PCN Care Coordinator

As a PCN Care Coordinator youwill be a key member of the Care Coordinator team, focusing on supporting PCNmulti-disciplinary teams to coordinate and deliver effective care for avariety of cohorts of patients.

The successful candidate willneed to be organised, self-motivated, flexible, and comfortable with adapting their workload to respond to changing and conflicting priorities. You will be expected to support the 6 memberpractices at any given time and therefore building effective relationships iskey to this role as well as being adaptable to change.

The rolewill be based at Wareham Health Centre, with some remote working considered after successful completion of the probationary period.

Thisrole will be aligned to support all the PCN services such as but not limited to Enhanced Health in Care Homes,Early Cancer Care, Mental Health, Learning disabilities, Digital and INTs. You may be required to travel toour member practices at times, therefore the post holder would need to be a car driver and have access toa car, mileage for this will be reimbursed at the agreed rates.

You will also be provided with a laptop andmobile phone to fulfil the role requirements.

Training is a key aspect of this role, the individual must be enrolled in, undertaking, or qualified from appropriate training set out by the Personalised Care Institute. There is also the prospect to enlist on opportunistic training to improve and develop your level of knowledge to support your job outcomes. Full training to undertake this role will be given during an induction.

Purbeck PCN is made up of 6 member Practices and works closely with the wider locality to improve and enhance patient care. Purbeck PCN is committed to delivering an integrated neighbourhood team approach within the community and works to improve patient access to local services, by working with many sectors including the voluntary sector, mental health services, Help & Care, and Dorset Mind.

CARE COORDINATOR RESPONSIBILITIES AND DUTIES

Utilise population health intelligence to proactively identify and work with a cohort of patients todeliver personalised care.

Support patients to utilise decision aids in preparation for a shared decision-making conversation.

Holistically bring together all a persons identified care and support needs and explore options tomeet these within a single personalised care and support plan (PCSP), in line with PCSP best practice, based on what matters to the person.

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 helpthem make choices about their care, using tools to understand peoples level of knowledge,confidence in skills in managing their own health.

Support people to take up training and employment, and to access appropriate benefits where eligible for example, through referral to social prescribing link workers.

Assist people to access self-management education courses, peer support or interventions that support them to take more control of their health and wellbeing.

Explore and assist people to access personal health budgets where appropriate.

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.

Work with the GPs and other primary care professionals within the PCN to identify and manage acaseload of patients, and where required and as appropriate, refer people back to other health professionals within the PCN.

Raise awareness of how to identify patients who may benefit from shared decision making and support PCN staff and patients to be more prepared to have shared decision-making conversations.

Interrogating clinical and operational systems to implement and maintain an effective service offering.

Devise and maintain efficient digital filing and general office systems for the PCN activities undertaken.

Produce & maintain accurate audits and data reports via Systm One and other digital programmes toprovide live status of…