About this role
Job summary
#TeamCastle are looking for a fun and caring person to join their Care Coordinator team to support patients with complex or additional needs to access health and wellbeing support.
#TeamCastle currently have five Care Coordinators led by the Social Prescriber and Care Coordinator Lead who work alongside the wider Practice and PCN Team of clinicians and allied health professionals.
We are looking for an individual able to work two, or three days - including a Friday.
Main duties of the job
* Utilise population health intelligence to proactively identify and work with a cohort of patients to deliver personalised care;
* Support patients to utilise decision aids in preparation for a shared decision-making conversation;
* Holistically bring together all of a persons identified care and support needs, and explore options to meet these within a single personalised care and support plan (PCSP), in line with PCSP best practice, based on what matters to the person;
* 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, using tools to understand peoples level of knowledge, confidence in skills in managing their own health;
* Work with GPs and other professionals within the PCN to identify and manage a caseload of patients, and where required and as appropriate, refer people back to other health professionals;
* Identify patients who may benefit from shared decision making and support PCN staff and patients to be more prepared to have shared decision-making conversations.
* Coordinate care for patients residing in care homes on a permanent and temporary basis, such as the recovery & reablement beds and PBL Hospice.
* Provide administrative support to the GP Safeguarding Lead.
* Support the recall of patients to manage their health conditions.
About us
#TeamCastle is a fabulous place to work, where there is a strong emphasis on ensuring our team members enjoy coming to work.
Job description Job responsibilities
Main duties of the job
* Utilise population health intelligence to proactively identify and work with a cohort of patients to deliver personalised care;
* Support patients to utilise decision aids in preparation for a shared decision-making conversation;
* Holistically bring together all of a persons identified care and support needs, and explore options to meet these within a single personalised care and support plan (PCSP), in line with PCSP best practice, based on what matters to the person;
* 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, using tools to understand peoples level of knowledge, confidence in skills in managing their own health; e. support people to take up training and employment, and to access appropriate benefits where eligible for example, through referral to social prescribing link workers;
* Work with the GPs and other primary care professionals within the PCN to identify and manage a caseload of patients, and where required and as appropriate, refer people back to other health professionals within the PCN;
* Raise awareness within the PCN of shared decision-making and decision support tools;
* Raise awareness of how to identify patients who may benefit from shared decision making and support PCN staff and patients to be more prepared to have shared decision-making conversations.
Person Specification
Qualifications Desirable
GCSE A*-C or equivalent in English and Maths Any qualification in Health or Social Care or Care Coordination.
Experience Essential
Experience of working as a Team and autonomously as an individual. Experience working within General Practice, ideally with a high level of referral and patient contact skills. Experience of working with multiple agencies.
Desirable
Experience of using SystmOne
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 Castle Partnership
Address Gurney Surgery
40 Fishergate
Norwich
Norfolk
NR3 1SE
United Kingdom
Employer's website https://www.castle-partnership.co.uk/ (Opens in a new tab)