Harlow South PCN are inviting applications from suitable candidates for the following placement, currently until March 31st 2026.
This is a Social Prescribing Health Inequalities Project Delivery role facilitating the ongoing implementation of population health management projects in Harlow South PCN which seek to address health inequalities. This is a partnership project involving multiple local stakeholders including working with HWE ICB, West Essex Place Team.
The successful applicant will engage a personalised care approach to patients meeting the project criteria. The Social Prescribing Health inequalities Projects are While You are Waiting and Right Care Right Place.
While You are Waiting Project: To enable them to optimise their health whilst waiting for treatment in secondary care.
Right Care Right Place Project: To work with this cohort to explore why they may be choosing A&E as their primary source of help for non emergency care, and to optimise their health so that the right care is sought at the right place.
You will work as part of the personalised care team within Harlow South PCN and will facilitate interventions which optimise a patients health and wellbeing with a particular emphasis on addressing the wider determinants of health. This support will be holistic and expand to the wider family support network where needed.
Main duties of the job
* Develop trusting relationships by giving peopletime and focusing on what matters to them
* Evaluate the individual impact of a personswellness progress. Record referrals within SystmOne and complete casemanagement notes for the projects using conversational questionnaire/s, aspathway and evaluation methods
* Support the delivery of the comprehensive model ofpersonalised care
* Draw on and increase the strengths and capacitiesof local communities, enabling local Voluntary Community and Social Enterpriseorganisations and community groups to receive referrals and utilise theirnetworks to build on what is already available to create a menu of communitygroups and assets
* Support pro-active personalised care, for examplethe promotion of health checks and screening.
* Critically analyse referral trends on a regularbasis, along with referrer and patient behaviours, generating development plansto guide future referral activity.
* Produce reports to evaluate effectiveness of theproject that demonstrate whether the interventions have reduced avoidablepatient demand in A&E or hospital admissions, and present forecasts andoutcomes to a wide range of stakeholders.
* Provide high quality project, service, initiativeand administrative support including information and analysis.
About us
Harlow South Primary Care Network is a friendly,supportive, well organised and enthusiastic PCN.
GP practices are grouping together and working closely inwhat are called primary care networks - PCNs - and we are committed to providingtraditional family orientated services, working together in the NHS to deliverbetter patient care on behalf of our 3 GP practices: Lister Medical Centre, TheHamilton Practice, and The Ross Practice. The PCN offices are based in a newpurpose built Health Centre in Harlow.
* The PCN has over 40,000, patients from threepractices. Lister Medical Centre based at Lister House, Staple Tye and The RossPractice & The Hamilton Practice based at Keats House, Bush Fair.
* We are a training hub and support learning &development.
* SystmOne clinical system
* Easy access to M11/M25, close to London andStansted and attractive Essex and Hertfordshire countryside.
Informal visits or contact prior to the interview processare welcome.
Job responsibilities
Overview
Harlow South PCN are inviting applications from suitable candidates for the following placement - currently until March 31st 2026.
PROJECT: Social Prescribing Health inequalities Project
* While You are Waiting Project
* Right Care Right Place Project
EMPLOYED BY: Harlow South PCN
REPORTS TO: PCN Manager/Clinical Director
HOURS: 37.5 hours per week (Full time)
DURATION: Fixed term contract to March 2026
LOCATION: Harlow South PCN, Lister Medical Centre, Harlow
Job Summary:
Support the ongoing implementation of the Social Prescribing Health inequalities Projects, focussing on While You are Waiting and Right Care Right Place projects, working in partnership with Hertfordshire and West Essex ICB, West Essex Place Team. The Social Prescribing Project Leads, will engage and develop a personalised care approach to patients meeting the project criteria.
Cohort 1. While You are Waiting Project: To enable them to optimise their health whilst waiting for treatment in secondary care.
Cohort 2. Right Care Right Place Project: To work with this cohort to explore why they may be choosing A&E as their primary source of help for non emergency care, and to optimise their health so that the right care is sought at the right place.
* Develop trusting relationships by giving people time and focusing on what matters to them
* Evaluate the individual impact of a persons wellness progress. Record referrals within SystmOne and complete case management notes for the projects using conversational questionnaire/s, as pathway and evaluation methods
* Support the delivery of the comprehensive model of personalised care
* Draw on and increase the strengths and capacities of local communities, enabling local Voluntary Community and Social Enterprise organisations and community groups to receive referrals and utilise their networks to build on what is already available to create a menu of community groups and assets
* Support pro-active personalised care, for example the promotion of health checks and screening.
* Critically analyse referral trends on a regular basis, along with referrer and patient behaviours, generating development plans to guide future referral activity.
* Produce reports to evaluate effectiveness of the project that demonstrate whether the interventions have reduced avoidable patient demand in A&E or hospital admissions, and present forecasts and outcomes to a wide range of stakeholders.
* Provide high quality project, service, initiative and administrative support including information and analysis.
