About this role
Job summary
Havering Libety PCN Care Coordinator
Learning Disabilities and Unpaid Carers
Make a Real Difference to People's Lives
Havering Liberty Primary Care Network is seeking a compassionate, organised and proactive Care Coordinator to support people with learning disabilities and unpaid carers across our five member practices.
This is an exciting opportunity to play a key role in reducing health inequalities, improving access to healthcare and helping some of our most vulnerable patients receive the support they need. You will work closely with GP practices, community services, social care, voluntary sector organisations and carers' services to help individuals navigate complex systems and access the right support at the right time.
If you are passionate about improving outcomes, building relationships and delivering person-centred care, we would love to hear from you.
Main duties of the job
The Role
As a PCN Care Coordinator, you will:
Support people with learning disabilities and unpaid carers to access health, social care and community services.
Promote and support uptake of annual health checks and health action plans.
Help ensure reasonable adjustments and accessible communication are in place.
Coordinate follow-up actions and maintain accurate records.
Work closely with GP practices, social prescribers, community teams and voluntary sector partners.
Support identification and recording of people with learning disabilities and unpaid carers.
Contribute to service development, patient engagement and quality improvement initiatives.
Help improve patient experience and reduce health inequalities across the PCN.
About You
We are looking for someone who:
Has experience working in health care, social care, community services, customer services or a care coordination role.
Is highly organised and able to manage competing priorities.
Has excellent communication and interpersonal skills.
Can build trusting relationships with patients, carers and professionals.
Is confident using IT systems and maintaining accurate records.
Demonstrates empathy, patience and a commitment to inclusion.
Understands the importance of confidentiality, safeguarding and professional boundaries.
Is passionate about improving outcomes for people with learning disabilities and unpaid carers.
About us
Havering Liberty Primary Care Network
Havering Liberty Primary Care Network is a collaborative neighbourhood network comprising:
Hornchurch Healthcare
Maylands Healthcare
Avon Road Surgery
Haiderian Medical Centre
Cranham Village Surgery
Working together, we deliver innovative services designed to improve health outcomes, tackle inequalities and provide joined-up care for our local population.
Havering Liberty PCN is led by our Clinical Director and PCN Leadership Team who work together with the GP leads and their practice colleagues. The PCN is supported by its GP Federation, Havering Health Ltd, who are the employing body for the workforce of the network. The GP Federation supports the provision of innovative, high-quality and responsible health care services for Haverings residents.
Job description Job responsibilities
We do not provide visa sponsorship
JOB SUMMARY
Job summary The PCN Care Coordinator will provide proactive, person-centred coordination and practical support for people with learning disabilities and for unpaid carers registered with Havering Liberty PCN practices. The post holder will work across the Primary Care Network to improve identification, access, communication, continuity and follow-up, helping patients and carers navigate health, social care and community services. The role will support practices to deliver high-quality annual health checks and health action plans for people with learning disabilities, promote reasonable adjustments and accessible communication, and strengthen the identification and support of unpaid carers. The post holder will coordinate activity across practices and partner organisations, maintain accurate records, support multidisciplinary working and contribute to service improvement and reduction of health inequalities. The post holder will work within agreed protocols and their level of competence. The role is non-clinical and does not replace clinical assessment, diagnosis or treatment. Key aims of the role Improve the identification and recording of people with learning disabilities and unpaid carers across PCN practices. Increase equitable access to timely, person-centred primary care, including annual health checks, health action plans and relevant preventative care. Help patients and carers understand, access and navigate appropriate health, social care, advocacy and voluntary sector support. Promote reasonable adjustments, accessible information and communication tailored to individual needs. Coordinate follow-up and agreed actions so that patients and carers experience joined-up support. Use data, patient and carer feedback and quality-improvement methods to identify gaps and improve services. Key duties and responsibilities 1. Support for people with learning disabilities Work with practices to identify patients on the learning disability register and support the validation and maintenance of accurate records in EMIS. Coordinate call and recall activity for annual health checks, using accessible and personalised methods of contact and following up non-response