Care Coordinator

Care Coordinators work closely with GPs and practice teams to manage a small caseload of patients to ensure appropriate support is made available to them and their carers. This is achieved by bringing together all the information about a person's identified care and support needs and exploring options to meet these within a single personalised care and support plan, based on what matters to the person. Their aim is to help people improve their quality of life.

Main duties of the job

• Review patients' needs and help them access the services and support they require to understand and manage their own health and wellbeing, referring to social prescribing link workers, health and wellbeing coaches, and other professionals where appropriate.
• This role is intended to become an integral part of the practice's multidisciplinary team, working alongside social prescribing link workers and health and wellbeing coaches to provide an all-encompassing approach to personalised care and promoting and embedding the personalised care approach across the practice.

About us

Alrewas Surgery is a semi-rural practice serving nearly 8000 patients. We are a staff team of 27 including GPs, nurses, HCA, clinical pharmacists and administrative and management staff.

Job responsibilities

• Work with people, their families, and carers to improve their understanding of the patient's condition and support them to develop and review personalised care and support plans to manage their needs and achieve better healthcare outcomes.
• Help people to manage their needs through answering queries, making, and managing appointments, and ensuring that people have good quality written or verbal information to help them make choices about their care.
• Be a central point of contact for our Care Home and organise appointment, prescription and care requests appropriately, including referrals to the community teams.
• Provide coordination and navigation for people and their carers across health and care services, working closely with social prescribing link workers, health and wellbeing coaches, and other primary care professionals; helping to ensure patients receive a joined-up service and the most appropriate support.
• Work collaboratively with GPs and other primary care professionals within the practice to proactively identify and manage a caseload, and where appropriate, refer back to other health professionals within the practice.
• Support the coordination and delivery of multidisciplinary teams with the practice, including arranging MDT and GSF meetings where appropriate.
• Raise awareness of how to identify patients who may benefit from shared decision making and support practice staff and patients to be more prepared to have shared decision making conversations.
• Explore and assist people to access a personal health budget where appropriate.
• Identify unpaid carers and help them access services to support them.
• Conduct follow-ups on communications from out of hospital and in-patient services.
• Maintain records of referrals and interventions to enable monitoring and evaluation of the Service.
• Support practices to keep care records up to date by identifying and updating missing or out-of-date information about the person's circumstances.

Person Specification

Experience

• Experience of working in health, social care and other support roles in direct contact with people, families or carers (in a paid or voluntary capacity).
• Experience of supporting people, their families and carers in a related role.
• Experience of data collection and using tools to measure the impact of services.
• Experience of working with elderly or vulnerable people, complying with best practice and relevant legislation.
• Experience of working directly in a care coordinator role, adult health and social care, learning support or public health / health improvement.

Qualifications

• Educated to high-school equivalent.
• Demonstrable commitment to professional and personal development.
• Ability to use Microsoft Office applications Word, Excel, PowerPoint, Outlook.
• NVQ Level 3 in adult care - advanced level or equivalent qualifications or working towards.

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.