Join to apply for the PCN Social Prescribing Link Worker role at The Confederation, Hillingdon CIC
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Join to apply for the PCN Social Prescribing Link Worker role at The Confederation, Hillingdon CIC
About Us
The Confederation, Hillingdon CIC works with General Practice and other healthcare providers to deliver its vision for “Hillingdon to deliver the best primary care outcomes for patients in the whole of London”. We are a not-for-profit community interest company. The Confederation works to develop and support individual GP practices, PCNs and Neighbourhoods and their changing needs. We deliver excellent clinical services ourselves both at scale and complementary to General Practice. We are the provider representative voice for local General Practice into the wider NHS and other Partners. We are ‘of the NHS’ but independent, innovative and transformational.
About Us
The Confederation, Hillingdon CIC works with General Practice and other healthcare providers to deliver its vision for “Hillingdon to deliver the best primary care outcomes for patients in the whole of London”. We are a not-for-profit community interest company. The Confederation works to develop and support individual GP practices, PCNs and Neighbourhoods and their changing needs. We deliver excellent clinical services ourselves both at scale and complementary to General Practice. We are the provider representative voice for local General Practice into the wider NHS and other Partners. We are ‘of the NHS’ but independent, innovative and transformational.
The Confederation determines to develop as an attractive place to work, providing rewarding roles and opportunities to grow in order to attract and retain great staff that in turn delivers our vision.
Our Values
Job Summary:
Social prescribing empowers people to take control of their health and wellbeing through referral to ‘link workers’ who give time, focus on ‘what matters to me’ and take a holistic approach to an individual’s health and wellbeing, connecting people to diverse community groups and statutory services for practical and emotional support. Link workers also support existing groups to be accessible and sustainable and help people to start new community groups, working collaboratively with all local diverse partners.
Social prescribing link workers will work as a key part of the primary care network (PCN) multi-disciplinary team. Social prescribing can help PCNs to strengthen community and personal resilience, reduce health inequalities (in relation to timely access and outcomes) and wellbeing inequalities by addressing the wider determinants of health, such as debt, poor housing and physical inactivity, by increasing people’s active involvement with their local diverse communities. It particularly works for people with long term conditions (including support for mental health), for people who are lonely or isolated, or have complex social needs which affect their wellbeing.
The successful candidate will work for an allocated Primary Care Network (PCN) to deliver a coordinated and high-quality social prescribing Link Worker service supporting clients to access and engage with the extensive range of support in the community.
The successful candidate will manage a caseload of clients through assessment to onward-referral, working with clients in the practice that have been referred by the GP. They will provide ongoing support for an allocated timeframe to promote engagement with identified services and achievement of goals.
Primary Responsibilities
* Working with direct supervision by a GP, take referrals from the PCN’s Core Network Practices and from a wide range of agencies, including pharmacies, wider multi-disciplinary teams, hospital discharge teams, allied health professionals (list not exhaustive).
* Provide personalised support to individuals, their families and carers to take control of their health and wellbeing, live independently and improve their health access and outcomes, as a key member of the PCN multi-disciplinary team. Develop trusting relationships by giving people time and focus on ‘what matters to me’. Take a holistic approach, based on the person’s priorities and the wider determinants of health. Co-produce a simple personalised care and support plan to improve health and wellbeing, introducing or reconnecting people to appropriate community groups and statutory services. The role will require managing and prioritising your own caseload, in accordance with the needs, priorities and any urgent support required by individuals on the caseload. It is vital that you have a strong awareness and understanding of when it is appropriate or necessary to refer people back to other health professionals/agencies, when the person’s needs are beyond the scope of the link worker role – e.g. when there is a mental health needs require a qualified practitioner.
* Work with a diverse range of people and communities, to draw on and increase the strengths and capacities of local communities, enabling local VCSE organisations and community groups (including faith groups) to receive social prescribing referrals.
* Alongside other members of the PCN multi-disciplinary team, work collaboratively with all local diverse partners to contribute towards supporting the local VCSE organisations and community groups to become sustainable and that community assets are nurtured, through sharing intelligence regarding any gaps or problems identified in local provision with commissioners and local authorities.
* Educating non-clinical and clinical staff within their PCN multi-disciplinary teams on what other services are available within the community and how and when patients can access them. This may include verbal or written advice and guidance.
* Promote social prescribing, its role in self-management, addressing health inequalities and the wider determinants of health.
* As part of the PCN multi-disciplinary team, build relationships with staff in GP practices within the local PCN, attending relevant MDT meetings, giving information and feedback on social prescribing.
* Be proactive in developing strong links with all local agencies to encourage referrals, recognising what they need to be confident in the service to make appropriate referrals.
* To work inclusively with the Primary Care Networks member practices, The Confederation, H4All and other members of the multi-disciplinary team.
* 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 access and outcomes and enable a holistic approach to care.