in line with agreed protocols. Support appointment booking, including longer appointments, appropriate timing, carer involvement, interpreter or communication support and other reasonable adjustments where required. Contact patients, families, carers or representatives, where appropriately authorised, to explain the purpose of annual health checks and help address practical barriers to attendance. Support practices to prepare for annual health checks by ensuring relevant information, templates and previous actions are available to the clinical team. After clinical review, help coordinate non-clinical actions arising from health action plans, referrals, screening, immunisation, medication reviews or wider wellbeing needs, as directed by an appropriate clinician. Maintain and communicate agreed reasonable-adjustment information so that patients do not have to repeat their needs unnecessarily, while respecting consent and confidentiality. Promote accessible information, including easy-read materials, and check understanding using clear, respectful communication. Escalate clinical, safeguarding, capacity, consent or welfare concerns promptly to the appropriate clinician or safeguarding lead. 2. Support for unpaid carers Work with practices and PCN colleagues to improve the proactive identification and accurate recording of unpaid carers, including young adult carers where appropriate. Support carers to access health checks, vaccinations, wellbeing support, social prescribing, contingency planning and other locally available services, in line with current pathways. Recognise that a person may be both a patient and an unpaid carer and ensure their own health and wellbeing needs are not overlooked. Support appropriate involvement of carers in a patients care while respecting the patients consent, capacity, privacy and right to confidentiality. Identify indicators of carer strain, isolation or breakdown of caring arrangements and escalate concerns through agreed practice and safeguarding processes. Maintain up-to-date information about local carers services and build effective working relationships with relevant organisation. 3. Care coordination and personalised support Act as a consistent, accessible point of contact for allocated patients and carers, within agreed role boundaries. Listen to what matters to the person, identify practical barriers and support agreed personalised care and support planning. Coordinate referrals, appointments and follow-up actions across primary care, community health, mental health, social care, advocacy and voluntary sector services. Support transitions between services and life stages where coordinated primary care input is required. Arrange and support multidisciplinary or multi-agency discussions, prepare information, record agreed actions and track completion. Encourage use of appropriate digital services while providing alternatives for people who are digitally excluded or need additional support. Provide information and signposting in an impartial way and support informed choice. 4. Practice and PCN administration Prepare reports, dashboards and updates for practices and the PCN, ensuring that information is accurate, proportionate and appropriately anonymised or aggregated. Support meetings through agenda preparation, coordination, minute taking and action tracking. Contribute to PCN communications, awareness campaigns and engagement activity relating to learning disabilities and unpaid carers. Support data-quality improvement related to PCN contracts, enhanced services and local priorities. 5. Partnership working and service development Build constructive working relationships with GP practice teams, PCN colleagues, community services, adult social care, carers organisations, advocacy services and voluntary and community sector partners. Help map referral routes and maintain an accurate directory of relevant local services. Seek and use patient and carer feedback to improve accessibility, experience and outcomes. Contribute to audits, quality-improvement activity, service evaluation and the development of new pathways or projects. Identify gaps, duplication, access barriers and health inequalities and raise these with the appropriate PCN lead. Work flexibly across PCN sites and provide reasonable cross-cover for other non-clinical PCN functions where compatible with the role. Collaborative working relationships People with learning disabilities, unpaid carers, families and authorised representatives PCN Clinical Director, Strategy and Transformation Manager, Operations Manager and Digital Facilitator GPs, practice managers, nurses, healthcare assistants and administrative teams Social prescribers, care coordinators, pharmacists and other Additional Roles Reimbursement Scheme colleagues Community learning disability services, mental health services, social care, advocacy and safeguarding teams Local carers organisations, voluntary and community sector services and neighbourhood partners Professional boundaries, consent and safeguarding Work within the limits of competence and seek advice from an appropriate clinician or manager whenever the situation falls outside the role. Follow organisational procedures relating to consent, mental capacity, best-interest decision-making, information sharing and involvement of carers or representatives. Do not make clinical