Are you looking for an exciting new challenge where you can makea genuine difference to peoples lives?
How about joining and developing our team of PCN CareCo-ordinators working across Chesterfield and Dronfield, working 30 hours per week.
This is an excitingopportunity to work innovatively across a wide range of work streams working closely with the practicesand the multidisciplinary team (MDT) within the PCN in the delivery ofhigh-quality primary health care.
You will need to be self-motivated and able to work autonomously and have excellent written and verbal communication skills. You will be a strategic thinker with the ability to work collaboratively across several multidisciplinary networks to fulfil the Chesterfield and Dronfield PCN vision.
Ideally, you should have experience in General Practice and you may have already completed the NHS 2 day National requirement personalised accredited care coordination course. You should be able to work flexibly and adapt to the rapidly changing environment that is primary care.
As the service operates between 8.00-6.00 applicants must be available to work between these hours.
Previous applicants do not need to reapply.
Please note we are not an Agenda for Change Organisation.
Interviews will be held face to face on the morning of 4 November at Dunston Innovation Centre, Chesterfield.
Main duties of the job
Chesterfield & DronfieldPCN is developing new and exciting additional roles under the 2020 NHSEimprovement scheme, to support GPs and clinical teams at enhancing patientservices across Chesterfield and Dronfield. We are recruiting to the team of PCNCare Coordinators to work across a variety of work streams (LearningDisabilities, Ageing Well, Pharmacy team), working closely with the practicesand the multidisciplinary team (MDT) within the PCN in the delivery ofhigh-quality primary health care. PCN Care Coordinators will support the PCN inachieving the Direct Enhanced Service specifications.
About us
Arc Primary Care is the umbrella organisation of the Primary Care Network (PCN) in Chesterfield and Dronfield. Arc Primary Care is an alliance of GP Practices.
Our members consist of 10 GP practices which cover a population of over 110,000 patients. We work closely together with other primary and community care staff and healthcareorganisations to provide integrated services to their local populations. Ourservice also provides clinical cover on behalf of RPC East & West for theirhome visits and care homes.
We deliver enhanced services within the PCN designed to support and enhance the services offered by our member GP Practices within Chesterfield. We do this by employing staff to work through the Additional Roles Reimbursement Scheme and finding innovative and sustainable solutions to the changing needs of the Practices; we bid for contracts to help tackle health inequalities and drive up standards of care within the Chesterfield and Dronfield locality.
Our mission: Committed to high quality collaborative person-centred care. Delivered with integrity and transparency, improving health and well-being for all.
Benefits of working with us:
* NHS Pension with employer contributions
* On appointment 27 days plus 8 Bank Holiday annual leave entitlement which rises annually with length of service up to 33 days (pro rata for part time staff)
* Entitlement of up to 5 days professional/study leave per annum, pro rata.
* Access to Well-Being Support
* Blue light Card Discount
Job responsibilities
1.Utilise population healthintelligence to proactively identify and work with a cohort of patients todeliver personalised care.
2.To work with the AWT to identifyand manage a caseload of patients and where appropriate, refer people back toother health professionals within the PCN.
3. Develop excellent working relationships with the key stakeholdersas listed above.
4. Direct liaison with multi agencies to coordinate care forpatients.
5. Fulfil an intermediary role between individuals, receptionists,administrators, clinicians, social workers, therapist and mental health teams.
6. KeepSystmOne/EMIS up to date with relevant records for colleagues involved in careto be able to access.
7. Keep an update todate portfolio of reflections and good case management stories. You will be allocateda Lead Clinician for supervision.
8. Work with colleagues to ensure a point of contact is available tocase-managed or potentially case-managed individuals at all times duringworking hours.
9. Communicate effectively with service users and theirfamilies/carers, other staff both internal and external and members of thepublic.
10. Communicate with other members of the integrated care systemincluding Local Navigation Hub, if individuals need to access other services.
11. Refer and identify complex cases following process with the LeadsGPs.
12. Recogniseopportunities to reduce inequalities and unwarranted variation in health carefor the practice population.
13. Manage and prioritise workload on a daily basis and deal with thecompeting demands of the service.
14. Act as an advocate with patients, families, friends and carers tosupport the assessment and identification of specific needs to maintainindependence in the community. To offer appropriate support andguidance to patients and their families / carers, utilising decision-makingaids in preparation for a shared decision-making conversation.
