The CVDHealth & Prevention Coordinator will play a key role in deliveringneighbourhood-based cardiovascular disease prevention and management programmesacross the South East Neighbourhood of Hillingdon.
Main duties of the job
This is apredominantly field-based role, working across community settings,outreach venues and GP practices. The post holder will lead and coordinateinitiatives to identify, support and manage patients at risk of, or livingwith, cardiovascular disease, including hypertension, atrial fibrillation,diabetes, coronary heart disease and stroke.
The rolecombines clinical support and care coordination, focusing on casefinding, health promotion, referral facilitation and personalised careplanning, with a strong emphasis on addressing health inequalities throughcommunity engagement.
About us
The Confederation, HillingdonCIC works with General Practice and other healthcare providers to deliver itsvision for Hillingdon to deliver the best primary care outcomes for patientsin the whole of London. We are a not-for-profit community interestcompany. The Confederation works to develop and support individual GPpractices, PCNs and Neighbourhoods and their changing needs. We deliverexcellent clinical services ourselves, both at scale and complementary toGeneral Practice. We are the provider representative voice for localGeneral Practice in the wider NHS and other Partners. We are of the NHSbut independent, innovative and transformational.
The Confederation determinesto develop as an attractive place to work, providing rewarding roles andopportunities to grow in order to attract and retain great staff that in turndelivers our vision.
Our Values
* We work together to make a difference for patients
* We care enough to go the extra mile
* We support, trust, and empower
* We sincerely value each other
* We support primary care to own its destiny
Job responsibilities
Clinical Support
* Undertake targeted case finding andscreening for CVD, including NHS Health Checks, blood pressure, atrialfibrillation and diabetes risk assessment, in line with agreed protocols.
* Conduct or assist with clinical risk assessments (for example blood pressure monitoring, risk scoring) and referappropriately
* Accurately record findings inclinical systems and ensure appropriate communication of results, escalation ofconcerns and onward referral.
* Work with neighbourhood partners toidentify barriers to access, using population health data to improve detection,prevalence and optimisation of care.
* Deliver health promotion advice onlifestyle, smoking cessation, weight management, physical activity and mentalwellbeing, signposting to relevant services as required.
Care Coordination and Addressing Health Inequalities
* Support patients, families andcarers to understand conditions and develop personalised care and supportplans.
* Improve health literacy andengagement, particularly within underserved or disengaged communities.
* Build and maintain relationshipswith community groups and leaders where language, culture or access presentbarriers.
* Attend and support community outreach and engagement events, including evenings and weekends, deliveringscreening and health education.
Administrative and Operational Duties
* Contribute to neighbourhood KPIsand service delivery targets.
* Maintain high-quality, up-to-dateclinical records and support data quality improvements.
* Access and interpret data fromsystems such as EMIS and WSIC for reporting, audit and service evaluation.
* Contribute to the development andimprovement of assessment tools, service pathways, or quality improvementinitiatives aligned with evidence and NICE guidance.
* Support audit, evaluation andreporting requirements to monitor service impact and outcomes.
Person Specification
Qualifications
* Minimum GCSE Grade C or equivalent in English and Maths
* Care coordination training course or be willing to complete one before taking referrals.
Experience
* Experienced Care Coordinator with EMIS experience
* Good IT Skills
* Ability to actively listen, empathise with people and provide personalised support in a non-judgemental way
* Ability to provide a culturally sensitive service supporting people from all backgrounds and communities, respecting lifestyles and diversity
* Commitment to reducing health inequalities and proactively working to reach people from diverse communities
* Ability to support people in a way that inspires trust and confidence, motivating others to reach their potential
* Ability to communicate effectively, both verbally and in writing, with people, their families, carers, partner agencies and stakeholders
* Ability to identify risk and assess/manage risk when working with individuals
* Strong awareness and understanding of when it is appropriate or necessary to refer people back to other health professionals/agencies, when what the person needs is beyond the scope of the care coordinator role, e.g. when there is a mental health need requiring a qualified practitioner
* Ability to maintain effective working relationships and to promote collaborative practice with all colleagues
* Ability to demonstrate personal accountability, emotional resilience and work well under pressure
* Ability to organise, plan and prioritise on own initiative, including when under pressure and meeting deadlines
* Demonstrable commitment to professional and personal development
* Excellent interpersonal, influencing and negotiating skills
* Excellent written and verbal communication skills
* Ability to provide motivational coaching to support people's behaviour change
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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