* Provide referral agencies with regular updates about social prescribing, including training for their staff and how to access information to encourage appropriate referrals.
* Seek regular feedback about the quality of service and impact of social prescribing on referral agencies.
* Be proactive in encouraging equality and inclusion, through self-referrals and connecting with all diverse local communities, particularly those communities that statutory agencies may find hard to reach.
* Meet people on a one-to-one basis, making home visits where appropriate within organisations’ policies and procedures. Give people time to tell their stories and focus on ‘what matters to me’. Build trust and respect with the person, providing non-judgemental and non-discriminatory support, respecting diversity and lifestyle choices. Work from a strength-based approach focusing on a person’s assets.
* To undertake holistic client needs assessments in the surgery, using the Patient Activation Measure (PAM) assessment and the ONS4 Wellbeing questionnaire full training on their use will be provided.
* Be a friendly and engaging source of information about health, wellbeing and prevention approaches.
* Help people identify the wider issues that impact on their health and wellbeing, such as debt, poor housing, being unemployed, loneliness and caring responsibilities.
* Work with the person, their families and carers and consider how they can all be supported through social prescribing.
* Help people maintain or regain independence through living skills, adaptations, enablement approaches and simple safeguards.
* Work with individuals to co-produce a simple personalised support plan to address the person’s health and wellbeing needs – based on the person’s priorities, interests, values, cultural and religious/faith needs and motivations – including what they can expect from the groups, activities and services they are being connected to and what the person can do for themselves to improve their health and wellbeing.
* Act as the bridge between health and care workers and local communities in order to make more effective use of social capital. Where appropriate, physically introduce people to culturally appropriate community groups, activities and statutory services, ensuring they are comfortable, feel valued and respected. Follow up to ensure they are happy, able to engage, included and receiving good support.
* Where people may be eligible for a personal health budget, help them to explore this option as a way of providing funded, personalised support to be independent, including helping people to gain skills for meaningful employment, where appropriate.
* Seek advice and support from the GP supervisor and/or identified individual(s) to discuss patient-related concerns (e.g. abuse, domestic violence and support with mental health), referring the patient back to the GP or other suitable health professional if required. Support community groups and VCSE organisations to receive referrals.
* Forge strong links with a wide range of local VCSE organisations, community and neighbourhood level groups, utilising their networks and building on what’s already available to create a menu of diverse community groups and assets, who promote diversity and inclusion.
* Develop supportive relationships with local diverse VCSE organisations, culturally appropriate community groups and statutory services, to make timely, appropriate and supported referrals for the person being introduced. Work collectively with all local partners to ensure community groups are strong and sustainable
* Work with commissioners and local partners to identify unmet diverse needs within the community and gaps in community provision. Map community resources and build and build community capacity to meet identified gaps in provision.
* Encourage people who have been connected to community support through social prescribing to volunteer and give their time freely to others, building their skills and confidence and strengthening community resilience.
* Encourage people, their families and carers to provide peer support and to do things together, such as setting up new community groups or volunteering.
* To ensure that the Link Worker programme is integrated into Hillingdon’s well-established social prescribing programme, delivered by H4All.
* Work sensitively with people, their families and carers to capture key information, enabling tracking of the impact of social prescribing on their health and wellbeing.
* Encourage people, their families and carers to provide feedback and to share their stories about the impact of social prescribing on their lives.
* Support referral agencies to provide appropriate information about the person they are referring. Provide appropriate feedback to referral agencies about the people they referred.
* Work closely within the MDT and with GP practices within the PCN to ensure that the social prescribing referral codes are inputted into clinical systems (as outlined in the Network Contract DES), adhering to data protection legislation and data sharing agreements.
Person Specification
Essential Criteria:
* Educated to NVQ Level 3, Advanced level or equivalent qualifications or equivalent work experience
* Experience of supporting people, their families and carers in a related role within a professional or personal capacity
* Able to recognise when it is necessary to refer patients to other healthcare professionals/organisations when it is outside of the scope/remit of the Social Prescriber.
* Understanding of, and commitment to, equality, diversity and inclusion.
* Knowledge of IT systems, including ability to use word processing skills, emails and the internet to create simple plans and reports
* Knowledge of the personalised care approach
Desirable Criteria
* Specialist knowledge acquired through postgraduate diploma level or equivalent training/experience in qualifications such as Social Care, Psychology, Sociology, Health Management etc.
* Training in motivational coaching and interviewing or equivalent experience
* Experience of working directly in a community development context, adult health and social care, learning support or public health/health improvement within a professional or personal capacity
* Experience of supporting people with their mental health within a professional or personal capacity
* Experience of working with the VCSE sector within a professional or personal capacity, including with volunteers and small community groups
Seniority level
* Seniority level
Entry level
Employment type
* Employment type
Full-time
Job function
* Job function
Other
* Industries
Hospitals and Health Care
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