<div><h3>Job Summary</h3><p>Bury GP Federation is seeking a dedicated Vulnerable Care Home Care Coordinator to assist us with patients across the Horizon PCN network residing in a care home. The role is full‑time (37.5 hrs) and permanent, working Monday to Friday between the core hours of 8am – 6pm.</p><p>You will be responsible for taking calls and using agreed lines of communication to liaise with care homes, GP practices, patients and Care Home team members determining patient needs, developing care plans, coordinating patient‑care services and working with the care team to evaluate interventions.</p><p>The successful applicant will display a compassionate nature, be knowledgeable about health care practices, and provide exceptional patient service.</p><h3>Responsibilities</h3><ul><li>Support GP practices with scheduling and coordinating regular care home ward rounds.</li><li>Liaise with care home staff to identify residents needing reviews, urgent visits, or MDT input.</li><li>Act as a key point of contact between practices and care homes, maintaining clear communication.</li><li>Build relationships with smaller homes supporting adults with learning disabilities, mental health needs, or complex care.</li><li>Ensure these homes are included in PCN support plans and pathways.</li><li>Promote equitable access to primary care services and health reviews.</li><li>Work with the occupational therapist to identify residents who may benefit from assessments or interventions.</li><li>Coordinate actions from MDT meetings, ensuring timely follow‑up.</li><li>Support case‑finding for anticipatory care and within the EHCH framework.</li><li>Collaborate with patients (where appropriate), their families, and carers to enable personalised care and shared decision‑making.</li><li>Facilitate advanced care planning and documentation alongside clinical colleagues.</li><li>Maintain accurate EMIS (or relevant system) records of interventions and outcomes.</li><li>Support data collection for PCN reporting and service evaluation.</li><li>Identify trends, gaps, and improvement opportunities across supported homes.</li><li>Following referral from the GP practice, communicate with the Care Home Team and liaise with the relevant team member to arrange patient interventions.</li><li>Assist in developing and updating Personalised Care and Support Plans to address patients personal health care needs.</li><li>Consult and collaborate with other health care providers and specialists to set up patient appointments and treatment plans.</li><li>Communicate with Care Homes on a regular basis to check on patient progress and evaluate and document as appropriate.</li><li>Assist the care home team with developing and accessing health interventions.</li><li>Support regular meetings of the Care Home Team to discuss operational issues and liaise with clinical lead and PCN Development Manager as required.</li><li>Build effective relationships across the PCN and multidisciplinary team to embed the care coordinator role and the work of the Care Home Team.</li><li>Treat patients and staff with empathy and respect and conduct oneself in a professional manner.</li><li>Be responsible for the organisation, planning and own workload to meet set deadlines.</li><li>Comply with organisational guidelines and health care laws and regulations.</li><li>Set up and run searches in practice clinical systems, analysing and managing the data to ensure the work of the Care Home Team is targeted appropriately.</li><li>Communicate new team changes/updates with care homes and practices.</li><li>Develop and review processes to help ensure the team works as efficiently and effectively as possible.</li><li>Proactively identifying issues and using a solutions‑focused approach to overcome these.</li><li>Liaise with PCN and GP Federation teams to assist with the induction of new starters.</li><li>Using data from appropriate sources, research findings and patterns relating to outcomes and analyse with the support of clinical lead.</li><li>Identify and report significant and adverse events.</li><li>Co‑ordinate patients initial admission to care home/GP surgery ensuring they are registered promptly, appropriately coded, referrals actioned, and completing any necessary further administrative tasks.</li><li>Have an understanding of the PCN DES/IIF and GP QOF requirements.</li><li>Keep up to date with relevant staff changes in practices.</li><li>Understand own role and scope and identify how this may develop over time in communication with the Care Home team, care home staff, GP Partners and Managers.</li><li>Work as an effective and responsible team member, supporting others and working with the Care Home team, care home staff, GP Partner and nursing team exploring mechanisms to develop new ways of working.</li><li>Prioritise own workload and ensure effective time‑management strategies are embedded within the culture of the team.</li><li>Work effectively with others to clearly define values, direction and policies impacting upon care delivery.</li><li>Discuss, highlight and work with the team to create opportunities to improve patient care.</li></ul><h3>Equality and Diversity</h3><p>The post‑holder will support and promote the equality, diversity and rights of patients, carers and colleagues, in a non‑discriminatory culture to include:</p><ul><li>Acting in a way that recognises the importance of peoples rights, interpreting them in a way that is consistent with Practice procedures and policies, and current legislation.</li><li>Respecting the privacy, dignity, needs and beliefs of patients, carers and colleagues.</li><li>Behaving in a manner which is welcoming to and of the individual, is non‑judgmental and respects their circumstances, feelings, priorities and rights.</li></ul><h3>Qualifications</h3><ul><li>Educated to GCSE or equivalent.</li><li>NVQ Level 3 in a health or social care related discipline (or equivalent experience).</li><li>Experience in a health or social care profession.</li></ul><h3>Experience</h3><ul><li>Experience of working in health, social care and other support roles in direct contact with people, families and carers.</li><li>Understanding of the current issues facing the NHS including Primary Care Networks.</li><li>Has attention to detail, able to work accurately, identifying errors quickly and easily.</li><li>Has a planned and organised approach with an ability to prioritise their own workload to meet strict deadlines.</li><li>Excellent communication skills, verbal and written, with the ability to adjust communication style and content to suit the audience.</li><li>An excellent understanding of data protection and confidentiality issues.</li><li>Able to arrange suitable meetings with multiple individuals with often conflicting priorities.</li><li>Self‑motivated and proactive.</li><li>Continued commitment to improve skills and abilities in new areas of work.</li><li>Able to undertake the demands of the post with reasonable adjustment if required.</li><li>Able to access transport to work across the practices within the Primary Care Network, Care Homes and attend meetings in other locations.</li><li>Excellent time keeping and prioritisation skills.</li><li>Professional attributes and appearance.</li><li>Experience in care coordinator role with vulnerable patients.</li></ul><h3>Disclosure and Barring Service Check</h3><p>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.</p></div>