Team Leader - Thornton Cleveleys, United Kingdom - Torentum Primary Care Network

Description

Job Title :
Team Leader Care Coordination / PCN Project Officer


Accountable to :
Torentum Primary Care Network


Reports to:
Clinical Director / PCN Manager


Salary:
from £23,000 to £28,500 depending on experience


Hours: 37 hours per week (would consider part time)


Primary Care Networks

A Primary Care Network (PCN) enables the provision of proactive, accessible, co-ordinated and integrated primary and community care, improving outcomes for patients.

They are formed around natural communities based on GP registered lists, serving populations of around 30,000 to 50,000.

The Torentum Primary Care Network was formed in June 2020.

It includes 3 GP Practice's, The Cleveleys Group Practice, The Crescent Surgery and The Thornton Practice, serving a population of approximately 33,500 registered patients.

What is a Care Coordinator?

Care Coordinators play an important role within a Primary Care Network to proactively identify and work with people, including the frail and elderly and those with long-term conditions to provide co-ordination and navigation of care and support across health and care services.

The role is non-clinical and is an integral part of the PCN's multi-disciplinary team, working alongside practice staff, Social Prescribing Link Workers, Mental Health Practitioners, the Neighbourhood Care Team, the PCN Medicines Management Team etc.

Care Coordinators work closely with GPs and Practice Teams, acting as a central point of contact to ensure appropriate support is made available to the patient and their carers.

Care Coordinators bring together all the information about a patient's care and support needs; helping patients to access services, managing referrals in to the PCN Wellbeing Hub and associated services.

Job Summary

The Team Leader is a non-clinical role with responsibility for managing and motivating two Care Coordinators and supporting the PCN Manager with projects.

The role requires experience of leading others and someone with strong organisation and communication skills. Training on clinical systems will be provided.


Primary Duties and Areas of Responsibility

Line Management

• Line manage the two Care Coordinators in the team, ensuring that the team's workload is fairly allocated and delivered to a high standard.
• Take ownership of the team's documentation, ensuring operational procedures are up to date for all tasks and procedures written for new activities.
• Manage the business continuity of the team, ensuring cover at all times and the appropriate skills mix is available to ensure all activities can be completed.

Project Support

• Provide project support to the PCN Project Managers and Project Sponsors in delivering PCN Network Contract DES specifications.
• Set up and manage attendance at meetings; minute meetings and take responsibility for following up actions.
• Prepare and present data from emis, or other sources e.g. Fingertips/Aristotle to support decisions being made in projects.

Direct patient facing work

• Work collaboratively with staff across the PCN to proactively identify and support patients; working with those patients, their families and carers, to provide coordination and navigation across health and care services.
• Holistically bring together all of a person's identified care and support needs, and explore options to meet these within a single personalised care and support plan (PCSP), based on what matters to the person. This will be done in liaison with clincial staff and Social Prescriber Link Workers who can advise on community services.
• 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.
• Receive and collate information from transfers of care (including hospital admissions and discharges), out of hours calls, DNARs etc and follow up with the patient to identify their needs.

Care Home Multi-Disciplinary Teams
Support the Care Coordinators with

• The administration of the weekly Care Home MDT meetings; managing the meeting agenda, supporting the Chair, taking minutes, dealing with follow up actions, ensuring that all new referrals are identified, and information circulated to team members in advance of the meeting.
• Act as a point of contact for residents, families, carers and professionals who visit the care home, such as MDT members and inreach specialists. Communicate effectively and sensitively and use language appropriate to a patient and carer/relative's condition and level of understanding.
• Following MDT meetings, ensuring that Personalised Care and Support Plans and EPaCCs are completed for all patients in Care Homes; working with clinical staff to create new plans and update plans as patient needs change.
• Receive and collate information from transfers of care (including hospital admissions and discharges), out