Main Duties:
* Provide high quality project support including high quality data analysis.
* Effectively manage a caseload of clients and be able to prioritise workload.
* Manage caseload in partnership with GP Practices within the PCN and support the collaborative approach to delivering healthcare in Primary care.
* May be required to support and train staff as appropriate.
* Analyse data produced by Princess Alexandra Hospital to screen patients viability to be included in the project against project criteria.
* Be a friendly, trusted source- of information about health, wellbeing and prevention approaches, enabling the patient to focus on what matters to them.
* Engage eligible patients by building trust and rapport through the use of a conversational questionnaire and follow a patient pathway which may include referral to a range of community support services.
* Work with the person, their families and carers to provide personalised support to take control of their health and wellbeing to improve their outcomes.
* Consider how patients and where appropriate their carers/families can be supported through social prescribing, using local agencies to maximise the package of support.
* Introduce or reconnect people to community groups and services, both over the phone and in person, and working with a range of community partners
* Help people identify the wider issues that impact on their health and wellbeing such as debt, good housing, being unemployed, loneliness, caring responsibilities etc. and help maintain or regain their independence through living skills, adaptations, enablement approaches and safeguards.
* Using person centred strengths-based approach, co-produce with the patient their personalised care and support plan to address the patients health and wellbeing needs by introducing or reconnecting people to community groups and statutory services both over the telephone.
* Take a holistic approach, based on the persons priorities, and the wider determinants of health.
* Follow up calls to ensure continued support to the patient and where appropriate their families.
* Attend multi-disciplinary meetings and Integrated neighbourhood team meetings giving information and feedback.
* Build relationships and work in partnership with all local agencies to raise awareness of social prescribing and how partnership working can reduce pressure on statutory services, improve health outcomes and enable a holistic approach to care.
* Be proactive in undertaking community development to encourage self-referrals where appropriate and connecting with all local communities, particularly those communities that statutory agencies may find hard to reach.
* Assess, monitor, manage risk and safeguarding issues (supervised by GP) and work collaboratively with local agencies/primary care to maximise the potential of health outcomes for patients, tasking internally at GP practice using agreed methods where the needs of the clients are beyond the scope of the social prescriber.
* Work proactively to develop relationships with external providers to facilitate joint case management of clients accessing multiple services
* Be an active member of the PCN, driving continuous improvement in the Social Prescribing programme at Harlow South, working collaboratively within the PCN workforce.
* Support the Primary Care Network to ensure the requirements of all policies related to clinical and non-clinical governance are fully met.
Disclosure and Barring Service Check
Please note 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 to check for any previous criminal convictions.
Person Specification
Qualifications
* High level of written and oral communication skills; Computer literate, Microsoft, NHS systems or equivalent
* NVQ Level 3 or equivalent qualification in a biological, social or behavioural science; Professional health and social care qualification; Evidence of continuous professional development with regard to wellbeing; Mental Health awareness training; Trained in motivational coaching/interviewing or equivalent; Learning and development delivery skills eg coaching.
Experience
* Experience of supporting people, their families and carers in a related role - including unpaid work; Experience managing own time and can demonstrate ability to hold a caseload. Including scheduling of appointments, meeting deadlines, effective utilisation of IT; Experience coordinating or signposting and integration of care across multiple health, care and social care settings; Experience of delivering multidisciplinary interventions in supporting behaviour changes; Experience of communicating effectively key messages to Stakeholders
* Experience with reaching and working with disadvantaged, vulnerable or excluded groups, particularly one or more of - People with health conditions - People with mental health conditions - Family interventions - People from marginalised groups; Experience of developing a personalised programme of support for individuals from differing backgrounds and communities which demonstrate that the programmes respected their lifestyle and diversity; Experience of delivering asset based approaches
Knowledge
* Have a strong awareness and understanding of when it is appropriate or necessary to refer people back to other health professionals or agencies, both internal and external, when what the person needs is beyond the scope of the social prescriber link worker role. e.g. when their mental health need requires a qualified practitioner.
Communication
* Excellent communication skills; Excellent ability to build and maintain rapport with clients; Ability to build and maintain effective working relationships and to promote collaborative practice with all colleagues
Personal
* Positive disposition which inspires trust and confidence, motivating others to reach their potential; Non-judgemental approach to working with the client group; Commitment to equal opportunities; Commitment to tackling health inequalities in innovative and collaborative ways across the health and social care system; Willingness to undergo DBS check at enhanced level
Problem Solving and Flexibility
* Excellent problem solving skills; Excellent time management skills; Willingness to work flexible hours when required to meet work demands; Able to work independently with minimum supervision
IT Skills
* Good all round IT skills; Knowledge of Microsoft Office suite; Experience of patient or client management systems; understanding of GDPR and confidentiality in a medical setting
* TPP SystmOne experience; knowledge of local systems and services
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 name
Harlow South PCN
Address
Harlow South PCN
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