Coastal Fareham and Gosport Primary Care Network is looking for a self-motivated, disciplined and enthusiastic individual to join Stubbington Medical Practice as a QOF Care Coordinator.
If you are enthusiastic, committed to patient centred care and would love to work in a collaborative, friendly and ambitious network, then we would love to hear from you.
Asa Care Coordinator you will be responsible for recalling and inviting patientswith long term health conditions for their annual reviews, enabling patients toaccess health, social care and wellbeing services, professionals andinformation tailored to their individual needs.
Youwill manage a caseload of patients, guiding each patient through the variouspathways and processes, facilitating actions and liaising as required.
TheCare Coordinator is a key member of the Practice and PCN, working in tandemwith the GPs, the nursing, administrative, reception and pharmacy teams.Additionally, linking with PCN services such as social prescribers, the homevisiting service, wellbeing coaches and first contact practitioners. They playan important role in improving healthcare outcomes for patients in Coastal PCNand managing aspects of the Quality and Outcomes Framework such as long-termcondition management (QOF).
Interviews will be held on Thursday 18 November 2025.
Main duties of the job
Dutiesmay be varied from time to time under the direction of the QOF lead dependenton current and evolving Practice workload and staffing levels:
Youwill be working with the practice and relevant PCN teams to identify cohorts ofpatients who require annual reviews.
Contactand work with these patients to organise review appointments.
Checkand ensure each patient understand and considers the options and choicesavailable to them.
Sourceand provide patients with relevant and appropriate information to supportshared decision making.
Collatepatient data with best practice and upload and regularly update the patientrecord.
Create,amend and use searches within the clinical system to identify cohorts ofpatients.
Create,amend and produce letter/text templates for the individual practices.
Produceprotocols and spreadsheets to provide audit.
Assistthe patient to navigate and progress through the relevant pathways, processesand systems, answering patient questions, making phone-calls, appointments,arrangements for care, liaising with professionals, service personnel and widerstakeholders.
Implementa process for safety-netting at the practice, so patients are followed upeffectively.
Ensurethat knowledge of clinical IT systems is up to date and ensure the effectiveutilisation of these systems.
About us
About Coastal Fareham & Gosport PCN
Coastal Fareham and Gosport Primary Care Network was formed in 2019, bringing together three established independent practices:
* Lockswood Surgery
* Stubbington Medical Practice
With a patient population of approximately 39,000 we serve a largely suburban area between Portsmouth and Southampton. We are equidistant from Queen Alexandra Hospital and Southampton General Hospital, allowing us to collaborate with major local healthcare providers.
Our mission is the practices within the PCN will work collaboratively, whilst maintaining their independence, to provide additional services for all our patients. We aim to empower patients to improve their own health and wellbeing.
Job responsibilities
Dutiesmay be varied from time to time under the direction of the QOF Lead dependenton current and evolving Practice workload and staffing levels:
Workingwith the primary care team, identify cohorts of patients who require annualreviews.
Contactand work with these patients to organise review appointments.
Checkand ensure each patient understand and considers the options and choicesavailable to them.
Sourceand provide patients with relevant and appropriate information to supportshared decision making.
Collatepatient data with best practice and upload and regularly update the patientrecord.
Beresponsible for improving healthcare outcomes by leading Quality and OutcomesFramework (QOF) work in the practices.
Create,amend and use searches within the clinical system to identify cohorts ofpatients.
Create,amend and produce letter/text templates for the individual practices.
Produceprotocols and spreadsheets to provide audit.
Assistthe patient to navigate and progress through the relevant pathways, processesand systems, answering patient questions, making phone-calls, appointments,arrangements for care, liaising with professionals, service personnel and widerstakeholders.
Implementnew pathways for effective follow-up of patients with Long Term Conditions.
Implementa process for safety-netting at the practice, so patients are followed upeffectively.
Ensurethat knowledge of clinical IT systems is up to date and ensure the effectiveutilisation of these systems.
Befamiliar with, and maintain up to date knowledge of the GP and PCN EnhancedService requirements, regarding QOF.
Attendregular training and webinars to keep up to date with the contract changes.
Workin a safe and organised manner.
Workwith the other PCN Care Coordinators to share learning and best practice.
Buildand maintain effective relationships with the practice teams and PCN staff.
Organiseand participate in Practice management, reception and PCN Meetings.
