needs, and explore their options to meet these into a single personalised care and support plan (PCSP), in line with PCSP best practice 23. Help people to manage their needs, answering their queries and supporting them to make appointments 24.
Support people to take up training, employment and access appropriate benefits where eligible 25. Raise awareness of shared decision-making and decision support tools, and assist people to be more prepared to have a shared decision-making conversation 26.
Ensure that people have good quality information to help them make choices about their care 27. Support people to understand their level of knowledge, skills and confidence their Activation level when engaging with their health and wellbeing, including using the Patient Activation Measure 28.
Assist people to access self-management education courses, peer support or interventions that support them in their health and wellbeing 29. Explore and assist people to access personal health budgets where appropriate 30. Provide coordination and navigation for people and their carers across health and care services, alongside working closely with social prescribing link workers and other primary care roles 31.
Support the coordination and delivery of MDTs within PCNs. - Manage MDT meetings for this patients and identifying issues to be addressed, liaising with other agencies if necessary as well as GPs, Pharmacists and Nursing team. 32. Liaise directly with Care Homes and other key providers, to identify patients for discussion at MDT, and compile and circulate relevant information to attendees 33.
Other duties as defined by the PCN as necessary Confidentiality In the course of seeking treatment, patients entrust us with, or allow us to gather, sensitive information in relation to their health and other matters. They do so in confidence and have the right to expect that staff will respect their privacy and act appropriately.
In the performance of the duties outlined in this job description, the post-holder may have access to confidential information relating to patients, their carers, practice or staff information. All such information from any source is to be regarded as strictly confidential.
Information relating to patients, carers, colleagues, or the members practices may only be divulged to authorised persons in accordance with PGPA policies and procedures relating to confidentiality and the protection of personal and sensitive data, or under the guidance of your manager.
Undertake work in line with PCN directed priorities. 2. Proactively identify and work with a cohort of people to support their personalised care requirements, using the available decision support aids 3. Ensure regular and consistent communication with the referrer regarding patient progress and any complications or guidance 4.
Raise awareness of health promotion and NHS health checks in practices 5. Work with Member Practices to facilitate the . 6. Evaluate treatment programmes that promote health and well-being 7. Co-ordinate clinics, liaising with the schedulers and contacting the identified patients with appointments.
8. Manage patient initiated calls for help/signposting etc, booking into named GP urgent care slots/tel slots if necessary. 9. Document and monitor aspects of patient co-ordination and service delivery, supporting data collection and audit using the patient administration system 10.
Demonstrate the ability to recognise and respond appropriately when faced with a sudden deterioration or emergency situation, alerting the team or enabling a rapid response. 11. Dependant on work plans, there may be a requirement to work across different tumour groups and teams.
12. Organise and prioritise own workload the postholder should be comfortable working independently and as a committed member of the multi-disciplinary team. 13. Support national screening programmes 14. Support immunization programmes 15. Monitor referrals to ensure tasks are completed and care delivered by keeping in regular telephone contact 16.
Direct liaison with multi agencies to coordinate care for patients 17. Refer to PCN social prescribing link workers were a patient is identified as potentially benefitting from this service 18. To support patient/carer contact roles, and collate patient and carer feedback on their experiences 19.
Support Quality and Outcome Frameworks and other DES/LES specifications 20. Maintain and develop engagement with all practice staff and encourage best practice 21. Act as the first port of call for patients, in their caseload in relation to their care.
22. Bring together all of a persons identified care and support needs, and explore their options to meet these into a single personalised care and support plan (PCSP), in line with PCSP best practice 23. Help people to manage their needs, answering their queries and supporting them to make appointments 24.
Support people to take up training, employment and access appropriate benefits where eligible 25. Raise awareness of shared decision-making and decision support tools, and assist people to be more prepared to have a shared decision-making conversation 26.
Ensure that people have good quality information to help them make choices about their care 27. Support people to understand their level of knowledge, skills and confidence their Activation level when engaging with their health and wellbeing, including using the Patient Activation Measure 28.
Assist people to access self-management education courses, peer support or interventions that support them in their health and wellbeing 29. Explore and assist people to access personal health budgets where appropriate 30. Provide coordination and navigation for people and their carers across health and care services, alongside working closely with social prescribing link workers and other primary care roles 31.
Support the coordination and delivery of MDTs within PCNs. - Manage MDT meetings for this patients and identifying issues to be addressed, liaising with other agencies if necessary as well as GPs, Pharmacists and Nursing team. 32. Liaise directly with Care Homes and other key providers, to identify patients for discussion at MDT, and compile and circulate relevant information to attendees 33.
Other duties as defined by the PCN as necessary Confidentiality In the course of seeking treatment, patients entrust us with, or allow us to gather, sensitive information in relation to their health and other matters. They do so in confidence and have the right to expect that staff will respect their privacy and act appropriately.
In the performance of the duties outlined in this job description, the post-holder may have access to confidential information relating to patients, their carers, practice or staff information. All such information from any source is to be regarded as strictly confidential.
Information relating to patients, carers, colleagues, or the members practices may only be divulged to authorised persons in accordance with PGPA policies and procedures relating to confidentiality and the protection of personal and sensitive data, or under the guidance of your manager.
This role profile is not exhaustive, and you may be directed to complete other tasks according to the skills and requirements for individual roles. These duties will always be reasonable and deemed within the expectations of your position.
City and County Healthcare Group LtdLondon
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