Care Coordinator

Job summary
With the advanced development of Primary Care Health Networks (PCNs) in Tower Hamlets, Bromley By Bow Health Partnership are looking for a highly motivated, innovative person to join our General Practice Team as a Care Coordinator on a part time basis 24 hours a week for 12 months whilst one of our care coordinator goes on sabbatical leave.

The role is pivotal in ensuring all patients receive the best possible care and service. The Care Coordinators role will support the Practice and PCN clinical director in coordinating all key activity including access to services, advice, and information, and ensuring health and care planning is timely, efficient, and patient-centred. The role will include supporting digital initiatives and includes responsibilities for the co-ordination of the patients journey through primary care.

Fuelled through the additional funding available via the national DES, it is currently under-going radical expansion into new areas including direct patient care. Now is a very exciting time to get involved in Primary Care.

Main duties of the job
Overall purpose of the post
To work closely with our PCN practices and the multidisciplinary team to provide a central co-ordination role in patient care planning and delivery, mostly but not exclusively in the context of the Networks Home Health Programme.

About us
We are
Bromley by Bow Health Partnership Comprising of 4 GP practices within East London (BBB Health Centre, XX Place Surgery, St Andrews and St Pauls Way Health Centre)

St Andrews Health Centre is based in Bow in East London and we recently merged with St Pauls Way Medical Centre.

We have a combined list size of 33,000 patients and have over 54,000 patients within our PCN demographic.

Please see a link for our website: Bromley by Bow Health Partnership - We are committed to creating healthy communities.

Job responsibilities
Job Description
Post Title: PCN Care Coordinator
Reporting to: Network Manager and Practice Manager
Accountable to: PCN Board
Working hours: 24 hrs per week (12 months contract: Sabbatical cover)
Pay: £16.23 an hour.

Overall purpose of the post
To work closely with our PCN practices and the multidisciplinary team to provide a central co-ordination role in patient care planning and delivery, mostly but not exclusively in the context of the Networks Home Health Programme.

Key responsibilities of the post

• To co-ordinate care packages for patients and their carers as identified by clinicians across health, social care and mental health services as appropriate.
• To provide a single point of access for staff & service users.
• To support the provision of continuity of care and act as a point of contact for families, residents, and professionals for identified patients in your caseload.
• To actively manage patients care plan delivery and liaise with the PCNs clinicians and Allied Professionals as needed.
• To help people to manage patients needs through answering queries, making and managing appointments, and ensuring that people have good quality information to help them make choices about their care.
• To assist people to access self-management information, interventions that support them in their health and wellbeing and increase their activation.
• To actively support the PCNs activities around immunisation including the delivery of the Covid 19 vaccination programme.
• To work with the Clinical Lead and support the further development of new services including the Home Health Programme
• To help support and coordinate monthly, quarterly, annual dashboard data, KPIs and additional target related performance reports.
• To support the coordination and delivery of MDTs including minute taking.
• Collate, prepare and submit data for returns to monitoring bodies
• Interpret data and communicate data outcomes
• To maintain accurate patients records.
• Assist with in the production of information for auditing purposes

To undertake any other duties commensurate to the role, particularly supporting new ways of working including remote working.

Attend all relevant and required training and comply with Network arrangements for continuing professional development.

Support PCN Locality work steams
To support call and recall i.e. Covid-19 booster vaccine, flu jab.
To support Patient Participation Groups
Supporting patients to use surgery pods and other online services
To support patients with long term health conditions

We aim is to keep quality high, services equitable and bureaucracy low in a partnership of mutual trust, respect and vision.

You will be part of a team dedicated to the delivery of high-quality health care whilst instigating/engaging-in initiatives to tackle the wider determinants of ill-health.

You will be part of a team working together in a collaborative model, to maximise the benefits to our patients and community, while preserving the integrity and working practices of each of our member Practices.

Performance management and appraisal
You are expected to participate in individual performance management process and reviews.

Personal development and training
We actively encourage development and are committed to offering learning and development opportunities for all full-time and part-time employees. To support this you must attend all statutory and mandatory training as required.

Health and safety at work
You have a responsibility to work within Bromley by Bow and Stepney Health CIC Network health and safety policies and procedures to ensure that a safe working environment for patients, visitors and employees is maintained.

Infection control
It is your responsibility to adhere to Bromley by Bow and Stepney Health CIC Network and Practice infection control polices and guidelines in order to promote cleanliness and reduce infections.

Confidentiality and data protection
You are expected to comply with all policies and procedures related to confidentiality and data protection and to work in accordance with relevant data protection legislation.

Risk management
You are expected to be familiar with the Bromley by Bow and Stepney Health CIC Network risk assessment and risk control processes and procedures and to report accidents or incidents promptly.

Conflict of interest
You are required to declare any interest, direct or indirect with contracts involving the Bromley by Bow and Stepney Health CIC Network and should not further your private interests in the course of your work with the Network.

Equality and diversity
We value equality and diversity in employment and in the services we provide. We will work hard to ensure that all job applicants, employees and service users are treated fairly and valued equally regardless of sex, marital status, domestic circumstances, age, race, colour, disablement, ethnic or national origin, social background or employment status, sexual orientation, religion, beliefs, HIV status, gender reassignment, political affiliation or trade union membership. You are responsible for understanding and adhering to Bromley by Bow and Stepney Health CIC Network policies and procedures regarding the promotion of equality for staff and service users.

Code of conduct
You are expected to follow the Bromley by Bow and Stepney Health CIC Network code of conduct for employees and managers.

Safeguarding adults and children
You must make yourself aware of your responsibilities to maintain the wellbeing and protection of vulnerable children and adults. If you have reason for concern that a patient is at risk you should escalate this to an appropriate person, such as your manager, a safeguarding lead or any other appropriate colleague.

Review of this Job Description
This job description seeks to outline the key duties and responsibilities of the post; it is not a definitive document and does not form part of the Statement of Main Terms of Employment (SMT). The job description will be reviewed on an annual basis.

The post holder may, with their agreement, which should not reasonably be withheld, be required to undertake other duties as required, which fall within the grading of this post, to meet the needs of this developing programme of work.

Person Specification PCN Care Coordinator
We will select people who have the following skills, knowledge or experience and we may ask you to tell us about these at interview. When you fill in your application form you should use examples to show us that you have these skills and experience. Examples can be from past jobs or from activities in your life.

Qualifications
Essential

• Higher education level e.g. Level II Diploma in Health and Social Care or equivalent level of training and experience
• Evidence of consistent pattern of learning from education, training and experience

Experience
Essential

• Experience of working with Health IT systems such as EMIS or AccuRx
• Knowledge of the needs of vulnerable adults, safeguarding and the associated legislative framework
• Experience and knowledge of working with communities within Tower Hamlets
• Understanding of human needs: physical, emotional, social
• Experience in Primary Care or social care
• Ability to communicate confidently both with clinical and non-clinical staff
• Good time management and prioritisation skills
• Ability to work on own initiative
• Adaptability and a flexible positive approach
• Willingness to undertake further learning and training
• Experience of developing relationships with a wide variety of people
• Demonstrate commitment to team working
• Good IT skills
• Fitness to do the job within manual-handling policy
• Ability to work with high volumes of patient contacts and a pressurised environment on a daily basis

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.

We value equality and diversity in employment and in the services we provide. We will work hard to ensure that all job applicants, employees and service users are treated fairly and valued equally regardless of sex, marital status, domestic circumstances, age, race, colour, disablement, ethnic or national origin, social background or employment status, sexual orientation, religion, beliefs, HIV status, gender reassignment, political affiliation or trade union membership.