15. Holisticallybring together all of a persons identified care and support needs and exploreoptions to meet these within a single personalised care and support plan(PCSP), in line with PCSP best practice, based on what matters to the person.
16. Coordinate and manage a designated caseload and work with the cliniciansto recommend the best course of intervention while participating in regularcaseload management supervision to ensure caseload remains fluid, comprising ofactive patients of a manageable size.
17.Where there are safeguarding concerns, theCare Coordinator should follow the safeguarding policy and raises issuesaccordingly.
18. Signpost team members, service users and carers to relevantservice, referring as appropriate.To provide coordination and navigation for people and their carers acrosshealth and care services, working closely with social prescribing link workersand other primary care professionals.
19. Contribute to assessments to identify a specific need, to maintainindependence in the place they call home (own home, residential home etc).
20. Coordinate, attend and manage the administrative functions of MDT and/orCST meetings which will involve identifying external services/people to attend.Take minutes of AHVT meetings and disseminate; chase progress prior andfollowing against actions identified in these meetings.
21. Towork effectively as part of a team to provide cover within the Chesterfield andDronfield PCN when required and to be flexible regarding working hours to meetthe needs of the service.
22. Identifyand build networks and/or pathways that might prevent hospital admission and/or raise awareness for particular cohorts within the community e.g.Learning Disabilities, complex patients.
23. Participatein quality improvements and innovations, e.g. audits, significant eventsanalysis and development of protocols and new services.
24. Recordall patient interactions within the patients medical record and contribute toreport generation, analysis and production.
25. To becustomer focused (patient, carer, GP) when representing the work stream.
26. Helppeople to manage their needs through answering queries, making and managing appointments,and ensuring that people have good quality written or verbal information tohelp them make choices about their care.
27. Tosupport people to take up training and employment, and to access appropriatebenefits where eligible.
28. Providecoordination of and participate in relevant internal and external workinggroups and provide project advice, expertise and support where requested.
29. Supportthe PCN team by inputting to the overall strategy development and programmingof work streams by applying knowledge and understanding of programme andproject management.
30. Engagewith patient participation groups in line with PCN community engagementactivities.
31. Toprovide excellent IT skills, to include Microsoft Office, Outlook and Excel.
32. To undertake generaladministrative duties to support the role and any other reasonable duties asrequested by a manager to ensure quality of service
Person Specification
Skills, Knowledge and Abilities
* Can organise and prioritise workload
* Knowledge of person-centred approaches.
* Understanding of local health and social care structures.
* Ability to work with patients on a 1:1 basis.
* Ability to listen, empathise with people and provide person-centred support in a non-judgemental way.
* Ability to work effectively as a member of a team.
* Ability to work effectively with colleagues, patients and external organisations.
* Ability to assess risk, anticipate difficulties and successfully address them
* Effective communication, both verbally and in writing.
* Willing to work flexibly within the team to cover annual leave or sickness, and to contribute to the extended hours' service if required.
* Ability to travel within the requirements of the role.
* Knowledge of the local voluntary sector and local services.
* Familiar with Safeguarding.
* Working with case loads
Qualifications
* NVQ Level 3, Advanced level or equivalent qualifications or working towards
* Demonstrable commitment to professional and personal development
* Qualified and proven comprehensive knowledge of Microsoft packages including spreadsheets.
* Previous experience of care co-ordination
* Successfully passed the 2 day personalised accreditation care coordination course
Experience
* Experience of working within health, community, social care or voluntary sector.
* Experience of Computer and Software packages. Including excellent use of Word and Excel
* Experience of using SystmOne or any other case management systems.
* Experience of working within primary care.
* Experience of working in a multi-disciplinary team.
* Experience of working with voluntary organisations including volunteers.
* Experience of producing individual care plans.
* Experience of managing a caseload.
* Experience of supporting people in a paid or unpaid capacity
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.
£27,611.09 a yearActual salary £22088.87 (0.8FTE)
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