Clinical Care Co-ordinator - Blackpool

apartmentBay Medical Group placeBlackpool calendar_month 

MAIN DUTIES

Identification of vulnerable and frail patients using the risk stratification, and the E-Frailty Tool (Aristotle and EMIS).
Holistic assessment, planning, implementation and evaluation of the patient; encouraging self-care, resilience and community involvement as appropriate.
Prioritise health problems and intervene appropriately.
Sign-positing to primary, secondary, and third sector services where necessary including the voluntary sector.
Working closely with clinical teams across the Practice and wider community.
Working in an integrated multi-disciplinary environment across the locality, linking closely with the relevant stakeholders where appropriate, and developing patient pathways.
Working closely with the Social Prescriber Care Co-ordinator to manage patient care and monitor progress against improvements following care planning and sign-posting.
Attendance at the ICC Monthly Meeting and weekly MDT (Multi-Disciplinary Team) to update on the progress of patient care, including quantitative performance information around care plans, and qualitative feedback from patients.

Flexibility within the Clinical Care Co-ordinator role to enable the post and the work of the Practice to evolve further, and in conjunction with the wider stakeholder group.

Other duties and activities involved in patient care in line with current clinical competencies

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