Observeand comply with appropriate statutory requirements in relation to Child andAdult Safeguarding and to be familiar with the reporting process could this berequired.
Undertakemandatory training.
Complywith Data Protection and Information Governance regulations and policies.
Confidentiality:
Whileseeking treatment, patients entrust us with, or allow us to gather, sensitiveinformation in relation to their health and other matters. They do so inconfidence and have the right to expect that staff will respect their privacyand act appropriately.
Inthe performance of the duties outlined in this Job Description, the post-holderwill have access to confidential information relating to patients and theircarers, PCN and practice staff and other healthcare workers. They may alsohave access to information relating to the PCN or practices as businessorganisations. All such information from any source is to be regarded asstrictly confidential.
Informationrelating to patients, carers, colleagues, other healthcare workers or thebusiness of the Practice and PCN may only be divulged to authorised persons inaccordance with the Practice and PCN policies and procedures relating toconfidentiality and the protection of personal and sensitive data.
Health & Safety:
Thepost-holder will assist in promoting and maintaining their own and othershealth, safety and security as defined in practice Health & SafetyPolicies, practice Health & Safety Manuals, and practice Infection ControlPolicies and published procedures. This will include:
Usingpersonal security systems within the workplace according to Practice and PCNguidelines.
Identifyingthe risks involved in work activities and undertaking such activities in a waythat manages those risks.
Makingeffective use of training to update knowledge and skills.
Usingappropriate infection control procedures, maintaining work areas in a tidy andsafe way and free from hazards.
Activelyreporting of health and safety hazards and infection hazards immediately whenrecognised.
Keepingown work areas and general / patient areas generally clean, assisting in themaintenance of general standards of cleanliness consistent with the scope ofthe job holders role.
Reporting potential risks identified to keypersonnel.
Equality & Diversity:
Thepost-holder will support the equality, diversity and rights of patients, carersand colleagues, to include:
Actingin a way that recognises the importance of peoples rights, interpreting themin a way that is consistent with Practice and PCN procedures and policies, andcurrent legislation;
Respectingthe privacy, dignity, needs and beliefs of patients, carers and colleagues; and
Behavingin a manner which is welcoming to and of the individual, is non-judgmental andrespects their circumstances, feelings priorities and rights.
Personal/Professional Development:
Thepost-holder will participate in any training programme implemented by thePractice and/or PCN as part of this employment, such training to include:
Participationin an individual performance review, including taking responsibility formaintaining a record of own personal and/or professional development.
Takingresponsibility for own development, learning and performance and demonstratingskills and activities to others who are undertaking similar work.
Workingwith clinicians in stages when working out templates for the Quick Messagesystem and or training.
Quality:
Thepost-holder will strive to maintain quality within the Practice and PCN, andwill:
Alertother team members to issues of quality and risk.
Assessown performance and take accountability for own actions, either directly orunder supervision.
Contributeto the effectiveness of the team by reflecting on own and team activities andmaking suggestions on ways to improve and enhance the teams performance.
Workeffectively with individuals in other agencies to meet patients needs.
Effectivelymanage own time, workload and resources.
Communication:
Thepost-holder should recognise the importance of effective communication withinthe team and will strive to:
Communicateeffectively with other team members;
Communicateeffectively with patients and carers;
Recognisepeoples needs for alternative methods of communication and respond accordingly; and
Contribute to the Implementation of Services.
Thepost-holder will:
Applypractice and PCN policies, standards and guidance.
Discusswith other members of the team how the policies, standards and guidelines willaffect own work.
Participatein audit where appropriate.
Assistthe PCN to deliver on the requirements of the PCN DES Contract, qualityinitiatives, public health initiatives.
Person Specification
Experience
* Understanding of service user confidentiality.
* Experience of administrative duties.
* Experience of working with Quality Outcome Framework (QOF) targets.
* Experience of the GP contract Enhanced Services.
* Knowledge of medical terminology.
* Experience of working in an NHS or social care organisation.
* Understanding of health and social care processes.
* Experience of SNOMED coding.
Knowledge and Skills
* Proven record of excellent written and verbal communication skills as well as interpersonal skills.
* Able to deal with patients sensitively. Able to work as part of a team.
* Able to prioritise and manage own workload. Analytical skills and ability to interpret information and present it in a clear and concise manner.
* Experience of using Ardens templates.
* Experience of Ardens Manager software.
* Experience of using Apex.
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.
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