Clinical Care CoOrdinator (Health Care Assistant)

Coordinate Multi-Disciplinary Team meetings for people living in the community. Be responsible for arranging, attending and minuting Multi-Disciplinary Team Meetings. Follow up on all forward actions resulting from MDT discussions Utilise Population Health Intelligence to proactively identify patients at risk and work with the PCN team to enable the PCN team to deliver personalised care Utilise Population Health Intelligence tools where needed to support other patients in the PCN.

Support the achievement of the IIF targets through reporting and communication Additional Duties Be responsible for daily updating of patients on e-HealthScope Workflow to identify patient to support the PCN team with identifying community pathways that might prevent hospital admission and for identifying potential gaps in care To record patient interventions on relevant electronic database systems (e.g. SystmOne) and contribute to report generation, analysis and production To contribute to the integration of health and social care by maintaining up to date recording systems for all agencies within the PCN Team and providing information to any member of the PCN Team in order to ease processes and communication in agreement with data protection protocol Use clinical systems for record keeping, audit and evaluation To be customer (patient, carer, GP) focused when representing the service To work collaboratively with other teams and services to maintain an effective and efficient service To offer appropriate support and guidance to patients and their families/carers To plan / organise work using own initiative, whilst being able to work as a valuable member of a team To work effectively as part of a team to provide cover for Care Coordination Teams when required and to be flexible regarding working hours to meet the needs of the service To ensure all electronic records are updated and complete within the agreed time-scales To use a range of verbal and non-verbal communication tools to communicate effectively with patients, carers and families and colleagues.

To participate in any relevant training/courses/conferences Complete mandatory training Adhere to organisational policies and procedures, including confidentiality, safeguarding, lone working, information governance, equality, diversity and inclusion training and health and safety.