Care Coordinator - Birmingham, United Kingdom - Sherwood House Medical Practice

Sherwood House Medical Practice

Verified Company

Birmingham, United Kingdom

4 weeks ago

Posted by:

Tom O´Connor

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Description

Sherwood House Medical Practice

Specialists in Family Health Care

Job Title:
Care Coordinator

Hours:
As defined in contract

Responsible to:
GP Partners

Accountable to:
GP Partners

Job summary:
This role involves supporting patients through various stages of treatment pathways.

The Care Coordinator will work closely with GPs and other Primary Care professionals within the PCN to identify a caseload of identified patients, ensuring that the appropriate support is made available to them and their families.

Tackling health inequalities with a focus on local priorities is pivotal as well as providing much needed advice and guidance to a diverse population of patients.

Working within an MDT model of support, the Care Coordinator will develop in line with best practice to offer an excellent service for vulnerable patients.

An ethos of promotion of independence and partnership-working is integral to this post.

Main Responsibilities:

The postholder will be expected to:

With the use of Clinical Systems and engagement with PCNs and Practices the care coordinator will actively identify and manage a caseload of patients who are in need of a care package.
Work with a cohort of identified patients to coordinate and navigate necessary personalised care requirements in line with PCSP best practice.
Process relevant requests from hospital discharge letters, i.e. support with palliative care, safeguarding and relevant referrals.
Help patients to manage needs, answering questions, supporting to make appointments, signposting to supporting agencies, i.e. training, employment and benefits.
Ensure that patients have good quality information to help them make informed choices about their care.
Ensure excellent communication channels with the patient and wider care system regarding patient progress.
Liaise with multi agencies to coordinate pathways of patient care.
Ensure close working relationships with other PCN roles such as Social Prescribers, Health Coaches and Dieticians.
Support Quality and Outcome Frameworks and Local and National Targets. To include a focus on PCN DES Specifications, in particular supporting cancer and care home initiatives.

Key Working Relationships

The post holder will be required to maintain constructive relationships with abroad range of internal and external stakeholders including but not limited to the Federation, GP practices, CCG, STP, Community services, Secondary Care, Mental Health and Third Sector providers.
Participate in relevant internal and external training which will be set out by the Personalised Care Institute.
Work closely with the Operations Manager; ensuring the appropriate level of priority is assigned to each task.

Functional Responsibilities

Case Management
Identify and manage a caseload of care packages to support our most vulnerable patients.
Process all requests received from relevant primary and secondary care professionals.
Coordinate the MDT to provide the best access and service for the patient.
Provide timely reports on patient progress and maintain excellent communication with all relevant stakeholders.
Attend all necessary meetings to support patient care requirements.

Information Management

Contribute to effective information management within the team including collation, analysis and reporting of data to support PCN DES targets in a timely fashion.
Participate in relevant internal and external groups to provide relevant information analysis and support.

Planning and Organisation

Produce and review care plans for identified patients.
Capture detailed information from all involved in the patients care to ensure informed decision making is possible.
Develop and maintain tracking tools to ensure care plans are kept on track.
The post holder is required to travel independently between work sites and to attend meetings etc. hosted by other agencies.

Communication

Establish communication with the Operations Manager, PCN Manager and other managers within the organisation and the wider Healthcare community to ensure that services are integrated.
Ensure that good practice is shared within the organisation as appropriate.

Competencies

To maintain appropriate consideration, dignity and respect when dealing with patients or other callers to the surgery
Ability to plan and organise own workload
Key board skills
Extensive demonstrable knowledge of Microsoft Word
Ability to understand and make use of computerised information systems
Ability to produce a variety of business documents using different methods of transcript
Ability to work in a team environment

Personal Attributes