Care Co-ordinator - Liverpool, United Kingdom - NHS Midlands and Lancashire Commissioning Support Unit

NHS Midlands and Lancashire Commissioning Support Unit

Verified Company

Liverpool, United Kingdom

2 weeks ago

Posted by:

Tom O´Connor

beBee Recruiter

Description

Care coordinators have a crucial role within South Sefton Primary Care Network, proactively identifying and working with people, including the frail/elderly, those in Care Homes and those with long-term conditions, to provide coordination and navigation of care and support across health and care services.

Working closely with GPs, Community Services, Care Homes and Practice Teams to manage a caseload of patients, acting as a central point of contact to ensure appropriate support is made available to patients and their carers; supporting them to understand and manage their condition and ensuring their changing needs are addressed.

We are seeking Care Coordinators to work in the following service areas:
Enhanced Health at Home.

Key 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
Support people to understand their level of knowledge, skills, and confidence, when engaging with their health and wellbeing
Work as part of the multidisciplinary team, building relationships with staff in GP practices within the PCN, care homes & other organisations.

Within South Sefton PCN our aims are to:

Improve resilience in General Practice
Build a stronger and more sustainable general practice service across the Primary Care Network footprint
Facilitate collaborative working between all Primary Care Network practices
Engage with local health and care providers to develop placebased care to assist in the transformation of local services to improve the health and wellbeing of the Primary Care Network population
Work with Patient Participation Groups to improved patient access, experience and quality
Reach out to strengthen and develop working relationships with nonNHS community groups
Develop signposting with Primary Care Network practices to streamline the patient journey to enhance more achievable and sustainable outcomes
Further develop digital technology as a primary resource for practices and patients
Work in collaboration with the local GP Federation to build and strengthen relationships

As Care Coordinator your key responsibilities will include, but not be limited to:
Multidisciplinary Team (MDT)

Arrange the EHAH led Huddles/MDT meetings, manage the meeting agenda items; ensuring that all new referrals are identified,

and information circulated to team members in advance of the meeting. Record actions agreed at the meetings or take minutes and
circulate as required.

Consult with all members of the MDT to ensure its effective function.
Work closely within the PCN roles, Community Services, Community Matron, MDT and with GP practices within the PCN to ensure that

the comprehensive records of MDT case discussions are entered into clinical systems, adhering to data protection legislation and data
sharing agreements.

Work as part of the MDT and wider PCN / Care Community to achieve its ICP (integrated care provider) directed objectives.

Referrals

As part of the PCN MDT, build relationships with staff in each GP Practice within the PCN, attending practice meetings as required providing information and feedback on care coordination priorities.
Consult directly with Community services, Acute Trust Ward Managers, Social Care, Practice staff and other key providers to identify

patients for discussion at MDT, and compile and circulate relevant information to attendees.

Refer patients to local services as required utilising providers referral processes.

Working with patients

Using clinical systems and data analysis to ensure a proactive approach to identifying patients that would benefit from review.
Alerting, referring or liaising with the relevant Service, Community Matron, professionals, family, and other services as required.
Raise awareness of shared decision-making and decision support tools and assist people to be more prepared to have a shared decision making conversation.
Work with patients, Carers, and professionals to deliver personalised care and support planning for patients.
Help people to manage their needs through answering queries, making, and managing appointments and ensure that patients have excellent quality information to help them make choices about their care.
Support people to understand their level of knowledge, skills and confidence when engaging with their health and wellbeing, including

through use of the tools.