Job description

Job responsibilities

Care coordinators will:

• Proactively identify and work with a cohort of patients to support their personalised care requirements, using the available decision support aids. These include patients with a Learning Disability, Mental Health, Dementia and vulnerable/frail patients.
• 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) based on what matters to the person, ensuring dignity, choice, respect, independence and rights are upheld at all times.
• Help people to manage their needs, answering their queries and supporting them to make appointments, and ensuring that people have good quality written or verbal information to help them make choices about their care.
• Identify barriers to or issues preventing greater engagement and/or uptake by patients actively participate in developing solutions for patients and service providers.
• Support people to take up training and employment, and to access appropriate benefits where eligible.
• Raise awareness of shared decision making and decision support tools and assist people to be more prepared to have a shared decision-making conversation.
• Ensure that people have good quality information to help them make choices about their care, e.g. support people to understand their level of knowledge, skills and confidence (their Activation level) when engaging with their health and wellbeing, including through use of the Patient Activation Measure.
• Assist people to access self-management education courses, peer support or interventions that support them in their health and wellbeing.
• Explore and assist people to access personal health budgets where appropriate.
• Provide coordination and navigation for people and their carers across health and care services, alongside working closely with social prescribing link workers, health and wellbeing coaches and other primary care professionals.
• Support the coordination and delivery of MDTs within practice.
• Monitor DNA patients in Vulnerable patient groups.
• Working with GPs to provide ongoing support to parents who may be struggling with their childs behaviour, sleep, anxiety and mental health or awaiting a child assessment for ADHD/ASD. Signposting these parents to support groups and charities. Coordinating referrals when necessary and submitting Right to Choose ASD and ADHD assessment requests. Liaising with other professionals to support families, e.g. Social Care, Health visitors
• Any other duties as requested by your line manager.

Job responsibilities

Care coordinators will:

• Proactively identify and work with a cohort of patients to support their personalised care requirements, using the available decision support aids. These include patients with a Learning Disability, Mental Health, Dementia and vulnerable/frail patients.
• 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) based on what matters to the person, ensuring dignity, choice, respect, independence and rights are upheld at all times.
• Help people to manage their needs, answering their queries and supporting them to make appointments, and ensuring that people have good quality written or verbal information to help them make choices about their care.
• Identify barriers to or issues preventing greater engagement and/or uptake by patients actively participate in developing solutions for patients and service providers.
• Support people to take up training and employment, and to access appropriate benefits where eligible.
• Raise awareness of shared decision making and decision support tools and assist people to be more prepared to have a shared decision-making conversation.
• Ensure that people have good quality information to help them make choices about their care, e.g. support people to understand their level of knowledge, skills and confidence (their Activation level) when engaging with their health and wellbeing, including through use of the Patient Activation Measure.
• Assist people to access self-management education courses, peer support or interventions that support them in their health and wellbeing.
• Explore and assist people to access personal health budgets where appropriate.
• Provide coordination and navigation for people and their carers across health and care services, alongside working closely with social prescribing link workers, health and wellbeing coaches and other primary care professionals.
• Support the coordination and delivery of MDTs within practice.
• Monitor DNA patients in Vulnerable patient groups.
• Working with GPs to provide ongoing support to parents who may be struggling with their childs behaviour, sleep, anxiety and mental health or awaiting a child assessment for ADHD/ASD. Signposting these parents to support groups and charities. Coordinating referrals when necessary and submitting Right to Choose ASD and ADHD assessment requests. Liaising with other professionals to support families, e.g. Social Care, Health visitors
• Any other duties as requested by your line manager.

Person Specification

Qualifications

Essential

• Demonstrable commitment to professional development

Experience

Essential

• Demonstrable experience of working in a public environment Demonstrable experience of working with an integrated multi-skilled team
• Demonstrable experience of working as part of a team

Desirable

• Experience of working in a GP surgery or in a health care environment

Personal Qualities and Attributes

Essential

• An understanding, acceptable and adherence to the need for strict confidentiality
• Ability to work without direct supervision and determine own workload priorities and those of others in the team
• Ability to use own judgement, resourcefulness and common sense Pleasant and articulate
• Able to work under pressure
• Ability to multi-task, especially under pressure
• Ability to stay calm in all circumstances
• Able to work in a constantly changing environment

Skills and Abilities

Essential

• Excellent communication and interpersonal skills
• Good personal organisation skills
• Ability to prioritise
• Ability to support members of the team when required

Qualifications

Essential

• Demonstrable commitment to professional development

Experience

Essential

• Demonstrable experience of working in a public environment Demonstrable experience of working with an integrated multi-skilled team
• Demonstrable experience of working as part of a team

Desirable

• Experience of working in a GP surgery or in a health care environment

Personal Qualities and Attributes

Essential

• An understanding, acceptable and adherence to the need for strict confidentiality
• Ability to work without direct supervision and determine own workload priorities and those of others in the team
• Ability to use own judgement, resourcefulness and common sense Pleasant and articulate
• Able to work under pressure
• Ability to multi-task, especially under pressure
• Ability to stay calm in all circumstances
• Able to work in a constantly changing environment

Skills and Abilities

Essential

• Excellent communication and interpersonal skills
• Good personal organisation skills
• Ability to prioritise
• Ability to support members of the team when required

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.

Employer details

Employer name

Downend Health Group

Address

The Willow Surgery

Hill House Road, Downend

Bristol

BS16 5FJ

Employer's website

https://www.downendhealthgroup.com (Opens in a new tab)