decisions, provide diagnosis or treatment advice, or independently interpret clinical results. Recognise and respond to safeguarding concerns involving adults or children, including concerns about neglect, abuse, coercion, carer stress or breakdown of care arrangements. Use professional curiosity, record concerns clearly and escalate promptly in accordance with local policy. Education, learning and development Complete all organisational mandatory and statutory training required for the role. Complete role-specific learning in learning disability awareness, accessible communication, reasonable adjustments, autism awareness, safeguarding, consent and mental capacity, unpaid carer awareness and personalised care. Participate in induction, supervision, annual appraisal and the development of a personal development plan. Keep knowledge of relevant local services, pathways and good practice up to date and share learning with colleagues. Quality, information governance and confidentiality Contribute to clinical governance, audit, risk management, incident learning and quality-improvement activity within the scope of the role. Maintain complete, accurate and timely records and meet agreed deadlines for reporting and follow-up. Treat all information as confidential and comply with organisational information-governance policies. Process personal data fairly, lawfully and only for authorised purposes, in accordance with the Data Protection Act 2018, UK GDPR and relevant organisational procedures. Share information only where there is a lawful basis, a legitimate need and appropriate authorisation. Health, safety, equality and inclusion Follow health and safety, infection prevention and control, lone-working, incident-reporting and risk-management procedures. Take reasonable care of personal safety and the safety of patients, carers, colleagues and visitors.
Person Specification
Knowledge and Skill Essential
Understanding of person-centred care, confidentiality, consent, safeguarding and professional boundaries. Awareness of health inequalities and common barriers experienced by people with learning disabilities and unpaid carers. Understanding of the importance of reasonable adjustments and accessible communication. Excellent verbal and written communication skills, with the ability to adapt communication to individual needs. Strong organisation, prioritisation, time management and follow-up skills. Ability to build trusting relationships while maintaining professional boundaries. Ability to handle sensitive conversations with empathy, patience and diplomacy. Ability to recognise risk or deterioration and escalate concerns appropriately. Ability to work independently within agreed protocols and contribute effectively to a team. Ability to collect, record and present information accurately. Proactive, flexible and solutions-focused approach.
Desirable
Knowledge of annual health checks and health action plans for people with learning disabilities. Knowledge of local learning disability, carers, social care, advocacy and voluntary sector services. Awareness of mental capacity principles and information-sharing considerations. Experience producing accessible or easy-read information. Quality-improvement, audit or service evaluation skills. Experience engaging people who are less likely to access services.
Experience Essential
At least two years experience in health, social care, education, community services or another support role involving direct contact with people, families or carers, in a paid or voluntary capacity. Experience of working within a multidisciplinary or multi-agency environment. Experience of maintaining accurate records, coordinating activity and following up actions. Experience of supporting people who may be vulnerable or experience barriers to accessing services.
Desirable
Experience in primary care or the NHS. Experience supporting people with learning disabilities and/or unpaid carers. Experience of call and recall, caseload administration or care navigation. Experience using EMIS or another clinical record system.
Other Requirements Essential
Able to travel efficiently between PCN practices and other local venues. Able to work flexibly in response to service needs, within contracted hours.
Desirable
Ability to undertake occasional community or home visits in accordance with policy and risk assessment.
Demonstration of PCN Values Essential
Commitment to patient-centred care, health equity, dignity and respect. Inclusive and non-judgemental approach. Reliable, accountable and able to maintain confidentiality. Commitment to collaborative working and continuous improvement.
Qualifications Essential
Good standard of general education, including English and mathematics at GCSE grade C/4 or equivalent. Competent in Microsoft Outlook, Word and Excel and confident using digital systems. Willingness to complete mandatory and role specific training.
Desirable
Care coordination or personalised care training recognised by the Personalised Care Institute. Training in learning disability awareness, autism, accessible communication, mental capacity or unpaid carer support.
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.
Employer details Employer name Havering Health Ltd
Address Hornchurch Healthcare
Romford
Essex
RM11 1AX
United Kingdom
Employer's website http://haveringhealth.co.uk/ (Opens in a new tab)