Care Co-ordinatorNHS

Job summary

We are looking for an enthusiastic, compassionate and motivated Care Coordinator to join our friendly practice team. This is a part-time position for 31.5 hours per week. The work pattern will be:

Monday 8.00 am to 5.00 pm

Tuesday 8.00 am to 4.00 pm

Thursday 8.00 am to 4.00 pm

Friday 8.00 am to 4.30 pm

Our Care Coordinators are an important part of our team and work closely with the Duty Doctor and wider team to support patients with complex health and care needs.

This is not a traditional reception-based Care Coordinator role. You will have a rewarding, varied, patient facing role, supporting the clinical team to provide pro-active and coordinated care to some of our most vulnerable patients.

You will work with with patients with long-term conditions, frailty, cancer diagnoses, dementia and other complex needs, helping to coordinate their care, reduce health inequalities and ensure they receive high-quality support. You will also be required to carry out home visits where appropriate.

You will have undertaken your Care Certificate, or be willing to complete it, enabling you to undertake a range of patient-facing clinical activities such as dementia reviews, blood pressure checks and other clinical reviews.

You will also play a role in supporting the practice to achieve QOF targets, maintain key patient registers and deliver proactive care.

This is an excellent opportunity for someone who enjoys working with people and is organised and proactive.

Main duties of the job

Main responsibilities include:

• Supporting the Duty Doctor with the coordination, follow-up and management of patients requiring additional support.
• Identifying patients who may benefit from proactive care and appropriate intervention.
• Supporting patients with long-term conditions, frailty, dementia, cancer and other complex needs.
• Coordinating care between patients, carers, GPs, community services, hospitals and other healthcare and voluntary sector organisations.
• Supporting patients and carers to navigate health and social care services and addressing barriers to accessing appropriate support.
• Maintaining accurate and up-to-date patient registers and supporting QOF targets, recalls and proactive care activity.
• Identifying patients due reviews or other aspects of care and helping to ensure these are completed.
• Undertaking appropriate patient reviews and clinical observations within your training and assessed level of competence, including dementia reviews and blood pressure checks.
• Supporting personalised care and care planning.
• Liaising with the wider multidisciplinary team to promote effective communication and coordinated care.
• Supporting carers and identifying where additional help, advice or signposting may be appropriate.
• Supporting audits, searches and other practice initiatives to improve patient care and outcomes.
• Contributing to service development and identifying opportunities to improve the way we deliver care.

Job description

Job Responsibilities:

Care coordination and patient support

• Coordinate care for patients with complex health and social care needs.
• Develop positive and supportive relationships with patients and carers.
• Help patients understand and navigate available health, social care and community services.
• Liaise with healthcare professionals and external agencies to ensure effective communication and continuity of care.
• Identify patients requiring additional support and escalate concerns appropriately.

Clinical support

• Undertake clinical and patient-facing activities within the individual's training, competence and agreed scope of practice.
• Undertake blood pressure checks, dementia reviews and other appropriate clinical reviews following appropriate training and assessment.
• Support clinicians with proactive patient care and recall activity.
• Recognise and escalate any concerns identified during patient contact to an appropriate clinician.

QOF and proactive care

• Support the practice in achieving QOF targets and other contractual requirements.
• Maintain and update relevant patient registers.
• Identify patients who are due reviews, investigations or follow-up.
• Assist with searches, recalls and proactive care programmes.
• Support the practice to identify gaps in care and improve patient outcomes.

Team working

• Work closely with the duty doctor and wider clinical team.
• Contribute to multidisciplinary team working.
• Communicate effectively with colleagues across primary, secondary, community and social care.
• Participate in practice meetings and service improvement activity as required.

Administration and record keeping

• Maintain accurate, timely and appropriate patient records.
• Ensure all activity is documented in accordance with practice policies and information governance requirements.
• Manage workload effectively and prioritise according to patient need and clinical urgency.
• Undertake administrative tasks associated with care coordination and proactive patient management.

About us

We are a friendly and forward-thinking GP Practice looking after over 25,000 patients in and around Herne Bay. We are based over two sites and have a large team of staff all working together to provide a high standard of person centred care for our patients.

We are a flexible, friendly and supportive Practice. Ensuring our employees feel valued and happy in the workplace is an important value to us.