Primary Care Network Nursing Homes Care Coordinator
Central Advertising - General Practitioners
Lewes, UK
2d ago
source : NHS

FOUNDRY HEALTHCARE LEWES is a Primary Care Network of merged NHS GP Practices looking after the residents of Lewes and the surrounding villages.

Due to an organisational restructure an exciting opportunity has arisen to work as a Care Coordinator within our Primary Care Network .

You will need a caring and compassionate nature, excellent organisational skills and to enjoy working with people. The world of General Practice is busy and ever changing so an ability to learn quickly and be adaptable to rapid change is essential.

The role will require an ability to organise and prioritise your own workload, and so you should be comfortable working independently and as a committed member of a multi-disciplinary team.

We welcome applications from both internal and external applicant

This is a full time post but job share will be considered

JOB SUMMARY

The Care Coordinator role is seen as a critical and evolving post to support the delivery of Enhanced Health in Care Homes (EHCH) within the Primary Care Network.

The care coordinator will have a key role in supporting the effective and co-ordinated delivery of care by the Multidisciplinary team that cares for the PCN’s vulnerable and frail care-home residents.

The role will require a focus on ensuring that health and care planning is timely, efficient, and patient-centred.

As part of the role the post-holder will have to work closely with Practice & Care Home teams to help create and get agreement on a long-term plan for the structure and processes to support the Multi-Disciplinary Team (MDT) meetings and the ongoing patient case management.

Applicants should also have :

  • A full UK driving License or suitable access to transport to be able to travel to sites within the PCN area
  • DBS check (will be conducted by PCN upon job offer)
  • PURPOSE

  • Support the functioning of the EHCH Multi-Disciplinary Team by liaising on a day to day basis with the PCN care home lead, the registered care home GP lead, other practice based staff, care home managers and members of the wider MDT to help deliver the MDT approach to delivering the EHCH.
  • To work as a key member of the EHCH and Locality MDT to help create and get agreement on the structure and processes to support effective MDT meetings.
  • Under guidance from the line manager, take initiative in the organisation and administration of MDT meetings including supporting the coordination and delivery of MDTs to minimise the demands upon the multidisciplinary team.
  • Manage agenda items, ensuring all new referrals and cases for discussion are identified and information circulated to team members in advance of the meetings.
  • To ensure that action points identified within the MDT are recorded and followed up
  • MAIN JOB DUTIES

  • Support the functioning of the EHCH Multi-Disciplinary Team by liaising on a day to day basis with the PCN care home lead, the registered care home GP lead, other practice based staff, care home managers and members of the wider MDT to help deliver the MDT approach to delivering the EHCH.
  • To work as a key member of the EHCH and Locality MDT to help create and get agreement on the structure and processes to support effective MDT meetings.
  • Provide enhanced support to Nursing and Residential home with a focus on strengthening relationships and improving access through information sharing, education and advice.
  • Plan the GP Nursing and Residential homes ward rounds
  • To provide administrative assistance to the Clinicians to ensure all people in Nursing and Residential homes have appropriate care plans in place and reviewed regularly.
  • Communicate any care plans to the GP and any other members of the EHCH MDT or Neighbourhood Team involved in the person’s care and upload to the relevant records.
  • Act as a contact to assist with case management of patients at risk of admission, identifying sources of support in liaison with case managers.
  • Provide support to individuals, their families and carers to take control of their health and wellbeing, live independently and improve their health outcomes, as a key member of the PCN multi-disciplinary team.
  • To provide coordination and navigation with the aid of digital tools for people and their carers across health and care services
  • To attend MDT meetings as appropriate.
  • Maintain accurate and up to date records of patient contacts using GP record systems and other IM&T systems relevant to the role i.
  • e. entering notes onto the Clinical System using agreed read codes.

  • To support the Care Home Lead in the delivery of the DES specifications
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