Address
Form of work
Salary To work with GPs and other primary care professionals within the PCN to identify and manage a caseload of patients. To support Clinical Directors and other key stakeholders in the successful delivery and implementation of the Directed Enhanced Service (DES). To work closely and in partnership with the Social Prescribing Link Workers and Health and Wellbeing Coaches, supporting patients to utilise decision aids, help create single personalised care and support plans, in line with best practice. To help patients manage their needs through proactively responding to queries, making and managing appointments, other interventions that progress the patients care journey, holistically bringing 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.
Modify and adapt working practices to meet the needs of the patient, where appropriate, providing coordination and navigation through the aid of digital tools for patients and their carers across the health and care services. Work as an effective member of a multi-professional team, giving support to non-registered staff as required, without assuming supervision, education or line management role. Complete documentation (including electronic patient records where used) as per PCN guidelines and Information Governance (IG) requirements, e.g. Data Protection.
Support the production and implementation of new working processes within the practice to optimise the quality of prescribing and patient care. To support the overall effectiveness of exemplary coordination and delivery of the MDTs within the PCN.
