Care Coordinator - Kingston upon Hull, United Kingdom - Holderness Health

Tom O´Connor

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Tom O´Connor

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Description

Accountable to:
Head of Projects & Performance; Care Co-Ordinator Team Leader Reports to: Care Co-

Ordinator Team Leader Role Purpose:

To support the practice in delivering excellent patient care by effectively coordinating different elements of care from multi-disciplinary teams within and outside the practice.

Service Co-ordination Provide coordination and navigation for patients and their carers across health and care services, working closely with Social Prescribing Link Workers, Health and Wellbeing Coaches, and other primary care professionals.

Co-ordinate the work of healthcare professionals and non-clinical staff involved in the care of patients registered at the practice.

Co-ordinate MDT meetings, collating information on patients requiring review and providing secretarial and administrative support, and ensuring the completion of resulting actions.

Act on communications from hospitals, community services, mental health services and other providers. Facilitate inter-agency communication to support the discharge and handover of patients between different health and care settings. Support Lead GPs with the administrative aspects of QOF (Quality Outcomes Framework). Act as a single point of contact for health professionals and patients within your remit.

Active Care Planning Work with GPs and other primary care professionals to identify and manage patients. Work with defined cohorts of patients, focusing on what matters to the person.

Patient Support Help people to manage their health needs through answering queries, making appointments, booking tests and arranging other reviews including long-term condition reviews.

Ensuring that actions from review meetings are progressed on behalf of patients.

Provide patients with good quality written or verbal information to support them in making choices about their care. Proactively support patients to participate in local and national screening programmes. Support patients in readiness for shared decision-making conversations.

Support people to understand their level of knowledge, skills and confidence (their Activation level) when engaging with their health and wellbeing.


Assist people to access self-management education courses, peer support or interventions that support them in their health and wellbeing and increase their activation level.

Identify and address safeguarding concerns. Identify and support carers of patients to ensure that they also look after their own wellbeing. Development Activity Actively promote your role within the practice and PCN.


Raise awareness of shared decision-making and support tools within the practice and how to identify patients who may benefit from this approach.

Contribute to tackling inequalities in health and social care particularly regarding individuals with long-term conditions and complex care needs. Support the development and implementation of projects and initiatives aimed at improving care for patients. Reporting Maintain accurate, effective records of activity and produce reports as required.

Provide agreed performance/activity data. This job description is intended to provide an outline of the key tasks and responsibilities only. There may be other duties required of the post-holder commensurate with the position.

This description will be open to regular review and may be amended to take into account development within the Practice.


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