PCN INT Health and Well Being Coach in Hythe

To ensure the delivery of an effective and competent level of support to the PCN INT team by delivering a patient focused service which promotes proactive care and effective working relationships. The PCN INT Health and Well Being Coach plays a central role in supporting frail and vulnerable patients to remain safe, well and independent at home. The role will be supporting both proactive and reactive patients, identified through risk stratification tool and will include basic observations and a supportive approach to person-centred self-management. The post holder should work within their scope of practice, under agreed protocols, with escalation to registered clinicians as required. The role will act as a bridge between GP Practices, MDT and other INT services.

Main duties of the job

• Detect early signs of patient deterioration through basic observations and holistic approved assessment.
• Increase patient confidence and understanding in their own health.
• Reduce crisis situations, unplanned admissions and carer breakdowns.
• Support safe and effective use of medicine using a non-medical patient centred approach.
• Explore patients' understanding of their medications.
• Support medicine reviews by feeding back to clinicians.
• Complete sarcopenia assessments to identify early risk to prevent falls and muscle wastage.
• Promote and support a proactive approach in patient care, working with INT coordinators to identify patients from risk stratification tool and highlighted frequent attenders at A&E.
• Support patients that are not managing their long term conditions, signposting to relevant services and highlighting concerns to GP practice.
• Support patients highlighted in need of reactive support, working with the rest of INT team to ensure that needs are supported accordingly.
• Liaise with PCN services, GP practices, community teams and voluntary services to support patients.
• Support discussion and provide feedback to MDT meetings.
• Where appropriate highlight ReSPECT form process with patients.
• Bridge the gap between GPs and realities patients face at home encompassing what really matters to them.
• Promote the image of the organisation and services by ensuring that all information and communication is up to date and suitably presented.
• Take responsibility for ensuring that internal and external communication systems are fit for purpose.
• Respond to telephone, email and written queries on behalf of the service area including call handling where appropriate.
• Demonstrate flexibility and adaptability to meet changing priorities within a dynamic operational environment.
• Be proactive and contribute ideas for improvement in the way the service is delivered.
• Support in providing telephone cover during annual leave, sickness or peak demand periods, including answering incoming calls, booking appointments, taking messages and signposting patients appropriately.
• Ensure that all complaints, compliments, concerns, comments and suggestions are escalated appropriately.
• Able to work on own initiative, prioritising work within defined policies and procedures to set timescales.
• Manage specific projects as requested by the PCN Operational manager and provide updates on progress.
• Develop use of community hubs for drop in BP monitoring sessions identifying hypertensive patients.

Person Specification

• Knowledge and Understanding
• Understanding of Primary Care, GP practices or the wider NHS landscape.
• Understanding of how multi-practice or multi-organisation working operates.
• Knowledge of operational processes, administration workflows or service coordination.
• Understanding of confidentiality, information governance and data handling principles.
• Understanding of PCN governance, DES requirements or NHS programme delivery.
• Experience
• Experience of working within a multi-disciplinary team.
• Strong administrative skills with excellent attention to detail.
• Experience of using IT systems such as EMIS Web, Docman or other GP Platforms.
• Experience in using the Microsoft Office suite of applications, including Word, PowerPoint and Outlook.
• Experience of working under pressure and managing varying workloads and changing demands.
• Excellent communication skills with the ability to communicate orally and in written form in a confident, articulate manner.
• Ability to build relationships with others to enable and support collaborative working.
• Experience of implementing or supporting service improvements.
• Qualifications
• GCSE grade A* to C (9-4) in English and Maths or equivalent.
• NVQ Level 3, Advanced level administrative qualification or equivalent.
• Demonstrable commitment to professional and personal development.
• Willingness to work towards further educational qualifications required for the role.

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.